Risk Factors for Severe Influenza A–Related Pneumonia in Adult Cohort, Mexico, 2013–14

Gómez-Gómez, Alejandro; Magaña-Aquino, Martín; Bernal‐Silva, Sofía; Araujo-Meléndez, Javier; Comas‐García, Andreu; Alonso-Zúñiga, Emma; Torres-Torres, Eliana; Noyola, Daniel E.

doi:10.3201/eid2009.140115

Cited by 10 publications

(9 citation statements)

References 11 publications

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“…Pregnancy was present in one patient and she was underwent C/S in the ICU. obesity which has bMI > 30, pregnancy, and diabetes mellitus were the most frequently seen comorbid conditions (2,(10)(11)(12). Contrary to the literature, obesity was not seen as a risk factor in this study.…”

Section: Discussioncontrasting

confidence: 77%

Characteristics of influenza pneumonia patients admitted to the ICU due to hypoxemic respiratory failure

2018

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SuMMARYCharacteristics of influenza pneumonia patients admitted to the iCu due to hypoxemic respiratory failure introduction: Hypoxemic respiratory failure due to influenza pneumonia during epidemic seasons sometimes may require mechanical ventilation support and intensive care unit (ICU) stay. We aimed to evaluate the characteristics and risk factors of influenza pneumonia patients admitted to our ICU due to hypoxemic respiratory failure.

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Section: Discussioncontrasting

confidence: 77%

Characteristics of influenza pneumonia patients admitted to the ICU due to hypoxemic respiratory failure

2018

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“…Young children and the elderly contribute most to mortality in seasonal flu, while pandemic scenarios are notable for their tendency to generate greater mortality or serious complications among groups that do not normally experience strong illness, such as adults under 65 [5, 18, 47, 48, 42]. These events are characterized by different distributions of age risk: an initial pandemic wave may be dominated by morbidity among school-aged children, and some empirical and modeling studies suggest that adults are more likely to become infected in the season following a pandemic [9, 10, 11, 12, 13]. While the mechanisms for this remain poor understood, it has been suggested that there is an accumulation of heterologous immunity with age [49].…”

Section: Discussionmentioning

confidence: 99%

“…Influenza virus genetic and antigenic data suggests that severity is linked to hemagglutinin protein novelty [3], and A/H3-dominant seasons have greater mortality rates than A/H1 or B dominant seasons [4, 5, 6, 7] as H3 strains disproportionately affect older populations [8]. Epidemiological studies of seasons following pandemics suggest that novel antigenic strains shift the expected age-related immune landscape, which generates relatively high susceptibility among adults [9, 10, 11, 12, 5, 13]. In congruence with a link between severity and low pre-existing immunity, high T cell concentrations correlate with subsiding illness and high viral shedding correlates with high clinical severity[14].…”

Section: Introductionmentioning

confidence: 99%

Detecting Signals of Seasonal Influenza Severity through Age Dynamics

Lee

Viboud

Simonsen

et al. 2015

Preprint

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Background: Measures of population-level influenza severity are important for public health planning, but estimates are often based on case-fatality and case-hospitalization risks, which require multiple data sources, are prone to surveillance biases, and are typically unavailable in the early stages of an outbreak. To address the limitations of traditional indicators, we propose a novel severity index based on influenza age dynamics estimated from routine physician diagnosis data that can be used retrospectively and for early warning. Methods:We developed a quantitative 'ground truth' severity benchmark that synthesizes multiple traditional severity indicators from publicly available influenza surveillance data in the United States. Observing that the age distribution of cases may signal severity early in an epidemic, we constructed novel retrospective and early warning severity indexes based on the relative risk of influenza-like illness (ILI) among working-age adults to that among schoolaged children using weekly outpatient medical claims. We compared our relative risk-based indexes to the composite benchmark and estimated seasonal severity for flu seasons from 2001-02 to 2008-09 at the national and state levels. Results: The severity classifications made by the benchmark were not uniquely captured by any single contributing metric, including pneumonia and influenza mortality; the influenza epidemics of 2003-04 and 2007-08 were correctly identified as the most severe of the study period. The retrospective index was well correlated with the severity benchmark and correctly identified the two most severe seasons. The early warning index performance varied, but it projected 2007-08 as relatively severe 10 weeks prior to the epidemic peak. Influenza severity varied significantly among states within seasons, and four states were identified as possible early warning sentinels for national severity. Conclusions: Differences in age patterns of ILI may be used to characterize seasonal influenza severity in the United States in real-time and in a spatially resolved way. Future research on antigenic changes among circulating viruses, pre-existing immunity, and changing contact patterns may better elucidate the mechanisms underlying these indexes. Researchers and practitioners should consider the use of composite or ILI-based severity metrics in addition to traditional severity measures to inform epidemiological understanding and situational awareness in future seasonal outbreaks.

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“…It was not within the scope of our study to conduct an analysis of risk factors for A/H1N1 death. However, findings from a recent study based on epidemiological data for 102 adults with suspected influenza pneumonia and admitted to a hospital in Mexico indicate that unvaccinated status against A/H1N1 influenza and presence of comorbidities were frequently reported among the study cohort (30). …”

Section: Discussionmentioning

confidence: 99%

WITHDRAWN: Intense Seasonal A/H1N1 Influenza in Mexico, Winter 2013–2014

Dávila-Torres

Chowell

Borja-Aburto

et al. 2014

Archives of Medical Research

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Background and Aims A recrudescent wave of pandemic influenza A/H1N1 affected Mexico during the winter of 2013–2014 following a mild 2012–2013 A/H3N2 influenza season. Methods We compared the demographic and geographic characteristics of hospitalizations and inpatient deaths for severe acute respiratory infection (SARI) and laboratory-confirmed influenza during the 2013–2014 influenza season compared to previous influenza seasons, based on a large prospective surveillance system maintained by the Mexican Social Security health care system. Results A total of 14,236 SARI hospitalizations and 1,163 inpatient deaths (8.2%) were reported between October 1, 2013 and March 31, 2014. Rates of laboratory-confirmed A/H1N1 hospitalizations and deaths were significantly higher among individuals aged 30–59 years and lower among younger age groups for the 2013–2014 A/H1N1 season compared to the previous A/H1N1 season in 2011–2012 (χ2 test, p <0.001). The reproduction number for the winter 2013–2014 influenza season in central Mexico was estimated at 1.3–1.4, in line with that reported for the 2011–2012 A/H1N1 season but lower than during the initial waves of pandemic A/H1N1 activity in 2009. Conclusions We documented a substantial increase in the number of A/H1N1-related hospitalizations and deaths during the period from October 2013–March 2014 in Mexico and a proportionate shift of severe disease to middle-aged adults, relative to the preceding A/H1N1 2011–2012 season. In the absence of clear antigenic drift in globally circulating A/H1N1 viruses in the post-2009 pandemic period, the gradual change in the age distribution of A/H1N1 infections observed in Mexico suggests a slow build-up of immunity among younger populations, reminiscent of the age profile of past pandemics.

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Risk Factors for Severe Influenza A–Related Pneumonia in Adult Cohort, Mexico, 2013–14

Cited by 10 publications

References 11 publications

Characteristics of influenza pneumonia patients admitted to the ICU due to hypoxemic respiratory failure

Characteristics of influenza pneumonia patients admitted to the ICU due to hypoxemic respiratory failure

Detecting Signals of Seasonal Influenza Severity through Age Dynamics

WITHDRAWN: Intense Seasonal A/H1N1 Influenza in Mexico, Winter 2013–2014

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