Ronan Kelly
Retired 2020
Burden of Seasonal and Pandemic Influenza-Associated Hospitalization during and after 2009 A(H1N1)pdm09 Pandemic in a Rural Community in India
Mandeep S. Chadha equal contributor mail, Siddhivinayak Hirve equal contributor, Fatimah S. Dawood, Pallavi Lele, Avinash Deoshatwar, Somnath Sambhudas, Sanjay Juvekar, Kathryn E. LaFond, Joshua A. Mott, Renu B. Lal, Akhilesh C. Mishra mail
Abstract
Background
Influenza is vaccine-preventable; however, the burden of severe influenza in India remains unknown. We conducted a population-based study to estimate the incidence of laboratory confirmed influenza-associated hospitalizations in a rural community in western India.
Methods
We conducted active surveillance for hospitalized patients with acute medical illnesses or acute chronic disease exacerbations in Pune during pandemic and post pandemic periods (May 2009–April 2011). Nasal and throat swabs were tested for influenza viruses. A community health utilization survey estimated the proportion of residents hospitalized with respiratory illness at non-study facilities and was used to adjust incidence estimates from facility-based surveillance.
Results
Among 9,426 hospitalizations, 3,391 (36%) patients were enrolled; 665 of 3,179 (20.9%) tested positive for influenza. Of 665 influenza positives, 340 (51%) were pandemic A(H1N1)pdm09 and 327 (49%) were seasonal, including A/H3 (16%), A/H1 (3%) and influenza B (30%). The proportion of patients with influenza peaked during August 2009 (39%) and 2010 (42%). The adjusted annual incidence of influenza hospitalizations was 46.8/10,000 during pandemic and 40.5/10,000 during post-pandemic period with comparable incidence of A(H1N1)pdm09 during both periods (18.8 and 20.3, respectively). The incidence of both pH1N1 and seasonal hospitalized influenza disease was highest in the 5–29 year olds.
Conclusions
We document the previously unrecognized burden of influenza hospitalization in a rural community following the emergence of influenza A(H1N1)pdm09 viruses in India. During peak periods of influenza activity circulation i.e during the monsoon period, 20% of all hospital admissions in the community had influenza positivity. These findings can inform development of influenza prevention and control strategies in India.
Citation: Chadha MS, Hirve S, Dawood FS, Lele P, Deoshatwar A, et al. (2013) Burden of Seasonal and Pandemic Influenza-Associated Hospitalization during and after 2009 A(H1N1)pdm09 Pandemic in a Rural Community in India. PLoS ONE 8(5): e55918. doi:10.1371/journal.pone.0055918
Editor: Benjamin J. Cowling, University of Hong Kong, Hong Kong
Received: October 3, 2012; Accepted: January 3, 2013; Published: May 15, 2013
Copyright: © 2013 Chadha et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
Funding: The Influenza Disease Burden, India Study was supported by a Centers for Disease Control and Prevention co-operative agreement # 1U01IP000206. The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.
Competing interests: The authors have declared that no competing interests exist.
Full Paper (Open Access) at http://www.plosone.org/article/info:doi/10.1371/journal.pone.0055918
Mandeep S. Chadha equal contributor mail, Siddhivinayak Hirve equal contributor, Fatimah S. Dawood, Pallavi Lele, Avinash Deoshatwar, Somnath Sambhudas, Sanjay Juvekar, Kathryn E. LaFond, Joshua A. Mott, Renu B. Lal, Akhilesh C. Mishra mail
Abstract
Background
Influenza is vaccine-preventable; however, the burden of severe influenza in India remains unknown. We conducted a population-based study to estimate the incidence of laboratory confirmed influenza-associated hospitalizations in a rural community in western India.
Methods
We conducted active surveillance for hospitalized patients with acute medical illnesses or acute chronic disease exacerbations in Pune during pandemic and post pandemic periods (May 2009–April 2011). Nasal and throat swabs were tested for influenza viruses. A community health utilization survey estimated the proportion of residents hospitalized with respiratory illness at non-study facilities and was used to adjust incidence estimates from facility-based surveillance.
Results
Among 9,426 hospitalizations, 3,391 (36%) patients were enrolled; 665 of 3,179 (20.9%) tested positive for influenza. Of 665 influenza positives, 340 (51%) were pandemic A(H1N1)pdm09 and 327 (49%) were seasonal, including A/H3 (16%), A/H1 (3%) and influenza B (30%). The proportion of patients with influenza peaked during August 2009 (39%) and 2010 (42%). The adjusted annual incidence of influenza hospitalizations was 46.8/10,000 during pandemic and 40.5/10,000 during post-pandemic period with comparable incidence of A(H1N1)pdm09 during both periods (18.8 and 20.3, respectively). The incidence of both pH1N1 and seasonal hospitalized influenza disease was highest in the 5–29 year olds.
Conclusions
We document the previously unrecognized burden of influenza hospitalization in a rural community following the emergence of influenza A(H1N1)pdm09 viruses in India. During peak periods of influenza activity circulation i.e during the monsoon period, 20% of all hospital admissions in the community had influenza positivity. These findings can inform development of influenza prevention and control strategies in India.
Citation: Chadha MS, Hirve S, Dawood FS, Lele P, Deoshatwar A, et al. (2013) Burden of Seasonal and Pandemic Influenza-Associated Hospitalization during and after 2009 A(H1N1)pdm09 Pandemic in a Rural Community in India. PLoS ONE 8(5): e55918. doi:10.1371/journal.pone.0055918
Editor: Benjamin J. Cowling, University of Hong Kong, Hong Kong
Received: October 3, 2012; Accepted: January 3, 2013; Published: May 15, 2013
Copyright: © 2013 Chadha et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
Funding: The Influenza Disease Burden, India Study was supported by a Centers for Disease Control and Prevention co-operative agreement # 1U01IP000206. The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.
Competing interests: The authors have declared that no competing interests exist.
Full Paper (Open Access) at http://www.plosone.org/article/info:doi/10.1371/journal.pone.0055918