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Rose AM, Nicolay N, Sandonis Martín V, Mazagatos C, Petrović G, Baruch J, Denayer S, Seyler L, Domegan L, Launay O, Machado A, Burgui C, Vaikutyte R, Niessen FA, Loghin II, Husa P, Aouali N, Panagiotakopoulos G, Tolksdorf K, Horváth JK, Howard J, Pozo F, Gallardo V, Nonković D, Džiugytė A, Bossuyt N, Demuyser T, Duffy R, Luong Nguyen LB, Kislaya I, Martínez-Baz I, Gefenaite G, Knol MJ, Popescu C, Součková L, Simon M, Michelaki S, Reiche J, Ferenczi A, Delgado-Sanz C, Lovrić Makarić Z, Cauchi JP, Barbezange C, Van Nedervelde E, O'Donnell J, Durier C, Guiomar R, Castilla J, Jonikaite I, Bruijning-Verhagen PC, Lazar M, Demlová R, Wirtz G, Amerali M, Dürrwald R, Kunstár MP, Kissling E, Bacci S, Valenciano M. Vaccine effectiveness against COVID-19 hospitalisation in adults (≥ 20 years) during Omicron-dominant circulation: I-MOVE-COVID-19 and VEBIS SARI VE networks, Europe, 2021 to 2022. Euro Surveill 2023; 28:2300187. [PMID: 37997665 PMCID: PMC10668256 DOI: 10.2807/1560-7917.es.2023.28.47.2300187] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2023] [Accepted: 07/24/2023] [Indexed: 11/25/2023] Open
Abstract
IntroductionThe I-MOVE-COVID-19 and VEBIS hospital networks have been measuring COVID-19 vaccine effectiveness (VE) in participating European countries since early 2021.AimWe aimed to measure VE against PCR-confirmed SARS-CoV-2 in patients ≥ 20 years hospitalised with severe acute respiratory infection (SARI) from December 2021 to July 2022 (Omicron-dominant period).MethodsIn both networks, 46 hospitals (13 countries) follow a similar test-negative case-control protocol. We defined complete primary series vaccination (PSV) and first booster dose vaccination as last dose of either vaccine received ≥ 14 days before symptom onset (stratifying first booster into received < 150 and ≥ 150 days after last PSV dose). We measured VE overall, by vaccine category/product, age group and time since first mRNA booster dose, adjusting by site as a fixed effect, and by swab date, age, sex, and presence/absence of at least one commonly collected chronic condition.ResultsWe included 2,779 cases and 2,362 controls. The VE of all vaccine products combined against hospitalisation for laboratory-confirmed SARS-CoV-2 was 43% (95% CI: 29-54) for complete PSV (with last dose received ≥ 150 days before onset), while it was 59% (95% CI: 51-66) after addition of one booster dose. The VE was 85% (95% CI: 78-89), 70% (95% CI: 61-77) and 36% (95% CI: 17-51) for those with onset 14-59 days, 60-119 days and 120-179 days after booster vaccination, respectively.ConclusionsOur results suggest that, during the Omicron period, observed VE against SARI hospitalisation improved with first mRNA booster dose, particularly for those having symptom onset < 120 days after first booster dose.
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Affiliation(s)
| | - Nathalie Nicolay
- European Centre for Disease Prevention and Control, Stockholm, Sweden
| | | | - Clara Mazagatos
- National Centre for Epidemiology, Institute of Health Carlos III, Madrid, Spain
- Consortium for Biomedical Research in Epidemiology and Public Health (CIBERESP), Madrid, Spain
| | | | - Joaquin Baruch
- IDCU within Health promotion and disease prevention Directorate, G'mangia, Malta
| | | | - Lucie Seyler
- Universitair Ziekenhuis Brussel, Brussels, Belgium
| | - Lisa Domegan
- Health Service Executive-Health Protection Surveillance Centre, Dublin, Ireland
| | - Odile Launay
- Inserm, CIC Cochin-Pasteur, Paris, France
- AP-HP, Hôpital Cochin, Paris, France
- Faculty of Medicine, University of Paris City, Paris, France
| | - Ausenda Machado
- National Institute of Health Dr Ricardo Jorge, Lisbon, Portugal
| | - Cristina Burgui
- Instituto de Salud Pública de Navarra-IdiSNA, Pamplona, Spain
- Consortium for Biomedical Research in Epidemiology and Public Health (CIBERESP), Madrid, Spain
| | | | - F Annabel Niessen
- Centre for Infectious Disease Control, National Institute for Public Health and the Environment, Bilthoven, the Netherlands
| | - Isabela I Loghin
- St. Parascheva Clinical Hospital of Infectious Diseases, Iasi, Romania
- Grigore T. Popa University of Medicine and Pharmacy, Iasi, Romania
| | - Petr Husa
- Faculty of Medicine, Masaryk University, Brno, Czechia
- University Hospital Brno, Brno, Czechia
| | | | | | | | - Judit Krisztina Horváth
- National Laboratory for Health Security, Epidemiology and Surveillance Centre, Semmelweis University, Budapest, Hungary
| | | | - Francisco Pozo
- National Centre for Microbiology, Institute of Health Carlos III, Madrid, Spain
| | - Virtudes Gallardo
- Dirección General de Salud Pública y Ordenación Farmacéutica, Junta de Andalucía, Spain
| | - Diana Nonković
- Teaching Public Health Institute of Split-Dalmatia County, Split, Croatia
| | - Aušra Džiugytė
- IDCU within Health promotion and disease prevention Directorate, G'mangia, Malta
| | | | | | - Róisín Duffy
- Health Service Executive-Health Protection Surveillance Centre, Dublin, Ireland
| | | | - Irina Kislaya
- National Institute of Health Dr Ricardo Jorge, Lisbon, Portugal
| | - Iván Martínez-Baz
- Instituto de Salud Pública de Navarra-IdiSNA, Pamplona, Spain
- Consortium for Biomedical Research in Epidemiology and Public Health (CIBERESP), Madrid, Spain
| | - Giedre Gefenaite
- Faculty of Medicine, Lund University, Lund, Sweden
- Lithuanian University of Health Sciences, Kaunas, Lithuania
| | - Mirjam J Knol
- Centre for Infectious Disease Control, National Institute for Public Health and the Environment, Bilthoven, the Netherlands
| | - Corneliu Popescu
- Dr Victor Babes Clinical Hospital of Infectious and Tropical Diseases, Bucharest, Romania
- Carol Davila University of Medicine and Pharmacy, Bucharest, Romania
| | | | - Marc Simon
- Centre Hospitalier de Luxembourg, Luxembourg
| | | | | | - Annamária Ferenczi
- National Laboratory for Health Security, Epidemiology and Surveillance Centre, Semmelweis University, Budapest, Hungary
| | - Concepción Delgado-Sanz
- National Centre for Epidemiology, Institute of Health Carlos III, Madrid, Spain
- Consortium for Biomedical Research in Epidemiology and Public Health (CIBERESP), Madrid, Spain
| | | | - John Paul Cauchi
- IDCU within Health promotion and disease prevention Directorate, G'mangia, Malta
| | | | | | - Joan O'Donnell
- Health Service Executive-Health Protection Surveillance Centre, Dublin, Ireland
| | | | - Raquel Guiomar
- National Institute of Health Dr Ricardo Jorge, Lisbon, Portugal
| | - Jesús Castilla
- Instituto de Salud Pública de Navarra-IdiSNA, Pamplona, Spain
- Consortium for Biomedical Research in Epidemiology and Public Health (CIBERESP), Madrid, Spain
| | | | - Patricia Cjl Bruijning-Verhagen
- Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht, the Netherlands
- Centre for Infectious Disease Control, National Institute for Public Health and the Environment, Bilthoven, the Netherlands
