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40% of Severe Influenza Cases in European Region was detected among unvaccinated people; only 11% received both seasonal or pandemic vaccines.
Source: European Centre for Disease Prevention and Control (ECDC), full PDF report: http://www.ecdc.europa.eu/en/publica...e_Overview.pdf
According the latest ECDC weekly influenza report, around 40% of severe acute respiratory infections detected in the European Region during the first week of 2011 - were in unvaccinated patients.
Of 196 severe flu-like ilnness cases described in the report for week 1/2011, eleven (6%) received trivalent seasonal influenza vaccine for 2010-11 season; three (2%) received the 2009 monovalent pandemic H1N1 (2009) influenza virus vaccine and six (3.1%) received both the monovalent and the trivalent seasonal vaccine. Overall, 79 patients (40%) didn't receive any vaccine, whereas 20 did. Of the remaining 97 cases (49.9%) vaccination status was unknown.
Among the most common complications detected in severe influenza patients, severe acute respiratory distress syndrome (ARDS) was reported for 219 cases, and seconday bacterial pneumonia was reported in 267 cases.
An extract of the ECDC report about severe acute respiratory infection is available below. (IOH)
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Hospital surveillance – severe acute - respiratory infection (SARI) - Weekly analysis – SARI
Since week 40/2010, 1148 SARI cases, including 37 fatal cases, have been reported by seven countries (Table 4). Only three countries—Belgium, Romania and Slovakia—are collecting syndromic SARI cases. The remaining countries are reporting laboratory- confirmed hospitalised influenza cases or severe influenza cases admitted to intensive care, as in France.
During week 1/2011, 196 SARI cases were reported. Males and females were equally affected (Table 5). The number of SARI cases by week of onset appears to be increasing still (Figure 6). However, these increases may simply reflect a new system and new countries, few of which have a baseline for these data.
Of the 317 cases that tested positive for influenza in week 1/2011, 311 (98.1%) were infected by type A and 6 (1.9%) by type B viruses (Table 6). Of the 284 type A viruses subtyped, 283 (99.6%) were A(H1) 2009 and one was A(H3). Since week 40/2010, 495 (97.8%) of 506 influenza viruses detected were type A, and 454 (99.1%) of 458 type A viruses subtyped were A(H1) 2009.
Of the 1148 reported cases since week 40/2010, 402 (35.0%) were admitted to intensive care with 187 (16.3%) requiring ventilatory support (Table 8).
Table 4: Cumulative number of SARI cases, weeks 40/2010–1/2011
[Country - No. of SARI cases - Incidence of SARI cases per 100,000 population - Number of fatal cases reported - Incidence of fatal cases per 100,000 population - Estimated population covered]
* Austria - 9 - ... - 1 - ... - ...
* Belgium - 496 - ... - ... - ... - ...
* Spain - 345 - ... - 16 - ... - ...
* France - 171 - ... - 11 - ... - ...
* Portugal - 39 - ... - 4 - ... - ...
* Romania - 84 - 1.31 - 5 - 0.08 - 6.413.821
* Slovakia - 4 - ... - ... - ... - ...
* Total - 1148 - ... - 37 - ... - ...
(...)
Table 5: Number of SARI cases by age and gender, week 1/2011
[Age groups - Male - Female - Unknown]
* Under 2 - 18 - 14 - ...
* 2-17 - 9 - 3 - ...
* 18-44 - 27 - 28 - ...
* 45-59 - 27 - 19 - 2
* >=60 - 19 - 27 - 1
* Unknown - ... - 1 - 1
* Total - 100 - 92 - 4
Table 6: Number of SARI cases by influenza type and subtype, week 1/2011
[Virus type/subtype - Number of cases during current week - Cumulative number of cases since the start of the season]
* Influenza A - 311 - 495
o A(H1) 2009 - 283 - 454
o A(H1) - ... - ...
o A(H3) - 1 - 4
o A(subtyping not performed) - 27 - 37
* Influenza B - 6 - 11
* Unknown - 150 - 613
* Total - 467 - 1119
Table 7: Number of SARI cases by antiviral treatment, weeks 40/2010–1/2011
[Antiviral treatment - Number of patients who received prophylaxis - Number of patients who received anti-viral treatment]
* Oseltamivir - 1 - 328
* Zanamivir - ... - 7
* Other (or combinations with other) - 2 - 3
* Unknown - 1013 - 739
* None - 132 - 71
* Total - 1148 - 1148
Table 8: Number of SARI cases by level of care and respiratory support, weeks 40/2010–1/2011
[Respiratory support - ICU - Inpatient ward - Other - Unknown]
* No respiratory support available - ... - 1 - ... - ...
* No respiratory support necessary - 44 - 35 - 245 - ...
* Oxygen therapy - 40 - 40 - 195 - ...
