European all-cause excess and influenza-attributable mortality in the 2017/18 season: should the burden of influenza B be reconsidered?

Objectives: Weekly monitoring of European all-cause excess mortality, the EuroMOMO network, observed high excess mortality during the influenza B/Yamagata dominated 2017/18 winter season, especially among elderly. We describe all-cause excess and influenza-attributable mortality during the season 20...

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Detalles Bibliográficos
Autores: Nielsen, J, Vestergaard, L S, Richter, L, Schmid, D, Bustos, N, Asikainen, T, Trebbien, R, Denissov, G, Innos, K, Virtanen, M J, Fouillet, A, Lytras, T, Gkolfinopoulou, K, Heiden, M An der, Grabenhenrich, L, Uphoff, H, Paldy, A, Bobvos, J, Domegan, Lisa, O'Donnell, J, Scortichini, M, de Martino, A, Mossong, J, England, K, Melillo, J, van Asten, L, de Lange, M Ma, Tønnessen, R, White, R A, da Silva, Susana P, Rodrigues, Ana Paula, Larrauri, Amparo, Mazagatos, Clara, Farah, A, Carnahan, A D, Junker, C, Sinnathamby, M, Pebody, Richard, Andrews, N, Reynolds, A, McMenamin, J, Brown, C S, Adlhoch, C, Penttinen, P, Mølbak, K, Krause, T G
Tipo de recurso: artículo
Fecha de publicación:2019
País:España
Institución:Instituto de Salud Carlos III (ISCIII)
Repositorio:Repisalud
Idioma:inglés
OAI Identifier:oai:repisalud.isciii.es:20.500.12105/15458
Acceso en línea:http://hdl.handle.net/20.500.12105/15458
Access Level:acceso abierto
Palabra clave:Mortality
Adolescent
Adult
Age Factors
Aged
Descripción
Sumario:Objectives: Weekly monitoring of European all-cause excess mortality, the EuroMOMO network, observed high excess mortality during the influenza B/Yamagata dominated 2017/18 winter season, especially among elderly. We describe all-cause excess and influenza-attributable mortality during the season 2017/18 in Europe. Methods: Based on weekly reporting of mortality from 24 European countries or sub-national regions, representing 60% of the European population excluding the Russian and Turkish parts of Europe, we estimated age stratified all-cause excess morality using the EuroMOMO model. In addition, age stratified all-cause influenza-attributable mortality was estimated using the FluMOMO algorithm, incorporating influenza activity based on clinical and virological surveillance data, and adjusting for extreme temperatures. Results: Excess mortality was mainly attributable to influenza activity from December 2017 to April 2018, but also due to exceptionally low temperatures in February-March 2018. The pattern and extent of mortality excess was similar to the previous A(H3N2) dominated seasons, 2014/15 and 2016/17. The 2017/18 overall all-cause influenza-attributable mortality was estimated to be 25.4 (95%CI 25.0-25.8) per 100,000 population; 118.2 (116.4-119.9) for persons aged 65. Extending to the European population this translates into over-all 152,000 deaths. Conclusions: The high mortality among elderly was unexpected in an influenza B dominated season, which commonly are considered to cause mild illness, mainly among children. Even though A(H3N2) also circulated in the 2017/18 season and may have contributed to the excess mortality among the elderly, the common perception of influenza B only having a modest impact on excess mortality in the older population may need to be reconsidered.

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