| | - Mihaela Lazar
- "Cantacuzino" National Military Medical Institute for Research-Development, Bucharest, Romania
| | | | - Gil Wirtz
- Centre Hospitalier de Luxembourg, Luxembourg
| | - Marina Amerali
- National Public Health Organisation (EODY), Athens, Greece
| | | | - Mihály Pál Kunstár
- National Laboratory for Health Security, Epidemiology and Surveillance Centre, Semmelweis University, Budapest, Hungary
| | | | - Sabrina Bacci
- European Centre for Disease Prevention and Control, Stockholm, Sweden
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2
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Canelas-Fernández J, Mazagatos C, Delgado-Sanz C, Larrauri A. Influenza hospitalisations in Spain between the last influenza and COVID-19 pandemic (2009-2019). Epidemiol Infect 2023; 151:e177. [PMID: 37791484 PMCID: PMC10600905 DOI: 10.1017/s0950268823001620] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2023] [Revised: 09/11/2023] [Accepted: 09/15/2023] [Indexed: 10/05/2023] Open
Abstract
Knowing the burden of severe disease caused by influenza is essential for disease risk communication, to understand the true impact of vaccination programmes and to guide public health and disease control measures. We estimated the number of influenza-attributable hospitalisations in Spain during the 2010-2011 to 2019-2020 seasons - based on the hospitalisations due to severe acute respiratory infection (SARI) in Spain using the hospital discharge database and virological influenza information from the Spanish Influenza Sentinel Surveillance System (SISSS). The weekly numbers of influenza-attributable hospitalisations were calculated by multiplying the weekly SARI hospitalisations by the weekly influenza virus positivity, obtained from the SISSS in each season, stratified by age group and sex. The influenza-related hospitalisation burden is age-specific and varies significantly by influenza season. People aged 65 and over yielded the highest average influenza-attributable hospitalisation rates per season (615.6 per 100,000), followed by children aged under 5 (251.2 per 100,000). These results provide an essential contribution to influenza control and to improving existing vaccination programmes, as well as to the optimisation and planning of health resources and policies.
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Affiliation(s)
| | - Clara Mazagatos
- National Centre of Epidemiology, CIBERESP, Carlos III Health Institute, Madrid, Spain
| | | | - Amparo Larrauri
- National Centre of Epidemiology, CIBERESP, Carlos III Health Institute, Madrid, Spain
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3
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Mazagatos C, Delgado-Sanz C, Milagro A, Liébana-Rodríguez M, Larrauri A. Impact of Influenza Vaccination on the Burden of Severe Influenza in the Elderly: Spain, 2017-2020. Vaccines (Basel) 2023; 11:1110. [PMID: 37376499 DOI: 10.3390/vaccines11061110] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2023] [Revised: 06/14/2023] [Accepted: 06/15/2023] [Indexed: 06/29/2023] Open
Abstract
Annual influenza vaccination is the main strategy to reduce the burden of seasonal influenza epidemics and is recommended for the elderly in most countries with influenza vaccination strategies, with the main objective of preventing hospitalizations and mortality associated with seasonal influenza in this age group. Studies from different countries have estimated the benefits of seasonal influenza vaccination programs in the elderly, preventing a considerable number of cases, hospitalizations and deaths every year. A study measured the number of medically attended confirmed influenza cases in primary care that are prevented annually by vaccination in the population aged 65 and older in Spain, the Netherlands and Portugal, but estimates of the impact of the national influenza vaccination program in the prevention of severe disease in Spain are lacking. The two objectives of this study were to estimate the burden of severe influenza disease in the Spanish population and to measure the impact of influenza vaccination in the prevention of these outcomes in the population aged 65 years and older. Using influenza surveillance systems put in place before the COVID-19 pandemic, we conducted a retrospective observational study to estimate the burden of hospitalizations and ICU admissions in Spain between 2017-18 and 2019-20, by season and age group. Burden estimates for the 65+ group, combined with vaccine effectiveness (VE) and vaccination coverage (VC) data, were used as input data in an ecological, observational study to estimate the impact of the influenza vaccination program on the elderly. We found a higher burden of severe influenza disease in seasons 2017-18 and 2018-19, with A(H3N2) circulation, and in the youngest and oldest age groups. In those aged 65 and older, we estimated an average of 9900 influenza hospitalizations and 1541 ICU admissions averted by vaccination each year. Seasonal influenza vaccination was able to prevent between 11 and 26% influenza hospitalizations and around 40% ICU admissions in the elderly in the three pre-pandemic seasons. In conclusion, our study complements previous analyses in the primary care setting in Spain and demonstrates the benefits of the annual influenza vaccination program in the prevention of severe influenza disease in the elderly, even in seasons with moderate VE.
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Affiliation(s)
- Clara Mazagatos
- National Centre of Epidemiology, Institute of Health Carlos III, 28029 Madrid, Spain
- CIBER Epidemiología y Salud Pública (CIBERESP), 28029 Madrid, Spain
| | - Concepción Delgado-Sanz
- National Centre of Epidemiology, Institute of Health Carlos III, 28029 Madrid, Spain
- CIBER Epidemiología y Salud Pública (CIBERESP), 28029 Madrid, Spain
| | - Ana Milagro
- Miguel Servet University Hospital, Microbiology, 50009 Zaragoza, Spain
- Health Research Institute Aragón, 50009 Zaragoza, Spain
| | - María Liébana-Rodríguez
- Servicio Medicina Preventiva, Hospital Universitario Virgen de las Nieves, 18014 Granada, Spain
| | - Amparo Larrauri
- National Centre of Epidemiology, Institute of Health Carlos III, 28029 Madrid, Spain
- CIBER Epidemiología y Salud Pública (CIBERESP), 28029 Madrid, Spain
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4
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Singh DE, Marinescu MC, Guzmán-Merino M, Durán C, Delgado-Sanz C, Gomez-Barroso D, Carretero J. Corrigendum: Simulation of COVID-19 propagation scenarios in the Madrid metropolitan area. Front Public Health 2023; 11:1180932. [PMID: 37006587 PMCID: PMC10062450 DOI: 10.3389/fpubh.2023.1180932] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2023] [Accepted: 03/07/2023] [Indexed: 03/17/2023] Open
Abstract
[This corrects the article DOI: 10.3389/fpubh.2021.636023.].