* Respiratory support given unknown - 131 - 4 - 135 - 83
* Ventilator - 187 - 2 - 5 - 1
* Total - 402 - 82 - 580 - 84
Table 9: Number of SARI cases by vaccination status, week 1/2011
[Vaccination Status - Number Of Cases - Percentage of cases]
* Both, monovalent 2009 pandemic H1N1 and seasonal 2010 vaccination - 6 - 3.1
* Monovalent 2009 pandemic H1N1 vaccination - 3 - 2
* Not vaccinated - 79 - 40.3
* Seasonal 2010 vaccination - 11 - 6
* Unknown - 97 - 49.5
* TOTAL - 196 - ...
(...)
Table 10: Number of underlying conditions in SARI cases by age group, weeks 40/2010–1/2011
[Underlying condition/risk factor - 0-11 months - 1-4 y - 5-14 y - 15-24 y - 25-64 y - >=65 y]
* Asthma - ... - 1 - 1 - 1 - 1 - ...
* Cancer - ... - 1 - ... - ... - 2 - 2
* Diabetes - ... - ... - ... - ... - 36 - 15
* Chronic heart disease - 4 - ... - ... - ... - 25 - 15
* Chronic lung disease - 2 - 1 - ... - 1 - 14 - 6
* Pregnancy - ... - ... - ... - 6 - 22 - ...
* Underlying condition unknown - 15 - 23 - 8 - 14 - 157 - 26
* Other (including all other conditions) - 201 - 144 - 50 - 11 - 243 - 96
Note: The data is collected for asthma, cancer, diabetes, chronic heart disease, HIV/other immune deficiency, kidney-related conditions, liver-related conditions, chronic lung disease, neurocognitive disorder (including seizure), neuromuscular disorder, obesity (BMI between 30 and 40), morbid obesity (BMI above 40), pregnancy, other, underlying condition unknown and for no underlying condition.
Table 11: Additional clinical complications in SARI cases by age group, weeks 40/2010–1/2011
[Additional clinical complications - 0-11 months - 1-4 y - 5-14 y - 15-24 y - 25-64 y - >=65 y]
* Acute respiratory distress syndrome - 24 - 23 - 7 - 13 - 129 - 23
* Bronchiolitis - 1 - ... - ... - ... - 1 - ...
* Pneumonia (secondary bacterial infection) - 11 - 15 - 5 - 11 - 190 - 35
* Sepsis/Multi-organ failure - ... - ... - ... - ... - ... - 1
* None - 3 - 4 - ... - 3 - 16 - 9
* Other - ... - ... - ... - ... - 3 - ...
* Unknown - 183 - 128 - 47 - 6 - 161 - 92
(...)
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According the latest ECDC weekly influenza report, around 40% of severe acute respiratory infections detected in the European Region during the first week of 2011 - were in unvaccinated patients.
Of 196 severe flu-like ilnness cases described in the report for week 1/2011, eleven (6%) received trivalent seasonal influenza vaccine for 2010-11 season; three (2%) received the 2009 monovalent pandemic H1N1 (2009) influenza virus vaccine and six (3.1%) received both the monovalent and the trivalent seasonal vaccine. Overall, 79 patients (40%) didn't receive any vaccine, whereas 20 did. Of the remaining 97 cases (49.9%) vaccination status was unknown.
Among the most common complications detected in severe influenza patients, severe acute respiratory distress syndrome (ARDS) was reported for 219 cases, and seconday bacterial pneumonia was reported in 267 cases.
An extract of the ECDC report about severe acute respiratory infection is available below. (IOH)
-
----
(...)
Hospital surveillance – severe acute - respiratory infection (SARI) - Weekly analysis – SARI
Since week 40/2010, 1148 SARI cases, including 37 fatal cases, have been reported by seven countries (Table 4). Only three countries—Belgium, Romania and Slovakia—are collecting syndromic SARI cases. The remaining countries are reporting laboratory- confirmed hospitalised influenza cases or severe influenza cases admitted to intensive care, as in France.
During week 1/2011, 196 SARI cases were reported. Males and females were equally affected (Table 5). The number of SARI cases by week of onset appears to be increasing still (Figure 6). However, these increases may simply reflect a new system and new countries, few of which have a baseline for these data.
Of the 317 cases that tested positive for influenza in week 1/2011, 311 (98.1%) were infected by type A and 6 (1.9%) by type B viruses (Table 6). Of the 284 type A viruses subtyped, 283 (99.6%) were A(H1) 2009 and one was A(H3). Since week 40/2010, 495 (97.8%) of 506 influenza viruses detected were type A, and 454 (99.1%) of 458 type A viruses subtyped were A(H1) 2009.
Of the 1148 reported cases since week 40/2010, 402 (35.0%) were admitted to intensive care with 187 (16.3%) requiring ventilatory support (Table 8).
