The influenza season 2016/17 in Bucharest, Romania – surveillance data and clinical characteristics of patients with influenza-like illness admitted to a tertiary infectious diseases hospital

Drăgănescu, Anca; Săndulescu, Oana; Florea, Dragoș; Vlaicu, Ovidiu; Streinu‐Cercel, Anca; Oțelea, Dan; Aramă, Victoria; Luminos, Monica; Streinu‐Cercel, Adrian; Nițescu, Maria; Ivanciuc, Alina Elena; Bacruban, Rodica; Pițigoi, Daniela

doi:10.1016/j.bjid.2018.10.275

Cited by 12 publications

(22 citation statements)

References 18 publications

(18 reference statements)

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“…For the 2016/17 season, the data from our current study confirmed to some extent our previous report regarding the exclusive co‐circulation of A(H3N2) and B/Victoria 19 . However, in our study of elderly patients the season was dominated by the circulation of A viruses (90.0% compared with the national estimate of 65.7% in all age groups 20 and compared to our previous report of 33.9% in all age groups with an emphasis on children 19 ), suggesting that A viruses predominated in elderly patients in 2016/17; A(H3N2) accounted for 100% of all circulating A viruses in 2016/17 in the current study and in our previous report 19 . Data from Bulgaria and Poland also report the predominance of influenza A virus (97.5% 21 and 95.5% 22 of all influenza cases, respectively), and specifically the A(H3N2) subtype in the 2016/17 season, but A(H1N1)pdm09 was also present in these two countries, to a lower extent 21,22 .…”

Section: Discussionsupporting

confidence: 91%

Surveillance of medically‐attended influenza in elderly patients from Romania—data from three consecutive influenza seasons (2015/16, 2016/17, and 2017/18)

Pițigoi

Streinu‐Cercel

Ivanciuc³

et al. 2020

Influenza Resp Viruses

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Background Influenza is an acute infection affecting all age groups; however, elderly patients are at an increased risk. We aim to describe the clinical characteristics and the circulation of influenza virus types in elderly patients admitted for severe acute respiratory infection (SARI) to a tertiary care hospital in Bucharest, Romania, part of the I‐MOVE+ hospital network. Methods We conducted an active surveillance study at the National Institute for Infectious Diseases “Prof. Dr Matei Balș,” Bucharest, Romania, during three consecutive influenza seasons: 2015/16, 2016/17, and 2017/18. All patients aged 65 and older admitted to our hospital for SARI were tested for influenza by PCR. Results A total of 349 eligible patients were tested during the study period, and 149 (42.7%) were confirmed with influenza. Most patients, 321 (92.5%) presented at least one underlying condition at the time of hospital admission, the most frequent being cardiovascular disease, 270 (78.3%). The main influenza viral subtype circulating in 2015/16 was A(H1N1)pdm09, followed by A(H3N2) in 2016/17 and B influenza in 2017/18. Case fatality was highest in the 2015/16 season (3.7%), 0% in 2016/17, and 1.0% in 2017/18. Vaccination coverage in elderly patients with SARI from our study population was 22 (6.3%) over the three seasons. Conclusions Our study has highlighted a high burden of comorbidities in elderly patients presenting with SARI during winter season in Romania. The influenza vaccine coverage rate needs to be substantially increased in the elderly population, through targeted interventions.

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Section: Discussionsupporting

confidence: 91%

Surveillance of medically‐attended influenza in elderly patients from Romania—data from three consecutive influenza seasons (2015/16, 2016/17, and 2017/18)

Pițigoi

Streinu‐Cercel

Ivanciuc³

et al. 2020

Influenza Resp Viruses

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“…Almost one-half of the patients were less than 5 years of age, and more than one-fifth of all patients had comorbidities. Influenza hospitalizations of young, otherwise healthy children have been frequently reported in previous seasons at the same hospital [7] and at other public healthcare facilities in Romania [5]. Young children have a higher risk of developing severe influenza illness as well as other complications (e.g., bacterial superinfections [14]), which emphasizes the importance of vaccination for this age group [1].…”

Section: Discussionmentioning

confidence: 99%

“…Two respiratory swabs were obtained from each patient: for patients aged < 14 years, nasopharyngeal and nasal swabs were collected; for patients aged ≥14 years, nasopharyngeal and pharyngeal swabs were obtained. Real-time reverse-transcription polymerase chain reaction assays were used to detect and differentiate influenza A (A/H1 and A/H3 subtypes), influenza B (Yamagata and Victoria lineages), and respiratory syncytial virus (RSV) from the swabs, as previously described [7].…”

Section: Methodsmentioning

confidence: 99%

“…Influenza vaccination is provided by health authorities in Romania to persons aged 65 years and older, patients with comorbidities, pregnant women, institutionalized persons, and social and healthcare workers [6, 7]. Despite this, Romania has an influenza vaccination coverage rate well below the WHO’s 75% target for key risk groups [6, 8].…”

