Influenza associated mortality in Southern China, 2010–2012

Wang, Hui; Fu, Chuanxi; Li, Kuibiao; Lu, Jianyun; Chen, Yiyun; Lu, Enjie; Xiao, Xue; Di, Biao; Liu, Huazhang; Yang, Zhicong; Wang, Ming

doi:10.1016/j.vaccine.2013.12.013

Cited by 31 publications

(45 citation statements)

References 27 publications

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“…Our findings for the all‐age mortality burden of seasonal influenza are comparable with previous studies derived from similar approaches in China (Table 5) 3, 4, 5 and other areas, such as Hong Kong,14 Singapore,16 USA,18 and Mexico 20. For adults aged ≥65 years, however, our estimate is lower than previous estimates made for China overall, 3 northern cities in China, and a southern city in China (105 [46.9‐386.1] vs 145.5 [95.8‐227.3], 150.8 [66.2‐502.5], and 185.6 [152.5‐218.7] per 100 000, respectively) 3, 4, 5.…”

Section: Discussionsupporting

confidence: 90%

“…For adults aged ≥65 years, however, our estimate is lower than previous estimates made for China overall, 3 northern cities in China, and a southern city in China (105 [46.9‐386.1] vs 145.5 [95.8‐227.3], 150.8 [66.2‐502.5], and 185.6 [152.5‐218.7] per 100 000, respectively) 3, 4, 5. One explanation for this lower burden of seasonal influenza mortality among older adults in Beijing may be the higher seasonal influenza vaccine coverage among older adults in Beijing compared with older adults in the rest of China.…”

Section: Discussioncontrasting

confidence: 79%

“…3, 4, 5, 13, 14, 15, 16, 17, 18, 19, 20, 21, 22, 23 Notably, our study observed that influenza B caused the highest burden (20.5 [CI 14.2‐34.9] per 100 000) when influenza B virus predominated in 2007/2008. This mortality pattern is consistent with those described in studies conducted by China CDC and Guangzhou CDC,3, 5 but differs from studies conducted in other regions such as Hong Kong,14 Singapore,16 Thailand,17 United States,18, 19 and New Zealand,23 where the highest death rates were associated with influenza A(H3N2). In addition, the highest mortality burden was not observed in 2011/2012 when influenza B also predominated in Beijing.…”

Section: Discussionmentioning

confidence: 47%

“…We defined an influenza season as the period ranging from the 27th week in 1 year to the 26th week in the next year, based on influenza surveillance data 11. The registration system categorized weekly numbers of deaths into two underlying causes of death according to the International Classification of Disease, Tenth Revision [ICD‐10]: respiratory (ICD‐10 codes J00‐99) and circulatory diseases (ICD‐10 codes I00‐99) (respiratory and circulatory: R&C), and all‐cause deaths (including both respiratory and circulatory deaths which have been previously been associated with influenza‐associated deaths) 2, 3, 4, 5, 6. Two age groups were considered: <65 years and ≥65 years.…”

Section: Methodsmentioning

confidence: 99%

“…Although several statistical models have estimated the mortality burden of influenza,2 few have focused on mainland China,3, 4, 5 and information on mortality burden in northern China is especially limited. Considering the diverse seasonality patterns,6 income levels and healthcare access across China, mortality burden may vary by region.…”

Section: Introductionmentioning

confidence: 99%

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Mortality burden from seasonal influenza and 2009 H1N1 pandemic influenza in Beijing, China, 2007‐2013

Wei

Greene

et al. 2017

Influenza Resp Viruses

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BackgroundData about influenza mortality burden in northern China are limited. This study estimated mortality burden in Beijing associated with seasonal influenza from 2007 to 2013 and the 2009 H1N1 pandemic.MethodsWe estimated influenza‐associated excess mortality by fitting a negative binomial model using weekly mortality data as the outcome of interest with the percent of influenza‐positive samples by type/subtype as predictor variables.ResultsFrom 2007 to 2013, an average of 2375 (CI 1002‐8688) deaths was attributed to influenza per season, accounting for 3% of all deaths. Overall, 81% of the deaths attributed to influenza occurred in adults aged ≥65 years, and the influenza‐associated mortality rate in this age group was higher than the rate among those aged <65 years (113.6 [CI 49.5‐397.4] versus 4.4 [CI 1.7‐18.6] per 100 000, P < .05). The mortality rate associated with the 2009 H1N1 pandemic in 2009/2010 was comparable to that of seasonal influenza during the seasonal years (19.9 [CI 10.4‐33.1] vs 17.2 [CI 7.2‐67.5] per 100 000). People aged <65 years represented a greater proportion of all deaths during the influenza A(H1N1)pdm09 pandemic period than during the seasonal epidemics (27.0% vs 17.7%, P < .05).ConclusionsInfluenza is an important contributor to mortality in Beijing, especially among those aged ≥65 years. These results support current policies to give priority to older adults for seasonal influenza vaccination and help to define the populations at highest risk for death that could be targeted for pandemic influenza vaccination.

