Nielsen, J; Vestergaard, LS; Richter, L; Schmid, D; Bustos, N; Asikainen, T; Trebbien, R; Denissov, G; Innos, K; Virtanen, MJ; +36 more... Fouillet, A; Lytras, T; Gkolfinopoulou, K; Heiden, M An der; Grabenhenrich, L; Uphoff, H; Paldy, A; Bobvos, J; Domegan, L; O'Donnell, J; Scortichini, M; de Martino, A; Mossong, J; England, K; Melillo, J; van Asten, L; de Lange, M Ma; Tønnessen, R; White, RA; da Silva, SP; Rodrigues, AP; Larrauri, A; Mazagatos, C; Farah, A; Carnahan, AD; Junker, C; Sinnathamby, M; Pebody, RG; Andrews, N; Reynolds, A; McMenamin, J; Brown, CS; Adlhoch, C; Penttinen, P; Mølbak, K; Krause, TG; (2019) European all-cause excess and influenza-attributable mortality in the 2017/18 season: should the burden of influenza B be reconsidered? Clinical microbiology and infection : the official publication of the European Society of Clinical Microbiology and Infectious Diseases, 25 (10). pp. 1266-1276. ISSN 1198-743X DOI: https://doi.org/10.1016/j.cmi.2019.02.011
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Abstract
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.
Item Type | Article |
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Faculty and Department | Faculty of Public Health and Policy > Public Health, Environments and Society |
PubMed ID | 30790685 |
Elements ID | 138856 |
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