Circulation of influenza A viruses among patients hospitalized for severe acute respiratory infection in a tertiary care hospital in Romania in the 2018/19 season

Abstract

The seasonal circulation of influenza viruses and the impact that this infection has on the population varies from year to year. We have prospectively captured hospital-based surveillance data describing the circulation of influenza viruses and characterizing patients with influenza admitted to a tertiary hospital in Bucharest, Romania in the 2018/19 season. We have conducted an observational descriptive epidemiological study analyzing all consecutive patients hospitalized for influenza like illness or severe acute respiratory infection at the National Institute for Infectious Diseases “Prof. Dr. Matei Balş”, Bucharest, Romania, from November 2018 to April 2019. For all patients we actively collected standardized clinical information and performed real-time reverse transcription polymerase chain reaction testing of respiratory samples to identify the presence of influenza viruses and to determine the subtype/lineage. A total of 1128 hospitalized patients were tested in this study, with an influenza positivity rate of 41.2% (n = 465). We identified an exclusive circulation of influenza A viruses (A/H1 – 57.2%, A/H3 – 29.3%, A not subtyped – 13.3%), with only 1 case of influenza B detected at the end of the season (week 18/2019). Children under 5 years of age accounted for the majority of cases (40%, n = 186), and all cases had a favorable evolution. Females were more likely to test positive for influenza (53.3%) compared to males (46.7%), P = .048, and presence of asthma or chronic obstructive pulmonary disease increased the risk of influenza 4.4-fold and 2-fold, respectively ( P < .001 and P = .034). Thirteen influenza patients required hospitalization in intensive care and 5 deaths were recorded (1.1%). The vaccination rate for all patients included in the study was low (4.6%). The existence of chronic conditions or age over 65 years prolonged the hospitalization period with 2 days ( P < .001 each). In the 2018/19 season, we identified an important circulation of influenza A viruses among patients hospitalized for influenza like illness/severe acute respiratory infection in a tertiary care hospital in Romania, with a higher likelihood of affecting females and patients with pre-existing lung conditions. Monitoring of the clinical and epidemiological characteristics of influenza virus infection is of great interest and should be done carefully each season to better inform on the necessary measures to limit the impact that this infection may have on risk groups.

Hospitalizations for Acute Otitis and Sinusitis in Patients Living with HIV: A Retrospective Analysis of a Tertiary Center in Romania

“…Influenza vaccination is notoriously safe and is associated with acceptable levels of immunogenicity among patients with HIV infection [ 19 , 20 ]. However, in Romania, vaccination rates among this patient population remain generally low, and influenza-related hospitalizations and deaths among patients with HIV infection are reported annually [ 21 , 22 ]. Similarly, SARS-CoV-2 vaccination [ 23 ] and pneumococcal vaccination [ 24 ] have been shown to be safe and to display acceptable efficacy among patients with HIV infection.…”

Pharmacy-Based Influenza Vaccination: A Study of Patient Acceptance in Romania

“…Globally, primary care physicians play a pivotal role in providing free flu vaccinations to individuals in high-risk groups, a practice also observed in Romania. 5 Recognizing the convenience and widespread accessibility of pharmacists, an evolving strategy aims to strengthen vaccination efforts by integrating them as administrators. This shift has demonstrated efficacy in augmenting coverage rates, supported by empirical evidence showcasing pharmacists’ contributions to safeguarding those susceptible to the flu.…”

Severe acute respiratory syndrome by influenza and factors associated with death in older adults: a population study

“…A study by Shi et al [29] showed peaks of Influenza A -H3N2 for four years in a row in northern China; however, at the peak of the flu in 2015-2016, this subtype circulated together with influenza A-H1N1, already in southern China, and the predominant virus was the A-H3N2 subtype. On the other hand, in the studies by Araújo et al carried out in the state of Goiás [28], and in a study by Drăgănescu et al carried out in Romania [30], the predominant etiology was the A-H1N1 virus. In mainland China, the influenza B virus (mainly the B-Victoria subtype) was identified as circulating in all years between 2005-2016, but with lower activity than influenza A [31].…”