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Affiliation(s)
- David E. Singh
- Department Computer Science, Universidad Carlos III de Madrid, Leganés, Spain
- *Correspondence: David E. Singh
| | | | | | - Christian Durán
- Department Computer Science, Universidad Carlos III de Madrid, Leganés, Spain
| | - Concepción Delgado-Sanz
- CIBER en Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
- National Centre for Epidemiology, Carlos III Institute of Health, Madrid, Spain
| | - Diana Gomez-Barroso
- CIBER en Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
- National Centre for Epidemiology, Carlos III Institute of Health, Madrid, Spain
| | - Jesus Carretero
- Department Computer Science, Universidad Carlos III de Madrid, Leganés, Spain
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5
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Adlhoch C, Delgado-Sanz C, Carnahan A, Larrauri A, Popovici O, Bossuyt N, Thomas I, Kynčl J, Slezak P, Brytting M, Guiomar R, Redlberger-Fritz M, Maistre Melillo J, Melillo T, van Gageldonk-Lafeber AB, Marbus SD, O’Donnell J, Domegan L, Gomes Dias J, Olsen SJ. Effect of neuraminidase inhibitor (oseltamivir) treatment on outcome of hospitalised influenza patients, surveillance data from 11 EU countries, 2010 to 2020. Euro Surveill 2023; 28:2200340. [PMID: 36700868 PMCID: PMC9881178 DOI: 10.2807/1560-7917.es.2023.28.4.2200340] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/27/2023] Open
Abstract
BackgroundTimely treatment with neuraminidase inhibitors (NAI) can reduce severe outcomes in influenza patients.AimWe assessed the impact of antiviral treatment on in-hospital deaths of laboratory-confirmed influenza patients in 11 European Union countries from 2010/11 to 2019/20.MethodsCase-based surveillance data from hospitalised patients with known age, sex, outcome, ward, vaccination status, timing of antiviral treatment, and hospitalisation were obtained. A mixed effect logistic regression model using country as random intercept was applied to estimate the adjusted odds ratio (aOR) for in-hospital death in patients treated with NAIs vs not treated.ResultsOf 19,937 patients, 31% received NAIs within 48 hours of hospital admission. Older age (60-79 years aOR 3.0, 95% CI: 2.4-3.8; 80 years 8.3 (6.6-10.5)) and intensive care unit admission (3.8, 95% CI: 3.4-4.2) increased risk of dying, while early hospital admission after symptom onset decreased risk (aOR 0.91, 95% CI: 0.90-0.93). NAI treatment initiation within 48 hours and up to 7 days reduced risk of dying (0-48 hours aOR 0.51, 95% CI: 0.45-0.59; 3-4 days 0.59 (0.51-0.67); 5-7 days 0.64 (0.56-0.74)), in particular in patients 40 years and older (e.g. treatment within 48 hours: 40-59 years aOR 0.43, 95% CI: 0.28-0.66; 60-79 years 0.50 (0.39-0.63); ≥80 years 0.51 (0.42-0.63)).ConclusionNAI treatment given within 48 hours and possibly up to 7 days after symptom onset reduced risk of in-hospital death. NAI treatment should be considered in older patients to prevent severe outcomes.
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Affiliation(s)
- Cornelia Adlhoch
- European Centre for Disease Prevention and Control (ECDC), Stockholm, Sweden
| | | | | | - Amparo Larrauri
- National Centre of Epidemiology, CIBERESP, Carlos III Health Institute, Madrid, Spain
| | - Odette Popovici
- National Institute of Public Health Romania-National Centre for Communicable Diseases Surveillance and Control, Bucharest, Romania
| | | | | | - Jan Kynčl
- Department of Infectious Diseases Epidemiology, National Institute of Public Health, Prague, Czechia
| | - Pavel Slezak
- Department of Infectious Diseases Epidemiology, National Institute of Public Health, Prague, Czechia
| | - Mia Brytting
- Public Health Agency of Sweden, Stockholm, Sweden
| | - Raquel Guiomar
- National Influenza Reference Laboratory, National Institute of Health Dr. Ricardo Jorge, Lisbon, Portugal
| | | | | | - Tanya Melillo
- Infectious Disease prevention and Control unit, Malta
| | | | - Sierk D. Marbus
- National Institute for Public Health and the Environment (RIVM), Bilthoven, the Netherlands
| | - Joan O’Donnell
- Health Service Executive-Health Protection Surveillance Centre, Dublin, Ireland
| | - Lisa Domegan
- Health Service Executive-Health Protection Surveillance Centre, Dublin, Ireland
| | - Joana Gomes Dias
- European Centre for Disease Prevention and Control (ECDC), Stockholm, Sweden
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6
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Mazagatos C, Delgado-Sanz C, Monge S, Pozo F, Oliva J, Sandonis V, Gandarillas A, Quiñones-Rubio C, Ruiz-Sopeña C, Gallardo-García V, Basile L, Barranco-Boada MI, Hidalgo-Pardo O, Vazquez-Cancela O, García-Vázquez M, Fernández-Sierra A, Milagro-Beamonte A, Ordobás M, Martínez-Ochoa E, Fernández-Arribas S, Lorusso N, Martínez A, García-Fulgueiras A, Sastre-Palou B, Losada-Castillo I, Martínez-Cuenca S, Rodríguez-Del Águila M, Latorre M, Larrauri A. COVID-19 vaccine effectiveness against hospitalization due to SARS-CoV-2: A test-negative design study based on Severe Acute Respiratory Infection (SARI) sentinel surveillance in Spain. Influenza Other Respir Viruses 2022; 16:1014-1025. [PMID: 35880469 PMCID: PMC9350393 DOI: 10.1111/irv.13026] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2022] [Revised: 07/05/2022] [Accepted: 07/07/2022] [Indexed: 11/26/2022] Open
Abstract
Background With the emergence of SARS‐CoV‐2, influenza surveillance systems in Spain were transformed into a new syndromic sentinel surveillance system. The Acute Respiratory Infection Surveillance System (SiVIRA in Spanish) is based on a sentinel network for acute respiratory infection (ARI) surveillance in primary care and a network of sentinel hospitals for severe ARI (SARI) surveillance in hospitals. Methods Using a test‐negative design and data from SARI admissions notified to SiVIRA between January 1 and October 3, 2021, we estimated COVID‐19 vaccine effectiveness (VE) against hospitalization, by age group, vaccine type, time since vaccination, and SARS‐CoV‐2 variant. Results VE was 89% (95% CI: 83–93) against COVID‐19 hospitalization overall in persons aged 20 years and older. VE was higher for mRNA vaccines, and lower for those aged 80 years and older, with a decrease in protection beyond 3 months of completing vaccination, and a further decrease after 5 months. We found no differences between periods with circulation of Alpha or Delta SARS‐CoV‐2 variants, although variant‐specific VE was slightly higher against Alpha. Conclusions The SiVIRA sentinel hospital surveillance network in Spain was able to describe clinical and epidemiological characteristics of SARI hospitalizations and provide estimates of COVID‐19 VE in the population under surveillance. Our estimates add to evidence of high effectiveness of mRNA vaccines against severe COVID‐19 and waning of protection with time since vaccination in those aged 80 or older. No substantial differences were observed between SARS‐CoV‐2 variants (Alpha vs. Delta).
