Mortality, morbidity, and hospitalisations due to influenza lower respiratory tract infections, 2017: an analysis for the Global Burden of Disease Study 2017

Abstract

SummaryBackgroundAlthough the burden of influenza is often discussed in the context of historical pandemics and the threat of future pandemics, every year a substantial burden of lower respiratory tract infections (LRTIs) and other respiratory conditions (like chronic obstructive pulmonary disease) are attributable to seasonal influenza. The Global Burden of Disease Study (GBD) 2017 is a systematic scientific effort to quantify the health loss associated with a comprehensive set of diseases and disabilities. In this Article, we focus on LRTIs that can be attributed to influenza.MethodsWe modelled the LRTI incidence, hospitalisations, and mortality attributable to influenza for every country and selected subnational locations by age and year from 1990 to 2017 as part of GBD 2017. We used a counterfactual approach that first estimated the LRTI incidence, hospitalisations, and mortality and then attributed a fraction of those outcomes to influenza.FindingsInfluenza LRTI was responsible for an estimated 145 000 (95% uncertainty interval [UI] 99 000–200 000) deaths among all ages in 2017. The influenza LRTI mortality rate was highest among adults older than 70 years (16·4 deaths per 100 000 [95% UI 11·6–21·9]), and the highest rate among all ages was in eastern Europe (5·2 per 100 000 population [95% UI 3·5–7·2]). We estimated that influenza LRTIs accounted for 9 459 000 (95% UI 3 709 000–22 935 000) hospitalisations due to LRTIs and 81 536 000 hospital days (24 330 000–259 851 000). We estimated that 11·5% (95% UI 10·0–12·9) of LRTI episodes were attributable to influenza, corresponding to 54 481 000 (38 465 000–73 864 000) episodes and 8 172 000 severe episodes (5 000 000–13 296 000).InterpretationThis comprehensive assessment of the burden of influenza LRTIs shows the substantial annual effect of influenza on global health. Although preparedness planning will be important for potential pandemics, health loss due to seasonal influenza LRTIs should not be overlooked, and vaccine use should be considered. Efforts to improve influenza prevention measures are needed.FundingBill & Melinda Gates Foundation.

Coronavirus Disease (COVID-19): A primer for emergency physicians

“…39,40 When compared to other recent epidemics such as SARS (9.56) or EVD (39.53), the average case fatality rate (4.2%) for COVID-19 is much lower (Table 1). 41,42 In comparison, the 2009 H1N1 influenza pandemic and 2017 influenza season were responsible for approximately 220 times more cases. 41,42 J o u r n a l P r e -p r o o f 41,42 Based on what is known about similar coronaviruses, the longest potential incubation period for COVID-19 is thought to be 14 days from initial exposure.…”

“…41,42 In comparison, the 2009 H1N1 influenza pandemic and 2017 influenza season were responsible for approximately 220 times more cases. 41,42 J o u r n a l P r e -p r o o f 41,42 Based on what is known about similar coronaviruses, the longest potential incubation period for COVID-19 is thought to be 14 days from initial exposure. 4,6 The mean incubation period is 5.2 days (95% CI 4.1-7.0) but can range from 2 to 14 days.…”

“…Comparison of epidemiological characteristics of recent global epidemics as of March 21, 2020 41,42. Estimated global burden of disease from influenza-related lower respiratory tract infections; excludes cases with alternative causes (i.e.…”

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“…Introduction Acute respiratory tract infections (ARTI) are a leading cause of morbidity and mortality worldwide and a frequent reason for seeking medical care [1]. Most pathogens have predilection for either the upper or lower respiratory tract but may move into the other compartment.…”

Characterising the epidemic spread of Influenza A/H3N2 within a city through phylogenetics

“…When looking to which groups these were connected, we found 352 them to be associated with other school-aged children. However, they are unlikely to be 353 sampled more than preschoolers [39], and we do not see evidence for oversampling of 354 this group compared to preschoolers (see figure 2b). We therefore interpret our results 355 as school-aged children being involved in more transmission events compared to the 356 other patient groups, including preschoolers.…”