Epidemiology of hospital admissions with influenza during the 2013/2014 Northern hemisphere influenza season: Results from the Global Influenza Hospital Surveillance Network
Puig-Barberà J., Natividad-Sancho A., Trushakova S., Sominina A., Pisareva M., Ciblak MA., Badur S., Yu H., Cowling BJ., El Guerche-Séblain C., Mira-Iglesias A., Kisteneva L., Stolyarov K., Yurtcu K., Feng L., López-Labrador X., Burtseva E., Afanasieva V., Aktaş F., Borekci S., Buigues-Vila A., Buzitskaya Z., Cai J., Çakir B., Carballido-Fernández M., Carratalá-Munuera C., Chai C., Chen E., Çelebi S., Cui Y., Deniz DB., Dong H., Dong X., Durusu M., Fadeev A., Feng S., Garina E., Gencer S., Gil-Guillén V., Hacimustafaoǧlu M., Hancerli S., Huang L., Ip DK., Kolobukhina L., Krasnoslobotsev K., Li C., Limón-Ramírez R., Mahé C., Merkulova L., Mollar Maseres J., Mukasheva E., Ozisik L., Otero-Reigada MC., Özer S., Qin Y., Eren-Şensoy A., Smorodintseva E., Sukhovetskaya V., Sun G., Tang Y., Tormos A., López-Labrador FX., Tortajada-Girbés M., Vartanyan R., Voloshchuk L., Wang Q., Wen D., Wu P., Yang P., Yi B., Zhang S., Zhang Y., Zheng J.
Background: The Global Influenza Hospital Surveillance Network was established in 2012 to obtain valid epidemiologic data on hospital admissions with influenza-like illness. Here we describe the epidemiology of admissions with influenza within the Northern Hemisphere sites during the 2013/2014 influenza season, identify risk factors for severe outcomes and complications, and assess the impact of different influenza viruses on clinically relevant outcomes in at-risk populations. Methods: Eligible consecutive admissions were screened for inclusion at 19 hospitals in Russia, Turkey, China, and Spain using a prospective, active surveillance approach. Patients that fulfilled a common case definition were enrolled and epidemiological data were collected. Risk factors for hospitalization with laboratory-confirmed influenza were identified by multivariable logistic regression. Findings: 5303 of 9507 consecutive admissions were included in the analysis. Of these, 1086 were influenza positive (534 A(H3N2), 362 A(H1N1), 130 B/Yamagata lineage, 3 B/Victoria lineage, 40 untyped A, and 18 untyped B). The risk of hospitalization with influenza (adjusted odds ratio [95% confidence interval]) was elevated for patients with cardiovascular disease (1.63 [1.33-2.02]), asthma (2.25 [1.67-3.03]), immunosuppression (2.25 [1.23-4.11]), renal disease (2.11 [1.48-3.01]), liver disease (1.94 [1.18-3.19], autoimmune disease (2.97 [1.58-5.59]), and pregnancy (3.84 [2.48-5.94]). Patients without comorbidities accounted for 60% of admissions with influenza. The need for intensive care or in-hospital death was not significantly different between patients with or without influenza. Influenza vaccination was associated with a lower risk of confirmed influenza (adjusted odds ratio = 0.61 [0.48- 0.77]). Conclusions: Influenza infection was detected among hospital admissions with and without known risk factors. Pregnancy and underlying comorbidity increased the risk of detecting influenza virus in patients hospitalized with influenza-like illness. Our results support influenza vaccination as a measure for reducing the risk of influenza-associated hospital admission.