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Affiliation(s)
- Clara Mazagatos
- National Centre for Epidemiology, Institute of Health Carlos III, Madrid, Spain.,Consortium for Biomedical Research in Epidemiology and Public Health (CIBERESP), Madrid, Spain
| | - Concepción Delgado-Sanz
- National Centre for Epidemiology, Institute of Health Carlos III, Madrid, Spain.,Consortium for Biomedical Research in Epidemiology and Public Health (CIBERESP), Madrid, Spain
| | - Susana Monge
- National Centre for Epidemiology, Institute of Health Carlos III, Madrid, Spain.,Consortium for Biomedical Research in Infectious Diseases (CIBERINFEC), Madrid, Spain
| | - Francisco Pozo
- Consortium for Biomedical Research in Epidemiology and Public Health (CIBERESP), Madrid, Spain.,National Centre for Microbiology, Institute of Health Carlos III, Madrid, Spain
| | - Jesús Oliva
- National Centre for Epidemiology, Institute of Health Carlos III, Madrid, Spain.,Consortium for Biomedical Research in Epidemiology and Public Health (CIBERESP), Madrid, Spain
| | - Virginia Sandonis
- National Centre for Microbiology, Institute of Health Carlos III, Madrid, Spain
| | - Ana Gandarillas
- Subdirección General de Epidemiología, Dirección General de Salud Pública, Madrid, Spain
| | - Carmen Quiñones-Rubio
- Servicio de Epidemiología y Prevención Sanitaria, Dirección General de Salud Pública, Consumo y Cuidados, Logroño, Spain
| | | | - Virtudes Gallardo-García
- Dirección General de Salud Pública y Ordenación Farmacéutica, Junta de Andalucía, Seville, Spain
| | - Luca Basile
- Subdirección General de Vigilancia y Respuesta a Emergencias de Salud Pública, Agencia de Salud Pública, Catalonia, Spain
| | | | - Olga Hidalgo-Pardo
- Servicio de Medicina Preventiva Hospital Universitario Son Espases, Servicio de Epidemiología, Consellería de Salut, Palma, Spain
| | - Olalla Vazquez-Cancela
- Servicio de Medicina Preventiva, Complejo Hospitalario Universitario de Santiago, Santiago de Compostela, Spain
| | - Miriam García-Vázquez
- Vigilancia Epidemiológica, Dirección General de Salud Pública, Departamento de Sanidad, Gobierno de Aragón, Zaragoza, Spain
| | | | - Ana Milagro-Beamonte
- Laboratorio de Microbiología, Hospital Universitario Miguel Servet, Zaragoza, Spain.,Instituto de Investigación Sanitaria Aragón (IIS Aragón), Zaragoza, Spain
| | - María Ordobás
- Subdirección General de Epidemiología, Dirección General de Salud Pública, Madrid, Spain
| | - Eva Martínez-Ochoa
- Servicio de Epidemiología y Prevención Sanitaria, Dirección General de Salud Pública, Consumo y Cuidados, Logroño, Spain
| | | | - Nicola Lorusso
- Dirección General de Salud Pública y Ordenación Farmacéutica, Junta de Andalucía, Seville, Spain
| | - Ana Martínez
- Consortium for Biomedical Research in Epidemiology and Public Health (CIBERESP), Madrid, Spain.,Subdirección General de Vigilancia y Respuesta a Emergencias de Salud Pública, Agencia de Salud Pública, Catalonia, Spain
| | - Ana García-Fulgueiras
- Consortium for Biomedical Research in Epidemiology and Public Health (CIBERESP), Madrid, Spain.,Servicio de Epidemiología, Dirección General de Salud Pública, Consejería de Salud, Murcia, Spain
| | - Bartolomé Sastre-Palou
- Servicio de Medicina Preventiva Hospital Universitario Son Espases, Servicio de Epidemiología, Consellería de Salut, Palma, Spain
| | - Isabel Losada-Castillo
- Servizo de Epidemioloxía, Dirección Xeral de Saúde Pública, Consellería de Sanidade, Xunta de Galicia, Galicia, Spain
| | - Silvia Martínez-Cuenca
- Vigilancia Epidemiológica, Dirección General de Salud Pública, Departamento de Sanidad, Gobierno de Aragón, Zaragoza, Spain
| | | | - Miriam Latorre
- Laboratorio de Microbiología, Hospital Universitario Miguel Servet, Zaragoza, Spain.,Instituto de Investigación Sanitaria Aragón (IIS Aragón), Zaragoza, Spain
| | - Amparo Larrauri
- National Centre for Epidemiology, Institute of Health Carlos III, Madrid, Spain.,Consortium for Biomedical Research in Epidemiology and Public Health (CIBERESP), Madrid, Spain
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7
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Guzmán-Merino M, Durán C, Marinescu MC, Delgado-Sanz C, Gomez-Barroso D, Carretero J, Singh DE. Assessing population-sampling strategies for reducing the COVID-19 incidence. Comput Biol Med 2021; 139:104938. [PMID: 34678482 PMCID: PMC8507586 DOI: 10.1016/j.compbiomed.2021.104938] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2021] [Revised: 10/08/2021] [Accepted: 10/09/2021] [Indexed: 01/04/2023]
Abstract
As long as critical levels of vaccination have not been reached to ensure heard immunity, and new SARS-CoV-2 strains are developing, the only realistic way to reduce the infection speed in a population is to track the infected individuals before they pass on the virus. Testing the population via sampling has shown good results in slowing the epidemic spread. Sampling can be implemented at different times during the epidemic and may be done either per individual or for combined groups of people at a time. The work we present here makes two main contributions. We first extend and refine our scalable agent-based COVID-19 simulator to incorporate an improved socio-demographic model which considers professions, as well as a more realistic population mixing model based on contact matrices per country. These extensions are necessary to develop and test various sampling strategies in a scenario including the 62 largest cities in Spain; this is our second contribution. As part of the evaluation, we also analyze the impact of different parameters, such as testing frequency, quarantine time, percentage of quarantine breakers, or group testing, on sampling efficacy. Our results show that the most effective strategies are pooling, rapid antigen test campaigns, and requiring negative testing for access to public areas. The effectiveness of all these strategies can be greatly increased by reducing the number of contacts for infected individual.
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Affiliation(s)
| | | | | | - Concepción Delgado-Sanz
- CIBER en Epidemiología y Salud Pública (CIBERESP), Madrid, Spain; National Centre for Epidemiology, Carlos III Institute of Health, Madrid, Spain
| | - Diana Gomez-Barroso
- CIBER en Epidemiología y Salud Pública (CIBERESP), Madrid, Spain; National Centre for Epidemiology, Carlos III Institute of Health, Madrid, Spain
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Nicolay N, Innocenti F, Beauté J, Učakar V, Grgič Vitek M, Poukka E, Hannila-Handelberg T, Gauci C, Melillo T, Georgakopoulou T, Jarkovsky J, Slezak P, Delgado-Sanz C, Olmedo-Lucerón C, Suija H, Liausediene R, O'Lorcain P, Murphy N, Peralta-Santos A, Casaca P, Gregoriou I, Bundle N, Spiteri G, Ravasi G. Initial assessment of the COVID-19 vaccination's impact on case numbers, hospitalisations and deaths in people aged 80 years and older, 15 EU/EEA countries, December 2020 to May 2021. Euro Surveill 2021; 26:2101030. [PMID: 34857068 PMCID: PMC8641072 DOI: 10.2807/1560-7917.es.2021.26.48.2101030] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2021] [Accepted: 12/02/2021] [Indexed: 11/20/2022] Open
Abstract
Prioritisation of elderly people in COVID-19 vaccination campaigns aimed at reducing severe outcomes in this group. Using EU/EEA surveillance and vaccination uptake, we estimated the risk ratio of case, hospitalisation and death notifications in people 80 years and older compared with 25-59-year-olds. Highest impact was observed for full vaccination uptake 80% or higher with reductions in notification rates of cases up to 65% (IRR: 0.35; 95% CI: 0.13-0.99), hospitalisations up to 78% (IRR: 0.22; 95% CI: 0.13-0.37) and deaths up to 84% (IRR: 0.16; 95% CI: 0.13-0.20).
