Estimating burden of influenza‐associated influenza‐like illness and severe acute respiratory infection at public healthcare facilities in Romania during the 2011/12‐2015/16 influenza seasons

Abstract

BackgroundInfluenza is responsible for substantial morbidity and mortality, but there is limited information on reliable disease burden estimates, especially from middle‐income countries in the WHO European Region.ObjectivesTo estimate the incidence of medically attended influenza‐associated influenza‐like illness (ILI) and hospitalizations due to severe acute respiratory infection (SARI) presenting to public healthcare facilities in Romania.Patients/MethodsSentinel influenza surveillance data for ILI and SARI from 2011/12‐2015/16, including virological data, were used to estimate influenza‐associated ILI and SARI incidence/100 000 and their 95% confidence intervals (95% CI).ResultsThe overall annual incidence of ILI and influenza‐associated ILI per 100 000 persons in Romania varied between 68 (95% CI: 61‐76) and 318 (95% CI: 298‐338) and between 23 (95% CI: 19‐29) and 189 (95% CI: 149‐240), respectively. The highest ILI and influenza incidence was among children aged 0‐4 years. We estimated that SARI incidence per 100 000 persons was 6 (95% CI: 5‐7) to 9 (95% CI: 8‐10), of which 2 (95% CI: 1‐2) to 3 (95% CI: 2‐4) were due to influenza. Up to 0.3% of the Romanian population were annually reported with ILI, and 0.01% was hospitalized with SARI, of which as much as one‐third could be explained by influenza.ConclusionsThis evaluation was the first study estimating influenza burden in Romania. We found that during each influenza season, a substantial number of persons in Romania suffer from influenza‐related ILI or are hospitalized due to influenza‐associated SARI.

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“…There is a widespread consensus that influenza imposes a considerable burden on public health, including substantial numbers of severely ill patients resulting in hospitalisations and deaths. [1][2][3][4][5][6][7][8][9][10][11][12][13][14][15][16][17][18][19] The impact of influenza on public health varies across seasons, mainly due to the varying influenza virus types/subtypes, vaccine uptake in the community and the match between the recommended vaccine with the circulating viruses. [4][5][6][7][8] Quantifying the burden of influenza disease is important so as to assess the severity of the virus, evaluate how well public health services are coping with the additional burden or determine whether additional interventions should be considered to reduce the impact.…”