Epidemiology and burden of influenza in the U.S. Department of Veterans Affairs

Lucero-Obusan, Cynthia; Schirmer, Patricia; Wendelboe, Aaron M.; Oda, Gina; Holodniy, Mark

doi:10.1111/irv.12512

Cited by 7 publications

(10 citation statements)

References 9 publications

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“… 2 Similar clinical and economic burdens were reported within the Veterans Affairs (VA) hospital setting. 3 , 4 During the 2014 to 2015 influenza season, more than 11 500 confirmed cases and a hospitalization rate of 74.2 per 100 000 VA users were observed. 4 Recent estimates of health care–associated influenza range between 1% and 5%.…”

Section: Introductionmentioning

confidence: 99%

“… 3 , 4 During the 2014 to 2015 influenza season, more than 11 500 confirmed cases and a hospitalization rate of 74.2 per 100 000 VA users were observed. 4 Recent estimates of health care–associated influenza range between 1% and 5%. 5 , 6 The Centers for Disease Control and Prevention Advisory Committee on Immunization Practices continues to recommend that all health care personnel (HCP) be vaccinated annually against influenza.…”

Section: Introductionmentioning

confidence: 99%

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Changes in Influenza Vaccination Requirements for Health Care Personnel in US Hospitals

et al. 2018

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Key Points Question How has the proportion of US hospitals requiring receipt of annual influenza vaccination among health care personnel changed in recent years? Findings In this national survey study, which included responses from 1062 infection preventionists at both Veterans Affairs and non–Veterans Affairs hospitals between the 2013 and 2017 calendar years, required influenza vaccinations among health care personnel increased from 37.1% to 61.4%; this change was driven by increases in non–Veterans Affairs hospitals. Meaning Influenza vaccination mandates for health care personnel have increased in recent years, coinciding with concurrent increases in vaccination coverage among health care personnel.

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Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Changes in Influenza Vaccination Requirements for Health Care Personnel in US Hospitals

et al. 2018

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“…Our key independent variable was the season in which ED encounters occurred, starting at the week beginning 1 October (calendar week 40) and ending at the week beginning 30 September the following year (calendar week 39). Three measures of ILI-related ED visits were used as dependent variables in our analyses: CLS, influenza, and non-influenza ILIs [22]. We used ICD-10-CM diagnostic codes to identify influenza and non-influenza ILI.…”

Section: Methodsmentioning

confidence: 99%

Using an Administrative and Clinical Database to Determine the Early Spread of COVID-19 at the US Department of Veterans Affairs during the Beginning of the 2019–2020 Flu Season: A Retrospective Longitudinal Study

Lukowsky

Der‐Martirosian

Steers

et al. 2022

Viruses

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Background. Previous studies examining the early spread of COVID-19 have used influenza-like illnesses (ILIs) to determine the early spread of COVID-19. We used COVID-19 case definition to identify COVID-like symptoms (CLS) independently of other influenza-like illnesses (ILIs). Methods. Using data from Emergency Department (ED) visits at VA Medical Centers in CA, TX, and FL, we compared weekly rates of CLS, ILIs, and non-influenza ILIs encounters during five consecutive flu seasons (2015–2020) and estimated the risk of developing each illness during the first 23 weeks of the 2019–2020 season compared to previous seasons. Results. Patients with CLS were significantly more likely to visit the ED during the first 23 weeks of the 2019–2020 compared to prior seasons, while ED visits for influenza and non-influenza ILIs did not differ substantially. Adjusted CLS risk was significantly lower for all seasons relative to the 2019–2020 season: RR15–16 = 0.72, 0.75, 0.72; RR16–17 = 0.81, 0.77, 0.79; RR17–18 = 0.80, 0.89, 0.83; RR18–19 = 0.82, 0.96, 0.81, in CA, TX, and FL, respectively. Conclusions. The observed increase in ED visits for CLS indicates the likely spread of COVID-19 in the US earlier than previously reported. VA data could potentially help identify emerging infectious diseases and supplement existing syndromic surveillance systems.

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“…Young-Xu and colleagues found an estimated 10,674 emergency room visits, 2,538 hospitalizations, and 3,793 underlying respiratory or circulatory deaths among United States Veterans that were attributable to influenza each year from 2010 through 2014 [1,2]. Some studies have tried to improve the accuracy of influenza-attributable disease burden estimates [3][4][5][6], while others have worked to elucidate the causal pathways by discovering a strong association between laboratory-confirmed influenza infection (LCI) and acute myocardial infarction (AMI) [7][8][9][10].…”

Section: Introductionmentioning

confidence: 99%

Laboratory-confirmed influenza infection and acute myocardial infarction among United States senior Veterans

et al. 2020

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Background Previous studies established an association between laboratory-confirmed influenza infection (LCI) and hospitalization for acute myocardial infarction (AMI) but not causality. We aimed to explore the underlying mechanisms by adding biological mediators to an established study design used by earlier studies. Methods With data on biomarkers, we used a self-controlled case-series design to evaluate the effect of LCI on hospitalization for AMI among Veterans Health Administration (VHA) patients. We included senior Veterans (age 65 years and older) with LCI between 2010 through 2015. Patient-level data from VHA electronic medical records were used to capture laboratory results, hospitalizations, and baseline patient characteristics. We defined the “risk interval” as the first 7 days after specimen collection and the “control interval” as 1 year before and 1 year after the risk interval. More importantly, using mediation analysis, we examined the role of abnormal white blood cell (WBC) and platelet count in the relationship between LCI and AMI to explore the thrombogenic nature of this association, thus potential causality. Results We identified 391 hospitalizations for AMI that occurred within +/-1 year of a positive influenza test, of which 31 (31.1 admissions/week) occurred during the risk interval and 360 (3.5/per week) during the control interval, resulting in an incidence ratio (IR) for AMI admission of 8.89 (95% confidence interval [CI]: 6.16–12.84). In stratified analyses, AMI risk was significantly elevated among patients with high WBC count (IR, 12.43; 95% CI: 6.99–22.10) and high platelet count (IR, 15.89; 95% CI: 3.59–70.41). Conclusion We confirmed a significant association between LCI and AMI. The risk was elevated among those with high WBC or platelet count, suggesting a potential role for inflammation and platelet activation in the underlying mechanism.

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Epidemiology and burden of influenza in the U.S. Department of Veterans Affairs

Cited by 7 publications

References 9 publications

Changes in Influenza Vaccination Requirements for Health Care Personnel in US Hospitals

Changes in Influenza Vaccination Requirements for Health Care Personnel in US Hospitals

Using an Administrative and Clinical Database to Determine the Early Spread of COVID-19 at the US Department of Veterans Affairs during the Beginning of the 2019–2020 Flu Season: A Retrospective Longitudinal Study

Laboratory-confirmed influenza infection and acute myocardial infarction among United States senior Veterans

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