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Affiliation(s)
- Nathalie Nicolay
- European Centre for Disease Prevention and Control (ECDC), Solna, Sweden
| | - Francesco Innocenti
- European Centre for Disease Prevention and Control (ECDC), Solna, Sweden
- Epidemiology Unit, Regional Health Agency of Tuscany, Florence, Italy
| | - Julien Beauté
- European Centre for Disease Prevention and Control (ECDC), Solna, Sweden
| | | | | | - Eero Poukka
- Finnish Institute for Health and Welfare, Helsinki, Finland
| | | | - Charmaine Gauci
- Health Promotion and Disease Prevention Directorate, Msida, Malta
| | - Tanya Melillo
- Health Promotion and Disease Prevention Directorate, Msida, Malta
| | - Theano Georgakopoulou
- Department of Epidemiological Surveillance and Intervention of the National Public Health Organization (NPHO), Athens, Greece
| | - Jiri Jarkovsky
- Data analysis department, Institute of Health Information and Statistics of the Czech Republic, Prague, Czechia
| | - Pavel Slezak
- Department of Infectious Diseases Epidemiology, National Institute of Public Health, Prague, Czechia
| | | | | | - Heleene Suija
- Department of Communicable Diseases, Health Board, Tallin, Estonia
| | | | | | - Niamh Murphy
- Health Protection Surveillance Centre, Dublin, Ireland
| | - André Peralta-Santos
- Directorate of Information and Analysis, Directorate-General of Health, Lisbon, Portugal
| | - Pedro Casaca
- Directorate of Information and Analysis, Directorate-General of Health, Lisbon, Portugal
| | | | - Nick Bundle
- European Centre for Disease Prevention and Control (ECDC), Solna, Sweden
| | - Gianfranco Spiteri
- European Centre for Disease Prevention and Control (ECDC), Solna, Sweden
| | - Giovanni Ravasi
- European Centre for Disease Prevention and Control (ECDC), Solna, Sweden
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9
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Staadegaard L, Caini S, Wangchuk S, Thapa B, de Almeida WAF, de Carvalho FC, Fasce RA, Bustos P, Kyncl J, Novakova L, Caicedo AB, de Mora Coloma DJ, Meijer A, Hooiveld M, Huang QS, Wood T, Guiomar R, Rodrigues AP, Lee VJM, Ang LW, Cohen C, Moyes J, Larrauri A, Delgado-Sanz C, Demont C, Bangert M, Dückers M, van Summeren J, Paget J. Defining the seasonality of respiratory syncytial virus around the world: National and subnational surveillance data from 12 countries. Influenza Other Respir Viruses 2021; 15:732-741. [PMID: 34255934 PMCID: PMC8542954 DOI: 10.1111/irv.12885] [Citation(s) in RCA: 31] [Impact Index Per Article: 10.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2021] [Accepted: 06/14/2021] [Indexed: 11/28/2022] Open
Abstract
Background Respiratory syncytial virus (RSV) infections are one of the leading causes of lower respiratory tract infections and have a major burden on society. For prevention and control to be deployed effectively, an improved understanding of the seasonality of RSV is necessary. Objectives The main objective of this study was to contribute to a better understanding of RSV seasonality by examining the GERi multi‐country surveillance dataset. Methods RSV seasons were included in the analysis if they contained ≥100 cases. Seasonality was determined using the “average annual percentage” method. Analyses were performed at a subnational level for the United States and Brazil. Results We included 601 425 RSV cases from 12 countries. Most temperate countries experienced RSV epidemics in the winter, with a median duration of 10–21 weeks. Not all epidemics fit this pattern in a consistent manner, with some occurring later or in an irregular manner. More variation in timing was observed in (sub)tropical countries, and we found substantial differences in seasonality at a subnational level. No association was found between the timing of the epidemic and the dominant RSV subtype. Conclusions Our findings suggest that geographical location or climatic characteristics cannot be used as a definitive predictor for the timing of RSV epidemics and highlight the need for (sub)national data collection and analysis.
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Affiliation(s)
- Lisa Staadegaard
- Nivel (Netherlands Institute for Health Services Research), Utrecht, The Netherlands
| | - Saverio Caini
- Nivel (Netherlands Institute for Health Services Research), Utrecht, The Netherlands
| | - Sonam Wangchuk
- Royal Centre for Disease Control, Ministry of Health, Thimphu, Bhutan
| | - Binay Thapa
- Royal Centre for Disease Control, Ministry of Health, Thimphu, Bhutan
| | | | | | - Rodrigo A Fasce
- Subdepartamento Enfermedades Virales, Instituto de Salud Pública de Chile, Santiago, Chile
| | - Patricia Bustos
- Sección Virus Respiratorios, Subdepartamento Enfermedades Virales, Instituto de Salud Publica de Chile, Santiago, Chile
| | - Jan Kyncl
- Department of Infectious Diseases Epidemiology, National Institute of Public Health, Prague, Czech Republic.,Department of Epidemiology and Biostatistics, Third Faculty of Medicine, Charles University, Prague, Czech Republic
| | - Ludmila Novakova
- National Reference Laboratory for Influenza and Other Respiratory Viruses, National Institute of Public Health, Prague, Czech Republic
| | - Alfredo Bruno Caicedo
- Universidad Agraria del Ecuador, Guayaquil, Ecuador.,Instituto Nacional de Investigación en Salud Pública (INSPI), Centro de Referencia Nacional de Influenza y otros Virus Respiratorios, Guayaquil, Ecuador
| | - Domenica Joseth de Mora Coloma
- Instituto Nacional de Investigación en Salud Pública (INSPI), Centro de Referencia Nacional de Influenza y otros Virus Respiratorios, Guayaquil, Ecuador
| | - Adam Meijer
- National Institute for Public Health and the Environment, Bilthoven, The Netherlands
| | - Mariëtte Hooiveld
- Nivel (Netherlands Institute for Health Services Research), Utrecht, The Netherlands
| | - Q Sue Huang
- Institute of Environmental Science and Research Limited (ESR), National Centre for Biosecurity and Infectious Disease (NCBID), Upper Hutt, New Zealand
| | - Tim Wood
- Institute of Environmental Science and Research Limited (ESR), National Centre for Biosecurity and Infectious Disease (NCBID), Upper Hutt, New Zealand
| | - Raquel Guiomar
- Instituto Nacional de Saúde Doutor Ricardo Jorge, Lisbon, Portugal
| | | | | | - Li Wei Ang
- Ministry of Health, Singapore.,National Centre for Infectious Diseases, Singapore
| | - Cheryl Cohen
- Centre for Respiratory Disease and Meningitis, National Institute for Communicable Diseases, Johannesburg, South Africa.,School of Public Health, University of Witwatersrand, Johannesburg, South Africa
| | - Jocelyn Moyes
- Centre for Respiratory Disease and Meningitis, National Institute for Communicable Diseases, Johannesburg, South Africa.,School of Public Health, University of Witwatersrand, Johannesburg, South Africa
| | - Amparo Larrauri
- National Centre of Epidemiology, CIBER Epidemiología y Salud Pública (CIBERESP), Institute of Health Carlos III (ISCIII), Madrid, Spain
| | - Concepción Delgado-Sanz
- National Centre of Epidemiology, CIBER Epidemiología y Salud Pública (CIBERESP), Institute of Health Carlos III (ISCIII), Madrid, Spain
| | | | | | - Michel Dückers
- Nivel (Netherlands Institute for Health Services Research), Utrecht, The Netherlands
| | | | - John Paget
- Nivel (Netherlands Institute for Health Services Research), Utrecht, The Netherlands
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10
