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Estimation of influenza ‐ attributable medically attended acute respiratory illness by influenza type/subtype and age, Germany, 2001/02 – 2014/15

View Article: PubMed Central - PubMed

ABSTRACT

Background: The total burden of influenza in primary care is difficult to assess. The case definition of medically attended “acute respiratory infection” (MAARI) in the German physician sentinel is sensitive; however, it requires modelling techniques to derive estimates of disease attributable to influenza. We aimed to examine the impact of type/subtype and age.

Methods: Data on MAARI and virological results of respiratory samples (virological sentinel) were available from 2001/02 until 2014/15. We constructed a generalized additive regression model for the periodic baseline and the secular trend. The weekly number of influenza‐positive samples represented influenza activity. In a second step, we distributed the estimated influenza‐attributable MAARI (iMAARI) according to the distribution of types/subtypes in the virological sentinel.

Results: Season‐specific iMAARI ranged from 0.7% to 8.9% of the population. Seasons with the strongest impact were dominated by A(H3), and iMAARI attack rate of the pandemic 2009 (A(H1)pdm09) was 4.9%. Regularly the two child age groups (0‐4 and 5‐14 years old) had the highest iMAARI attack rates reaching frequently levels up to 15%‐20%. Influenza B affected the age group of 5‐ to 14‐year‐old children substantially more than any other age group. Sensitivity analyses demonstrated both comparability and stability of the model.

Conclusion: We constructed a model that is well suited to estimate the substantial impact of influenza on the primary care sector. A(H3) causes overall the greatest number of iMAARI, and influenza B has the greatest impact on school‐age children. The model may incorporate time series of other pathogens as they become available.

No MeSH data available.


Related in: MedlinePlus

Top panel: attack rates of influenza‐attributable medically attended acute respiratory infections (iMAARI), median of 14 seasons (2001/02‐2014/15), by age (shown are mid‐points of five age groups). Bottom panel: age‐specific median and interquartile range of iMAARI attack rates across all seasons with typical pattern stratified by type/subtype. Points for the medians were connected by lines to guide the eye
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irv12434-fig-0005: Top panel: attack rates of influenza‐attributable medically attended acute respiratory infections (iMAARI), median of 14 seasons (2001/02‐2014/15), by age (shown are mid‐points of five age groups). Bottom panel: age‐specific median and interquartile range of iMAARI attack rates across all seasons with typical pattern stratified by type/subtype. Points for the medians were connected by lines to guide the eye

Mentions: Figure 5 (top panel) sums up the age‐ and season‐specific all‐influenza iMAARI attack rates displaying the median and the interquartile range of all 14 seasons. The median seasonal attack rates were approximately 9% in both child age groups and 4% among the 15‐ to 34‐year‐old age group and went down to approximately 0.5% among the 60+.


Estimation of influenza ‐ attributable medically attended acute respiratory illness by influenza type/subtype and age, Germany, 2001/02 – 2014/15
Top panel: attack rates of influenza‐attributable medically attended acute respiratory infections (iMAARI), median of 14 seasons (2001/02‐2014/15), by age (shown are mid‐points of five age groups). Bottom panel: age‐specific median and interquartile range of iMAARI attack rates across all seasons with typical pattern stratified by type/subtype. Points for the medians were connected by lines to guide the eye
© Copyright Policy - creativeCommonsBy
Related In: Results  -  Collection

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getmorefigures.php?uid=PMC5304576&req=5

irv12434-fig-0005: Top panel: attack rates of influenza‐attributable medically attended acute respiratory infections (iMAARI), median of 14 seasons (2001/02‐2014/15), by age (shown are mid‐points of five age groups). Bottom panel: age‐specific median and interquartile range of iMAARI attack rates across all seasons with typical pattern stratified by type/subtype. Points for the medians were connected by lines to guide the eye
Mentions: Figure 5 (top panel) sums up the age‐ and season‐specific all‐influenza iMAARI attack rates displaying the median and the interquartile range of all 14 seasons. The median seasonal attack rates were approximately 9% in both child age groups and 4% among the 15‐ to 34‐year‐old age group and went down to approximately 0.5% among the 60+.

View Article: PubMed Central - PubMed

ABSTRACT

Background: The total burden of influenza in primary care is difficult to assess. The case definition of medically attended “acute respiratory infection” (MAARI) in the German physician sentinel is sensitive; however, it requires modelling techniques to derive estimates of disease attributable to influenza. We aimed to examine the impact of type/subtype and age.

Methods: Data on MAARI and virological results of respiratory samples (virological sentinel) were available from 2001/02 until 2014/15. We constructed a generalized additive regression model for the periodic baseline and the secular trend. The weekly number of influenza‐positive samples represented influenza activity. In a second step, we distributed the estimated influenza‐attributable MAARI (iMAARI) according to the distribution of types/subtypes in the virological sentinel.

Results: Season‐specific iMAARI ranged from 0.7% to 8.9% of the population. Seasons with the strongest impact were dominated by A(H3), and iMAARI attack rate of the pandemic 2009 (A(H1)pdm09) was 4.9%. Regularly the two child age groups (0‐4 and 5‐14 years old) had the highest iMAARI attack rates reaching frequently levels up to 15%‐20%. Influenza B affected the age group of 5‐ to 14‐year‐old children substantially more than any other age group. Sensitivity analyses demonstrated both comparability and stability of the model.

Conclusion: We constructed a model that is well suited to estimate the substantial impact of influenza on the primary care sector. A(H3) causes overall the greatest number of iMAARI, and influenza B has the greatest impact on school‐age children. The model may incorporate time series of other pathogens as they become available.

No MeSH data available.


Related in: MedlinePlus