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Section: Discussionsupporting

confidence: 90%

Section: Discussioncontrasting

confidence: 79%

Section: Discussionmentioning

confidence: 47%

Section: Methodsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 3 more Smart Citations

Mortality burden from seasonal influenza and 2009 H1N1 pandemic influenza in Beijing, China, 2007‐2013

Wei

Greene

et al. 2017

Influenza Resp Viruses

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Epidemiological study of influenza B in Shanghai during the 2009–2014 seasons: implications for influenza vaccination strategy

Zhao

Qin

Teng

et al. 2015

Clinical Microbiology and Infection

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A new quadrivalent influenza vaccine has been available for influenza B, which can pose a significant global health burden. Shanghai has the highest GDP and largest metropolitan population in China. To understand the impact of influenza B in Shanghai in terms of age-related incidence and relative prevalence compared with other subtypes, we conducted this retrospective epidemiological study of influenza B in the 2009-2014 seasons. A total of 71 354 outpatients with influenza-like illness were included, and both lineages of influenza B and subtypes of influenza A were identified using real-time RT-PCR. The antigenic characteristics of influenza B isolates were analysed by sequencing and reciprocal haemagglutinin inhibition assay. On average, 33.45% of influenza strains were influenza B, and 40.20% of strains isolated from children were influenza B. The incidence of influenza B was highest (12.52 per 100 people with influenza-like illness) in children ages 6-17 years and usually peaked in this age group at the early stage of an influenza B epidemic. Overall, both matched and mismatched influenza B strains co-circulated in Shanghai annually, and 44.57% of the circulating influenza B belonged to the opposite lineage of the vaccine strains. We concluded that influenza B has caused a substantial impact in Shanghai and that school-aged children play a key role in the transmission of influenza B. Hence, it may be beneficial to prioritize influenza vaccination for school-aged children to mitigate the outbreaks of influenza B.

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Age- and sex-specific excess mortality associated with influenza in Shanghai, China, 2010–2015

Jin

Cai

et al. 2020

International Journal of Infectious Diseases

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Few studies have explored the different lineages of influenza B viruses, which cause excessive fatalities. This study aimed to estimate age-and sex-specific excessive mortality associated with influenza subtypes/lineages in Shanghai, during 2010-2015. Methods: We used quasi-Poisson regression models to fit weekly numbers of deaths from various causes by adjusting long-term trend, seasonal trend, and absolute humidity as confounding factors. The mortality burden associated with influenza subtypes/lineages was estimated by age and sex. Results: The average influenza-associated excessive mortality rate in deaths coded as all-cause was 27.66 (95%CI: 22.30-33.88) per 100,000 person-years. The excessive deaths from six underlying causes in people aged !65 years weight heavily. Compared to influenza B(Victoria) lineage, influenza B(Yamagata) lineage had more effect on the influenza-associated disease burden, particularly in patients with respiratory and circulatory diseases. There was no statistical significance of sex in the mortality burden associated with influenza. Conclusion: Disproportionate mortality associated with influenza B virus is dominated by B(Yamagata) lineage in Shanghai, and the evidence for sex differences in the influenza-associated mortality burden for respiratory and circulatory diseases is limited. Improving the vaccination of the elderly and strengthening laboratory-based surveillance of influenza B lineages in Shanghai are needed to reduce this influenza's disease burden.

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Influenza associated mortality in Southern China, 2010–2012

Cited by 31 publications

References 27 publications

Mortality burden from seasonal influenza and 2009 H1N1 pandemic influenza in Beijing, China, 2007‐2013

Mortality burden from seasonal influenza and 2009 H1N1 pandemic influenza in Beijing, China, 2007‐2013

Epidemiological study of influenza B in Shanghai during the 2009–2014 seasons: implications for influenza vaccination strategy

Age- and sex-specific excess mortality associated with influenza in Shanghai, China, 2010–2015

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