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Staadegaard L, Caini S, Wangchuk S, Thapa B, de Almeida WAF, de Carvalho FC, Njouom R, Fasce RA, Bustos P, Kyncl J, Novakova L, Caicedo AB, de Mora Coloma DJ, Meijer A, Hooiveld M, Huang S, Wood T, Guiomar R, Rodrigues AP, Danilenko D, Stolyarov K, Lee VJM, Ang LW, Cohen C, Moyes J, Larrauri A, Delgado-Sanz C, Le MQ, Hoang PVM, Demont C, Bangert M, van Summeren J, Dückers M, Paget J. The Global Epidemiology of RSV in Community and Hospitalized Care: Findings From 15 Countries. Open Forum Infect Dis 2021; 8:ofab159. [PMID: 34337092 PMCID: PMC8320297 DOI: 10.1093/ofid/ofab159] [Citation(s) in RCA: 33] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2021] [Accepted: 03/25/2021] [Indexed: 12/19/2022] Open
Abstract
Background Respiratory syncytial virus (RSV) is one of the leading causes of acute respiratory tract infections. To optimize control strategies, a better understanding of the global epidemiology of RSV is critical. To this end, we initiated the Global Epidemiology of RSV in Hospitalized and Community care study (GERi). Methods Focal points from 44 countries were approached to join GERi and share detailed RSV surveillance data. Countries completed a questionnaire on the characteristics of their surveillance system. Results Fifteen countries provided granular surveillance data and information on their surveillance system. A median (interquartile range) of 1641 (552–2415) RSV cases per season were reported from 2000 and 2020. The majority (55%) of RSV cases occurred in the <1-year-olds, with 8% of cases reported in those aged ≥65 years. Hospitalized cases were younger than those in community care. We found no age difference between RSV subtypes and no clear pattern of dominant subtypes. Conclusions The high number of cases in the <1-year-olds indicates a need to focus prevention efforts in this group. The minimal differences between RSV subtypes and their co-circulation implies that prevention needs to target both subtypes. Importantly, there appears to be a lack of RSV surveillance data in the elderly.
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Affiliation(s)
- Lisa Staadegaard
- Nivel (Netherlands Institute for Health Services Research), Utrecht, the Netherlands
| | - Saverio Caini
- Nivel (Netherlands Institute for Health Services Research), Utrecht, the Netherlands
| | - Sonam Wangchuk
- Royal Centre for Disease Control, Ministry of Health, Thimphu, Bhutan
| | - Binay Thapa
- Royal Centre for Disease Control, Ministry of Health, Thimphu, Bhutan
| | | | | | - Richard Njouom
- Service de Virologie, Centre Pasteur du Cameroun, Yaounde, Cameroon
| | - Rodrigo A Fasce
- Subdepartamento Enfermedades Virales, Instituto de Salud Pública de Chile, Santiago, Chile
| | - Patricia Bustos
- Sección Virus Respiratorios, Subdepartamento Enfermedades Virales, Instituto de Salud Publica de Chile, Santiago, Chile
| | - Jan Kyncl
- Department of Infectious Diseases Epidemiology, National Institute of Public Health, Prague, Czech Republic.,Department of Epidemiology and Biostatistics, Third Faculty of Medicine, Charles University, Prague, Czech Republic
| | - Ludmila Novakova
- National Reference Laboratory for Influenza and Other Respiratory Viruses, National Institute of Public Health, Prague, Czech Republic
| | - Alfredo Bruno Caicedo
- Instituto Nacional de Investigación en Salud Pública (INSPI), Centro de Referencia Nacional de Influenza y otros Virus Respiratorios, Guayaquil, Ecuador.,Universidad Agraria del Ecuador, Guayaquil, Ecuador
| | - Domenica Joseth de Mora Coloma
- Instituto Nacional de Investigación en Salud Pública (INSPI), Centro de Referencia Nacional de Influenza y otros Virus Respiratorios, Guayaquil, Ecuador
| | - Adam Meijer
- National Institute for Public Health and the Environment, Bilthoven, the Netherlands
| | - Mariëtte Hooiveld
- Nivel (Netherlands Institute for Health Services Research), Utrecht, the Netherlands
| | - Sue Huang
- Institute of Environmental Science and Research Limited (ESR), National Centre for Biosecurity and Infectious Disease (NCBID), Upper Hutt, New Zealand
| | - Tim Wood
- Institute of Environmental Science and Research Limited (ESR), National Centre for Biosecurity and Infectious Disease (NCBID), Upper Hutt, New Zealand
| | - Raquel Guiomar
- Instituto Nacional de Saúde Doutor Ricardo Jorge, Lisbon, Portugal
| | | | - Daria Danilenko
- Smorodintsev Research Institute of Influenza, Saint Petersburg, Russian Federation
| | - Kirill Stolyarov
- Smorodintsev Research Institute of Influenza, Saint Petersburg, Russian Federation
| | | | - Li Wei Ang
- Ministry of Health, Singapore.,National Centre for Infectious Diseases, Singapore
| | - Cheryl Cohen
- Centre for Respiratory Disease and Meningitis, National Institute for Communicable Diseases, Johannesburg, South Africa.,School of Public Health, University of Witwatersrand, Johannesburg, South Africa
| | - Jocelyn Moyes
- Centre for Respiratory Disease and Meningitis, National Institute for Communicable Diseases, Johannesburg, South Africa.,School of Public Health, University of Witwatersrand, Johannesburg, South Africa
| | - Amparo Larrauri
- National Centre of Epidemiology, CIBER Epidemiología y Salud Pública (CIBERESP), Institute of Health Carlos III (ISCIII), Madrid, Spain
| | - Concepción Delgado-Sanz
- National Centre of Epidemiology, CIBER Epidemiología y Salud Pública (CIBERESP), Institute of Health Carlos III (ISCIII), Madrid, Spain
| | - Mai Quynh Le
- National Institute of Hygiene and Epidemiology, Hanoi, Vietnam
| | | | | | | | | | - Michel Dückers
- Nivel (Netherlands Institute for Health Services Research), Utrecht, the Netherlands.,ARQ National Psychotrauma Centre, Diemen, the Netherlands.,Faculty of Behavioural and Social Sciences, University of Groningen, Groningen, the Netherlands
| | - John Paget
- Nivel (Netherlands Institute for Health Services Research), Utrecht, the Netherlands
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11
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Singh DE, Marinescu MC, Guzmán-Merino M, Durán C, Delgado-Sanz C, Gomez-Barroso D, Carretero J. Simulation of COVID-19 Propagation Scenarios in the Madrid Metropolitan Area. Front Public Health 2021; 9:636023. [PMID: 33796497 PMCID: PMC8007867 DOI: 10.3389/fpubh.2021.636023] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2020] [Accepted: 02/11/2021] [Indexed: 12/23/2022] Open
Abstract
This work presents simulation results for different mitigation and confinement scenarios for the propagation of COVID-19 in the metropolitan area of Madrid. These scenarios were implemented and tested using EpiGraph, an epidemic simulator which has been extended to simulate COVID-19 propagation. EpiGraph implements a social interaction model, which realistically captures a large number of characteristics of individuals and groups, as well as their individual interconnections, which are extracted from connection patterns in social networks. Besides the epidemiological and social interaction components, it also models people's short and long-distance movements as part of a transportation model. These features, together with the capacity to simulate scenarios with millions of individuals and apply different contention and mitigation measures, gives EpiGraph the potential to reproduce the COVID-19 evolution and study medium-term effects of the virus when applying mitigation methods. EpiGraph, obtains closely aligned infected and death curves related to the first wave in the Madrid metropolitan area, achieving similar seroprevalence values. We also show that selective lockdown for people over 60 would reduce the number of deaths. In addition, evaluate the effect of the use of face masks after the first wave, which shows that the percentage of people that comply with mask use is a crucial factor for mitigating the infection's spread.