Section: Introductionmentioning

confidence: 99%

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The 2017–2018 influenza season in Bucharest, Romania: epidemiology and characteristics of hospital admissions for influenza-like illness

et al. 2019

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BackgroundSeasonal influenza causes a considerable burden to healthcare services every year. To better measure the impact of severe influenza cases in Romania, we analyzed active surveillance data collected during the 2017–2018 season from patients admitted for influenza-like illness (ILI) at a tertiary care hospital in Bucharest.MethodsPatients admitted for acute ILI were included if they were resident in the Bucharest-Ilfov region, had been hospitalized for at least 24 h, and had onset of symptoms within 7 days before admission. Patient demographics, healthcare use, vaccination status, and outcome data were collected by questionnaire or by searching clinical records. Respiratory swabs were also obtained from each patient to confirm influenza A (A/H1 and A/H3 subtypes) or influenza B (Yamagata and Victoria lineages) infection by real-time reverse-transcription polymerase chain reaction assay.ResultsThe study included 502 patients, many (45.2%) of whom were aged < 5 years. Overall, 108 patients (21.5%) had one or more comorbidities. Seventeen adults aged 18–64 years (3.4%) had been vaccinated against influenza. Patients were hospitalized for a median of 5 days and most (90.4%) were prescribed antiviral treatment. More than one-half of the patients (n = 259, 51.6%) were positive for influenza. Most influenza cases were caused by B viruses (172/259, 66.4%), which were mostly of the B/Yamagata lineage (85 of 94 characterized, 90.4%). Most of the subtyped A viruses were A/H1 (59/74, 79.7%). A/H1 viruses were frequently detected in influenza-positive admissions throughout the 2017–2018 season, whereas the predominant B/Yamagata viruses were detected around the middle of the season, with a peak in cases at week 7 of 2018. Eleven patients were admitted to an intensive care unit; of these, one patient with confirmed B/Yamagata infection died.ConclusionsThese results show that seasonal influenza results in considerable hospitalization in Bucharest-Ilfov, Romania and suggest vaccine coverage should be extended, especially to the youngest age groups. The data from this study should help inform and optimize national influenza healthcare policies.

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“…We present the results of a three-year prospective epidemiological surveillance study of the characteristics of influenza in elderly patients with and without diabetes hospitalized for severe acute respiratory infection (SARI) in the institute during three consecutive influenza seasons (2015/16, 2016/17, and 2017/18), as part of the I-MOVE+ hospital network. 5,6 The study consisted of systematic screening of all patients aged 65 and older admitted to our hospital and meeting the following SARI case definition: 7 at least one of the following general signs or symptoms: fever or feverishness, malaise, headache, myalgia, altered clinical state (asthenia, anorexia, confusion, weight loss) PLUS at least one of the following respiratory signs or symptoms: cough, odynophagia, dyspnea. 7…”

Section: Methodsmentioning

confidence: 99%

Characteristics of influenza in elderly patients with and without diabetes, hospitalized for severe acute respiratory infection in a tertiary care hospital from Bucharest Romania – a three-year prospective epidemiological surveillance study

Pițigoi¹,

Nițescu²,

Streinu‐Cercel³

et al. 2019

Germs

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Introduction Patients with diabetes may be at a higher risk of developing complicated influenza. We report the characteristics of influenza in hospitalized elderly patients with and without diabetes, in three consecutive influenza seasons. Methods The study included patients admitted for severe acute respiratory infection (SARI) in the National Institute for Infectious Diseases "Prof. Dr. Matei Balș", Bucharest, during a three-year active epidemiological surveillance study (2015/16, 2016/17, 2017/18), in the I-MOVE+ hospital network. Results A total of 349 patients were tested by PCR over the duration of the study. The percentage of patients with diabetes was comparable throughout the seasons: 34.7%, 28.3% and 30.4% (p=0.587). Influenza A was the main viral type circulating in 2015/16 and 2016/17 (100% and 97.6%) in our study population, while in 2017/18, B viruses predominated (90.0%). Diabetics presented a higher median number of comorbidities (3 vs. 2) p<0.001, and twofold higher odds of also associating obesity (OR=2.1, 95%CI:1.3-3.4, p=0.003), compared to those without diabetes. Diabetics also tested positive for influenza more often (p=0.296). Only 6 patients with diabetes (5.4%) from our study had been vaccinated against influenza, and most (n=4) of those who had been vaccinated tested negative for influenza. Conclusions Our study is the first to describe the circulation of influenza viral types in elderly diabetic patients hospitalized for SARI. The results reinforce the national and international recommendation to vaccinate against influenza all patients with diabetes.

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The influenza season 2016/17 in Bucharest, Romania – surveillance data and clinical characteristics of patients with influenza-like illness admitted to a tertiary infectious diseases hospital

Cited by 12 publications

References 18 publications

Surveillance of medically‐attended influenza in elderly patients from Romania—data from three consecutive influenza seasons (2015/16, 2016/17, and 2017/18)

Surveillance of medically‐attended influenza in elderly patients from Romania—data from three consecutive influenza seasons (2015/16, 2016/17, and 2017/18)

The 2017–2018 influenza season in Bucharest, Romania: epidemiology and characteristics of hospital admissions for influenza-like illness

Characteristics of influenza in elderly patients with and without diabetes, hospitalized for severe acute respiratory infection in a tertiary care hospital from Bucharest Romania – a three-year prospective epidemiological surveillance study

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