Table 4: Cumulative number of SARI cases, weeks 40/2010–1/2011
[Country - No. of SARI cases - Incidence of SARI cases per 100,000 population - Number of fatal cases reported - Incidence of fatal cases per 100,000 population - Estimated population covered]
* Austria - 9 - ... - 1 - ... - ...
* Belgium - 496 - ... - ... - ... - ...
* Spain - 345 - ... - 16 - ... - ...
* France - 171 - ... - 11 - ... - ...
* Portugal - 39 - ... - 4 - ... - ...
* Romania - 84 - 1.31 - 5 - 0.08 - 6.413.821
* Slovakia - 4 - ... - ... - ... - ...
* Total - 1148 - ... - 37 - ... - ...
(...)
Table 5: Number of SARI cases by age and gender, week 1/2011
[Age groups - Male - Female - Unknown]
* Under 2 - 18 - 14 - ...
* 2-17 - 9 - 3 - ...
* 18-44 - 27 - 28 - ...
* 45-59 - 27 - 19 - 2
* >=60 - 19 - 27 - 1
* Unknown - ... - 1 - 1
* Total - 100 - 92 - 4
Table 6: Number of SARI cases by influenza type and subtype, week 1/2011
[Virus type/subtype - Number of cases during current week - Cumulative number of cases since the start of the season]
* Influenza A - 311 - 495
o A(H1) 2009 - 283 - 454
o A(H1) - ... - ...
o A(H3) - 1 - 4
o A(subtyping not performed) - 27 - 37
* Influenza B - 6 - 11
* Unknown - 150 - 613
* Total - 467 - 1119
Table 7: Number of SARI cases by antiviral treatment, weeks 40/2010–1/2011
[Antiviral treatment - Number of patients who received prophylaxis - Number of patients who received anti-viral treatment]
* Oseltamivir - 1 - 328
* Zanamivir - ... - 7
* Other (or combinations with other) - 2 - 3
* Unknown - 1013 - 739
* None - 132 - 71
* Total - 1148 - 1148
Table 8: Number of SARI cases by level of care and respiratory support, weeks 40/2010–1/2011
[Respiratory support - ICU - Inpatient ward - Other - Unknown]
* No respiratory support available - ... - 1 - ... - ...
* No respiratory support necessary - 44 - 35 - 245 - ...
* Oxygen therapy - 40 - 40 - 195 - ...
* Respiratory support given unknown - 131 - 4 - 135 - 83
* Ventilator - 187 - 2 - 5 - 1
* Total - 402 - 82 - 580 - 84
Table 9: Number of SARI cases by vaccination status, week 1/2011
[Vaccination Status - Number Of Cases - Percentage of cases]
* Both, monovalent 2009 pandemic H1N1 and seasonal 2010 vaccination - 6 - 3.1
* Monovalent 2009 pandemic H1N1 vaccination - 3 - 2
* Not vaccinated - 79 - 40.3
* Seasonal 2010 vaccination - 11 - 6
* Unknown - 97 - 49.5
* TOTAL - 196 - ...
(...)
Table 10: Number of underlying conditions in SARI cases by age group, weeks 40/2010–1/2011
[Underlying condition/risk factor - 0-11 months - 1-4 y - 5-14 y - 15-24 y - 25-64 y - >=65 y]
* Asthma - ... - 1 - 1 - 1 - 1 - ...
* Cancer - ... - 1 - ... - ... - 2 - 2
* Diabetes - ... - ... - ... - ... - 36 - 15
* Chronic heart disease - 4 - ... - ... - ... - 25 - 15
* Chronic lung disease - 2 - 1 - ... - 1 - 14 - 6
* Pregnancy - ... - ... - ... - 6 - 22 - ...
* Underlying condition unknown - 15 - 23 - 8 - 14 - 157 - 26
* Other (including all other conditions) - 201 - 144 - 50 - 11 - 243 - 96
Note: The data is collected for asthma, cancer, diabetes, chronic heart disease, HIV/other immune deficiency, kidney-related conditions, liver-related conditions, chronic lung disease, neurocognitive disorder (including seizure), neuromuscular disorder, obesity (BMI between 30 and 40), morbid obesity (BMI above 40), pregnancy, other, underlying condition unknown and for no underlying condition.
Table 11: Additional clinical complications in SARI cases by age group, weeks 40/2010–1/2011
[Additional clinical complications - 0-11 months - 1-4 y - 5-14 y - 15-24 y - 25-64 y - >=65 y]
* Acute respiratory distress syndrome - 24 - 23 - 7 - 13 - 129 - 23
* Bronchiolitis - 1 - ... - ... - ... - 1 - ...
* Pneumonia (secondary bacterial infection) - 11 - 15 - 5 - 11 - 190 - 35
* Sepsis/Multi-organ failure - ... - ... - ... - ... - ... - 1
* None - 3 - 4 - ... - 3 - 16 - 9
* Other - ... - ... - ... - ... - 3 - ...
* Unknown - 183 - 128 - 47 - 6 - 161 - 92
(...)
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