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Affiliation(s)
- David E Singh
- Department Computer Science, Universidad Carlos III de Madrid, Leganés, Spain
| | | | | | - Christian Durán
- Department Computer Science, Universidad Carlos III de Madrid, Leganés, Spain
| | - Concepción Delgado-Sanz
- CIBER en Epidemiología y Salud Pública (CIBERESP), Madrid, Spain.,National Centre for Epidemiology, Carlos III Institute of Health, Madrid, Spain
| | - Diana Gomez-Barroso
- CIBER en Epidemiología y Salud Pública (CIBERESP), Madrid, Spain.,National Centre for Epidemiology, Carlos III Institute of Health, Madrid, Spain
| | - Jesus Carretero
- Department Computer Science, Universidad Carlos III de Madrid, Leganés, Spain
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12
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Delgado-Sanz C, Mazagatos-Ateca C, Oliva J, Gherasim A, Larrauri A. Illness Severity in Hospitalized Influenza Patients by Virus Type and Subtype, Spain, 2010-2017. Emerg Infect Dis 2021; 26:220-228. [PMID: 31961295 PMCID: PMC6986827 DOI: 10.3201/eid2602.181732] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022] Open
Abstract
Influenza A(H1N1)pdm09 caused more hospitalizations, intensive care unit admissions, and deaths than influenza A(H3N2) or B. We conducted a retrospective cohort study to assess the effect of influenza virus type and subtype on disease severity among hospitalized influenza patients in Spain. We analyzed the cases of 8,985 laboratory-confirmed case-patients hospitalized for severe influenza by using data from a national surveillance system for the period 2010–2017. Hospitalized patients with influenza A(H1N1)pdm09 virus were significantly younger, more frequently had class III obesity, and had a higher risk for pneumonia or acute respiratory distress syndrome than patients infected with influenza A(H3N2) or B (p<0.05). Hospitalized patients with influenza A(H1N1)pdm09 also had a higher risk for intensive care unit admission, death, or both than patients with influenza A(H3N2) or B, independent of other factors. Determining the patterns of influenza-associated severity and how they might differ by virus type and subtype can help guide planning and implementation of adequate control and preventive measures during influenza epidemics.
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13
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Redondo-Bravo L, Delgado-Sanz C, Oliva J, Vega T, Lozano J, Larrauri A, The Spanish Influenza Sentinel Surveillance System. Transmissibility of influenza during the 21st-century epidemics, Spain, influenza seasons 2001/02 to 2017/18. ACTA ACUST UNITED AC 2020; 25. [PMID: 32489178 PMCID: PMC7268270 DOI: 10.2807/1560-7917.es.2020.25.21.1900364] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
BackgroundUnderstanding influenza seasonality is necessary for determining policies for influenza control.AimWe characterised transmissibility during seasonal influenza epidemics, including one influenza pandemic, in Spain during the 21th century by using the moving epidemic method (MEM) to calculate intensity levels and estimate differences across seasons and age groups.MethodsWe applied the MEM to Spanish Influenza Sentinel Surveillance System data from influenza seasons 2001/02 to 2017/18. A modified version of Goldstein's proxy was used as an epidemiological-virological parameter. We calculated the average starting week and peak, the length of the epidemic period and the length from the starting week to the peak of the epidemic, by age group and according to seasonal virus circulation.ResultsIndividuals under 15 years of age presented higher transmissibility, especially in the 2009 influenza A(H1N1) pandemic. Seasons with dominance/co-dominance of influenza A(H3N2) virus presented high intensities in older adults. The 2004/05 influenza season showed the highest influenza-intensity level for all age groups. In 12 seasons, the epidemic started between week 50 and week 3. Epidemics started earlier in individuals under 15 years of age (-1.8 weeks; 95% confidence interval (CI):-2.8 to -0.7) than in those over 64 years when influenza B virus circulated as dominant/co-dominant. The average time from start to peak was 4.3 weeks (95% CI: 3.6-5.0) and the average epidemic length was 8.7 weeks (95% CI: 7.9-9.6).ConclusionsThese findings provide evidence for intensity differences across seasons and age groups, and can be used guide public health actions to diminish influenza-related morbidity and mortality.
