Respiratory syncytial virus or influenza?

Fleming, David G.; Cross, K. W.

doi:10.1016/s0140-6736(05)80082-0

Cited by 159 publications

(98 citation statements)

References 10 publications

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“…In 1990 Anderson and colleagues [25] revealed a strong correlation between RSV isolations in the United States with peaks of national respiratory deaths of infants and young children. Recently Fleming and Cross [26] compared consultation rates for acute respiratory disease, death registrations and the timing of influenza and RSV isolations in England and Wales from 1989/90 through 1992/3. Fleming and Cross were unable to quantify influenza and RSV-associated mortality, nonetheless they concluded that RSV is as important as influenza virus in causing morbidity and excess mortality among elderly people.…”

Section: Primary Regression With Forced Variablesmentioning

confidence: 99%

Impact of influenza and respiratory syncytial virus on mortality in England and Wales from January 1975 to December 1990

1996

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SUMMARYThe effects of influenza A and B and RSV on mortality in England and Wales were assessed by regression analysis for the period 1975-90. Morbidity data from sentinel practices were used to calculate 4-weekly rates of aggregated upper respiratory tract infections (URTI); PHLS laboratory reports were used as indices of infection, and 4-weekly death rates from all causes, excluding childbirths, were used to study relationships with mortality. Deaths correlated strongly with influenza A and B reports, temperature, and interactions between aggregated URTI and temperature, and RSV outbreaks and temperature. Estimates of 'seasonal' 4-weekly mortality associated with URTI were made by substituting into primary regression models the mean of annual trough consultation rates for aggregated URTI and baseline values for RSV and influenza. Peak 4-weekly mortality associated with URTIs was estimated at c. 24000 and c. 28000 during combined influenza and RSV epidemics of 1975-6 and 1989-90 respectively. Secondary regression analysis was carried out with the estimated 'seasonal' 4-weekly deaths associated with URTI as dependant variable and laboratory data as regressors. Estimated excess mortality associated with influenza was considerable even during years without major epidemics. Overall during the 15 winters the estimated mortality associated with RSV was 60-80% more than that associated with influenza. The modelling permits only a crude estimate of RSV associated mortality. None the less it suggests that RSV is an important cause of winter mortality.

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Section: Primary Regression With Forced Variablesmentioning

confidence: 99%

Impact of influenza and respiratory syncytial virus on mortality in England and Wales from January 1975 to December 1990

1996

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“…Conversely it seems that including respiratory disease in the adverse outcome category increases the level of misclassification to such an extent that the benefits of vaccination are more or less entirely obscured. The high background levels of acute respiratory infection due to microorganisms other than influenza viruses, such as respiratory syncytial virus, must be recognized [16].…”

Section: M Fleming and Othersmentioning

confidence: 99%

Study of the effectiveness of influenza vaccination in the elderly in the epidemic of 1989–90 using a general practice database

Fleming

Watson²,

Nicholas³

et al. 1995

Epidemiol. Infect.

105

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SUMMARYThe effectiveness of influenza vaccination in preventing serious illness and death was determined in an elderly population during the influenza epidemic of 1989-90. A retrospective cohort study was carried out using computerized general practitioner records on nearly 10000 patients aged 55 years and over. After adjustment for potential confounding factors, recent immunization was found to have a protective effect of 75% (95% confidence intervals: 21-92%) against death. Protection did not appear to vary with either age or the presence of underlying chronic disease. As the complications of influenza are most common in those with underlying chronic disease, the study findings are consistent with the recommended policy for the use of influenza vaccine in the UK. Further work is necessary to determine the cost-effectiveness of extending immunization to other groups.

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“…These methods have the advantage over laboratory data of being potentially more sensitive. This is because diagnostic tests have limited sensitivity and clinicians do not always carry out appropriate investigations such as blood cultures or virology [13,14]. Although apparently more sensitive, this analysis cannot replace laboratory-based surveillance which remains vitally important.…”

Section: Discussionmentioning

confidence: 99%

Modelling hospital admissions for lower respiratory tract infections in the elderly in England

Müller‐Pebody

Crowcroft²,

Zambon³

et al. 2006

Epidemiol. Infect.

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SUMMARYDespite the importance of lower respiratory-tract infection (LRI) in causing hospitalizations in elderly patients (o65 years of age) and recent advances in vaccine development, a complete picture of the causative organisms is not available. All hospital discharge diagnoses (ICD-10 code) for LRI in elderly patients in England during 1995-1998 were reviewed. Using known seasonality in potential causative agents of LRI, the contribution of different respiratory pathogens to hospitalizations coded as ' unspecified LRI' was estimated by multiple linear regression analysis. Ninety-seven per cent of 551 633 LRI-associated diagnoses had no specific organism recorded. From the statistical model the estimated proportions of admissions attributable to different pathogens were applied to calculate estimated hospitalization rates : 93 . 9 hospitalizations/10 000 population aged o65 years due to S. pneumoniae, 22 . 9 to influenza virus, 22 . 3 to H. influenzae, 17 . 0 to whooping cough, and 12 . 8 to respiratory syncytial virus. There is enormous potential to improve health using existing vaccines and those under development.

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Respiratory syncytial virus or influenza?

Cited by 159 publications

References 10 publications

Impact of influenza and respiratory syncytial virus on mortality in England and Wales from January 1975 to December 1990

Impact of influenza and respiratory syncytial virus on mortality in England and Wales from January 1975 to December 1990

Study of the effectiveness of influenza vaccination in the elderly in the epidemic of 1989–90 using a general practice database

Modelling hospital admissions for lower respiratory tract infections in the elderly in England

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