Comparison of Influenza Epidemiological and Virological Characteristics between Outpatients and Inpatients in Zhejiang Province, China, March 2011–June 2015

Cheng, Wei; Zhao, Yu; Liu, Shelan; Zhang, Xueying; Wang, Xiaoxiao; Cai, Jian; Li, Feng

doi:10.3390/ijerph14020217

Cited by 12 publications

(10 citation statements)

References 30 publications

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“…In total, influenza B virus accounted for the maximum number of laboratory-confirmed influenza cases, followed by pandemic A/H1N1 and seasonal A/H3N2. These results corresponded with the facts that a co-epidemic pattern of these three strains of influenza virus has formed in China since 2009, with seasonal A/H3N2 predominantly circulating in the south of China while influenza B virus and pandemic A/ H1N1 are more frequent in northern China [4,18,19,[33][34][35]. It is noteworthy that the number of influenza-positive cases was much lower in 2011 and 2012 than other years.…”

supporting

confidence: 82%

Epidemiological features and time-series analysis of influenza incidence in urban and rural areas of Shenyang, China, 2010–2018

et al. 2020

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In recent years, there have been a significant influenza activity and emerging influenza strains in China, resulting in an increasing number of influenza virus infections and leading to public health concerns. The aims of this study were to identify the epidemiological and aetiological characteristics of influenza and establish seasonal autoregressive integrated moving average (SARIMA) models for forecasting the percentage of visits for influenza-like illness (ILI%) in urban and rural areas of Shenyang. Influenza surveillance data were obtained for ILI cases and influenza virus positivity from 18 sentinel hospitals. The SARIMA models were constructed to predict ILI% for January–December 2019. During 2010–2018, the influenza activity was higher in urban than in rural areas. The age distribution of ILI cases showed the highest rate in young children aged 0–4 years. Seasonal A/H3N2, influenza B virus and pandemic A/H1N1 continuously co-circulated in winter and spring seasons. In addition, the SARIMA (0, 1, 0) (0, 1, 2)12 model for the urban area and the SARIMA (1, 1, 1) (1, 1, 0)12 model for the rural area were appropriate for predicting influenza incidence. Our findings suggested that there were regional and seasonal distinctions of ILI activity in Shenyang. A co-epidemic pattern of influenza strains was evident in terms of seasonal influenza activity. Young children were more susceptible to influenza virus infection than adults. These results provide a reference for future influenza prevention and control strategies in the study area.

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supporting

confidence: 82%

Epidemiological features and time-series analysis of influenza incidence in urban and rural areas of Shenyang, China, 2010–2018

et al. 2020

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“…Similar estimates for the percentage of ILI due to influenza (found to be 18% here) have been reported both in the literature 20 and from clinical laboratories reporting to the CDC. 5 More interestingly, if medically attended ILI is used to estimate respiratory viral infection within the broader population, we find that 95% of infections (and 79% of flu cases) would be unobserved.…”

Section: Discussionsupporting

confidence: 88%

Active surveillance documents rates of clinical care seeking due to respiratory illness

Galanti

Comito

Ligon

et al. 2020

Influenza Resp Viruses

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Background: Respiratory viral infections are a leading cause of disease worldwide.However, the overall community prevalence of infections has not been properly assessed, as standard surveillance is typically acquired passively among individuals seeking clinical care. Methods:We conducted a prospective cohort study in which participants provided daily diaries and weekly nasopharyngeal specimens that were tested for respiratory viruses. These data were used to analyze healthcare seeking behavior, compared with cross-sectional ED data and NYC surveillance reports, and used to evaluate biases of medically attended ILI as signal for population respiratory disease and infection. Results:The likelihood of seeking medical attention was virus-dependent: higher for influenza and metapneumovirus (19%-20%), lower for coronavirus and RSV (4%), and 71% of individuals with self-reported ILI did not seek care and half of medically attended symptomatic manifestations did not meet the criteria for ILI. Only 5% of cohort respiratory virus infections and 21% of influenza infections were medically attended and classifiable as ILI. We estimated 1 ILI event per person/year but multiple respiratory infections per year. Conclusion:Standard, healthcare-based respiratory surveillance has multiple limitations. Specifically, ILI is an incomplete metric for quantifying respiratory disease, viral respiratory infection, and influenza infection. The prevalence of respiratory viruses, as reported by standard, healthcare-based surveillance, is skewed toward viruses producing more severe symptoms. Active, longitudinal studies are a helpful supplement to standard surveillance, can improve understanding of the overall circulation and burden of respiratory viruses, and can aid development of more robust measures for controlling the spread of these pathogens.

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“…Influenza was detected in 9% of SARI cases, which is consistent with the 4−12% rates reported by other studies conducted in India and elsewhere in Asia [28][29][30]. Since 2015, the Ministry of Family and Health Welfare in India has recommended influenza vaccination for individuals with diabetes [31].…”

Section: Discussionsupporting

confidence: 81%

Epidemiology and costs of severe acute respiratory infection and influenza hospitalizations in adults with diabetes in India

Koul

Bhavsar

Mir

et al. 2019

J Infect Dev Ctries

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Introduction: The incidence of diabetes mellitus is increasing rapidly in India. In addition to well-known complications, diabetes increases the risk for hospitalization and death from severe acute respiratory infection (SARI) and influenza. Here we examined the impact of SARI and influenza in Indian adults with diabetes. Methodology: This was a single-center, active surveillance study conducted in Jammu and Kashmir State, India, during the 2015–2016 and 2016–2017 influenza seasons. Adults hospitalized for SARI and receiving at least one diabetes medication were included. Demographics, health care use, and direct costs were collected from medical records and interviews of patients or caregivers. Indirect costs were estimated based on lost earnings and WHO-CHOICE estimates for hospital costs. Results: The study included 192 patients with type 2 diabetes. Median age was 66 years, median body mass index was 26.6 kg/m2, and most patients had comorbidities, especially hypertension and cardiovascular disease (83.9%). Only 32.2% regularly monitored blood glucose or hemoglobin A1C, and median values at admission indicated poor glycemic control for most. Influenza was detected in 8.9% of cases. The median hospital stay for SARI was 8 days, and 22 patients (11.4%) died. Median total costs associated with hospitalization were US$710 (interquartile range, $539–$1067) for SARI patients and US$716 ($556–$1078) for influenza patients, mostly (~75%) from indirect costs. Conclusions: Adults with diabetes in India hospitalized with SARI or influenza are generally older, in poor health, and suffer from poor glycemic control. The costs for their hospitalization and care are substantial.

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Comparison of Influenza Epidemiological and Virological Characteristics between Outpatients and Inpatients in Zhejiang Province, China, March 2011–June 2015

Cited by 12 publications

References 30 publications

Epidemiological features and time-series analysis of influenza incidence in urban and rural areas of Shenyang, China, 2010–2018

Epidemiological features and time-series analysis of influenza incidence in urban and rural areas of Shenyang, China, 2010–2018

Active surveillance documents rates of clinical care seeking due to respiratory illness

Epidemiology and costs of severe acute respiratory infection and influenza hospitalizations in adults with diabetes in India

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