Surveillance of influenza B severe hospitalized cases during 10 seasons in Catalonia: Does the lineage make a difference?
Por:
Soldevila, N, Basile, L, Martinez, A, Torner, N, Marcos, MA, Mosquera, MD, Anton, A, Andres, C, Rius, C, Pumarola, T, Dominguez, A
Publicada:
1 sep 2022
Ahead of Print:
1 jun 2022
Resumen:
Influenza B viruses circulate in two lineages (B/Victoria and B/Yamagata). Although classically affecting children, recently it has shown a high rate of infection and increased hospitalization in the elderly. To describe and analyze the clinical and epidemiological characteristics of severe hospitalized laboratory-confirmed influenza B virus (SHLCI-B) cases in Catalonia associated with mismatch from Influenza B virus strain included in the trivalent influenza vaccine (TIV). SHLCI-B was registered by the influenza sentinel surveillance system of Catalonia (PIDIRAC) during ten surveillance seasons from 2010 to 2020. Variables age, comorbidities, and vaccination status were recorded. Vaccine effectiveness was estimated as (1-OR) for intensive care unit (ICU) admission. Statistical significance was established at p < 0.05. A total of 1159 SHLCI-B were registered, of these 68.2% (791) corresponded to the 2017-2018 season; 21.8% (253) were admitted to ICU and 13.8% (160) were exitus; 62.5% (725) cases occurred in those aged >64 years; most frequent risk factor was cardiovascular disease (35.1%, 407) followed by chronic pulmonary obstructive disease-COPD (24.6%, 285) and diabetes (24.1%, 279). In four seasons, the predominant circulating lineage was B/Victoria, in two seasons the B/Yamagata lineage and four seasons had no IBV activity. Four seasons presented discordance with the strain included within the TIV. Vaccine effectiveness (VE) to prevent ICU admission was 31% (95% confidence interval [CI]: 4%-51%; p = 0.03); being 29% (95% CI: -3% to 51%) in discordant and 43% (95% CI:-43% to 77%) in concordant seasons. Significant differences were observed in the number of affected aged > 64 years (odds ratio [OR] = 2.5; 95% CI: 1.9-3.4; p < 0.001) and in patients with heart disease (OR = 2.40 95% CI: 1.7-3.4; p < 0.001), COPD (OR = 1.6 95% CI: 1.1-2.3; p = 0.01), and diabetes (OR = 1.5 95% CI: 1.1-2.1; p = 0.04) between discordant and concordant seasons. The increase in hospitalization rate in people> 64 years of age and those presenting comorbidities in seasons with circulating influenza B virus belonging to a lineage discordant with the strain included in the TIV and the decrease of VE to prevent ICU admissions evidence the vital need to administer the quadrivalent influenza vaccine regardless of the findings of predominant circulation in the previous season.
Filiaciones:
Soldevila, N:
Univ Barcelona, Dept Med, Barcelona, Spain
Basile, L:
Publ Hlth Agcy Catalonia, Barcelona, Spain
Martinez, A:
Publ Hlth Agcy Catalonia, Barcelona, Spain
Inst Salud Carlos III, CIBER Epidemiol & Publ Hlth CIBERESP, Madrid, Spain
Torner, N:
Univ Barcelona, Dept Med, Barcelona, Spain
Inst Salud Carlos III, CIBER Epidemiol & Publ Hlth CIBERESP, Madrid, Spain
Marcos, MA:
Hosp Clin Barcelona, Dept Microbiol, Barcelona, Spain
Mosquera, MD:
Hosp Clin Barcelona, Dept Microbiol, Barcelona, Spain
Anton, A:
Univ Autonoma Barcelona, Vall dHebron Inst Recerca VHIR, Microbiol Dept, Resp Viruses Unit,Vall dHebron Barcelona Hosp Cam, Barcelona, Spain
Inst Salud Carlos III, Ctr Invest Biomed Red Enfermedades Infecciosas CI, Madrid, Spain
Andres, C:
Univ Autonoma Barcelona, Vall dHebron Inst Recerca VHIR, Microbiol Dept, Resp Viruses Unit,Vall dHebron Barcelona Hosp Cam, Barcelona, Spain
Inst Salud Carlos III, Ctr Invest Biomed Red Enfermedades Infecciosas CI, Madrid, Spain
Rius, C:
Inst Salud Carlos III, CIBER Epidemiol & Publ Hlth CIBERESP, Madrid, Spain
Publ Hlth Agcy Barcelona, Barcelona, Spain
Pumarola, T:
Univ Autonoma Barcelona, Vall dHebron Inst Recerca VHIR, Microbiol Dept, Resp Viruses Unit,Vall dHebron Barcelona Hosp Cam, Barcelona, Spain
Inst Salud Carlos III, Ctr Invest Biomed Red Enfermedades Infecciosas CI, Madrid, Spain
Dominguez, A:
Univ Barcelona, Dept Med, Barcelona, Spain
Inst Salud Carlos III, CIBER Epidemiol & Publ Hlth CIBERESP, Madrid, Spain
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