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Affiliation(s)
| | - Concepción Delgado-Sanz
- National Centre of Epidemiology, CIBER Epidemiología y Salud Pública (CIBERESP), Institute of Health Carlos III (ISCIII), Madrid, Spain
| | - Jesús Oliva
- National Centre of Epidemiology, CIBER Epidemiología y Salud Pública (CIBERESP), Institute of Health Carlos III (ISCIII), Madrid, Spain
| | - Tomás Vega
- Public Health Directorate, Castilla y León Regional Health Ministry, Valladolid, Spain
| | - Jose Lozano
- Public Health Directorate, Castilla y León Regional Health Ministry, Valladolid, Spain
| | - Amparo Larrauri
- National Centre of Epidemiology, CIBER Epidemiología y Salud Pública (CIBERESP), Institute of Health Carlos III (ISCIII), Madrid, Spain
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14
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Pastor-Barriuso R, Pérez-Gómez B, Hernán MA, Pérez-Olmeda M, Yotti R, Oteo-Iglesias J, Sanmartín JL, León-Gómez I, Fernández-García A, Fernández-Navarro P, Cruz I, Martín M, Delgado-Sanz C, Fernández de Larrea N, León Paniagua J, Muñoz-Montalvo JF, Blanco F, Larrauri A, Pollán M. Infection fatality risk for SARS-CoV-2 in community dwelling population of Spain: nationwide seroepidemiological study. BMJ 2020; 371:m4509. [PMID: 33246972 PMCID: PMC7690290 DOI: 10.1136/bmj.m4509] [Citation(s) in RCA: 106] [Impact Index Per Article: 26.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 11/19/2020] [Indexed: 01/02/2023]
Abstract
OBJECTIVE To estimate the infection fatality risk for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), based on deaths with confirmed coronavirus disease 2019 (covid-19) and excess deaths from all causes. DESIGN Nationwide seroepidemiological study. SETTING First wave of covid-19 pandemic in Spain. PARTICIPANTS Community dwelling individuals of all ages. MAIN OUTCOME MEASURES The main outcome measure was overall, and age and sex specific, infection fatality risk for SARS-CoV-2 (the number of covid-19 deaths and excess deaths divided by the estimated number of SARS-CoV-2 infections) in the community dwelling Spanish population. Deaths with laboratory confirmed covid-19 were obtained from the National Epidemiological Surveillance Network (RENAVE) and excess all cause deaths from the Monitoring Mortality System (MoMo), up to 15 July 2020. SARS-CoV-2 infections in Spain were derived from the estimated seroprevalence by a chemiluminescent microparticle immunoassay for IgG antibodies in 61 098 participants in the ENE-COVID nationwide seroepidemiological survey between 27 April and 22 June 2020. RESULTS The overall infection fatality risk was 0.8% (19 228 of 2.3 million infected individuals, 95% confidence interval 0.8% to 0.9%) for confirmed covid-19 deaths and 1.1% (24 778 of 2.3 million infected individuals, 1.0% to 1.2%) for excess deaths. The infection fatality risk was 1.1% (95% confidence interval 1.0% to 1.2%) to 1.4% (1.3% to 1.5%) in men and 0.6% (0.5% to 0.6%) to 0.8% (0.7% to 0.8%) in women. The infection fatality risk increased sharply after age 50, ranging from 11.6% (8.1% to 16.5%) to 16.4% (11.4% to 23.2%) in men aged 80 or more and from 4.6% (3.4% to 6.3%) to 6.5% (4.7% to 8.8%) in women aged 80 or more. CONCLUSION The increase in SARS-CoV-2 infection fatality risk after age 50 appeared to be more noticeable in men than in women. Based on the results of this study, fatality from covid-19 was greater than that reported for other common respiratory diseases, such as seasonal influenza.
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Affiliation(s)
- Roberto Pastor-Barriuso
- National Centre for Epidemiology, Institute of Health Carlos III, Monforte de Lemos 5, 28029 Madrid, Spain
- Consortium for Biomedical Research in Epidemiology and Public Health (CIBERESP), Institute of Health Carlos III, Madrid, Spain
- Joint first authors
| | - Beatriz Pérez-Gómez
- National Centre for Epidemiology, Institute of Health Carlos III, Monforte de Lemos 5, 28029 Madrid, Spain
- Consortium for Biomedical Research in Epidemiology and Public Health (CIBERESP), Institute of Health Carlos III, Madrid, Spain
- Joint first authors
| | - Miguel A Hernán
- Departments of Epidemiology and Biostatistics, Harvard TH Chan School of Public Health; Harvard-MIT Division of Health Sciences and Technology, Boston, MA, USA
| | - Mayte Pérez-Olmeda
- National Centre for Microbiology, Institute of Health Carlos III, Madrid, Spain
| | | | - Jesús Oteo-Iglesias
- National Centre for Microbiology, Institute of Health Carlos III, Madrid, Spain
- Spanish Network for Research in Infectious Diseases (REIPI), Institute of Health Carlos III, Madrid, Spain
| | | | - Inmaculada León-Gómez
- National Centre for Epidemiology, Institute of Health Carlos III, Monforte de Lemos 5, 28029 Madrid, Spain
- Consortium for Biomedical Research in Epidemiology and Public Health (CIBERESP), Institute of Health Carlos III, Madrid, Spain
| | - Aurora Fernández-García
- Consortium for Biomedical Research in Epidemiology and Public Health (CIBERESP), Institute of Health Carlos III, Madrid, Spain
- National Centre for Microbiology, Institute of Health Carlos III, Madrid, Spain
| | - Pablo Fernández-Navarro
- National Centre for Epidemiology, Institute of Health Carlos III, Monforte de Lemos 5, 28029 Madrid, Spain
- Consortium for Biomedical Research in Epidemiology and Public Health (CIBERESP), Institute of Health Carlos III, Madrid, Spain
| | - Israel Cruz
- National School of Public Health, Institute of Health Carlos III, Madrid, Spain
| | | | - Concepción Delgado-Sanz
- National Centre for Epidemiology, Institute of Health Carlos III, Monforte de Lemos 5, 28029 Madrid, Spain
- Consortium for Biomedical Research in Epidemiology and Public Health (CIBERESP), Institute of Health Carlos III, Madrid, Spain
| | - Nerea Fernández de Larrea
- National Centre for Epidemiology, Institute of Health Carlos III, Monforte de Lemos 5, 28029 Madrid, Spain
- Consortium for Biomedical Research in Epidemiology and Public Health (CIBERESP), Institute of Health Carlos III, Madrid, Spain
| | | | | | | | - Amparo Larrauri
- National Centre for Epidemiology, Institute of Health Carlos III, Monforte de Lemos 5, 28029 Madrid, Spain
- Consortium for Biomedical Research in Epidemiology and Public Health (CIBERESP), Institute of Health Carlos III, Madrid, Spain
- Joint senior authors
| | - Marina Pollán
- National Centre for Epidemiology, Institute of Health Carlos III, Monforte de Lemos 5, 28029 Madrid, Spain
- Consortium for Biomedical Research in Epidemiology and Public Health (CIBERESP), Institute of Health Carlos III, Madrid, Spain
- Joint senior authors
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Vestergaard LS, Nielsen J, Richter L, Schmid D, Bustos N, Braeye T, Denissov G, Veideman T, Luomala O, Möttönen T, Fouillet A, Caserio-Schönemann C, An der Heiden M, Uphoff H, Lytras T, Gkolfinopoulou K, Paldy A, Domegan L, O'Donnell J, De' Donato F, Noccioli F, Hoffmann P, Velez T, England K, van Asten L, White RA, Tønnessen R, da Silva SP, Rodrigues AP, Larrauri A, Delgado-Sanz C, Farah A, Galanis I, Junker C, Perisa D, Sinnathamby M, Andrews N, O'Doherty M, Marquess DF, Kennedy S, Olsen SJ, Pebody R, Krause TG, Mølbak K. Excess all-cause mortality during the COVID-19 pandemic in Europe - preliminary pooled estimates from the EuroMOMO network, March to April 2020. ACTA ACUST UNITED AC 2020; 25. [PMID: 32643601 PMCID: PMC7346364 DOI: 10.2807/1560-7917.es.2020.25.26.2001214] [Citation(s) in RCA: 145] [Impact Index Per Article: 36.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/02/2022]
Abstract
A remarkable excess mortality has coincided with the COVID-19 pandemic in Europe. We present preliminary pooled estimates of all-cause mortality for 24 European countries/federal states participating in the European monitoring of excess mortality for public health action (EuroMOMO) network, for the period March–April 2020. Excess mortality particularly affected ≥ 65 year olds (91% of all excess deaths), but also 45–64 (8%) and 15–44 year olds (1%). No excess mortality was observed in 0–14 year olds.
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Affiliation(s)
| | | | - Lukas Richter
- Austrian Agency for Health and Food Safety, Vienna, Austria
| | - Daniela Schmid
- Austrian Agency for Health and Food Safety, Vienna, Austria
| | | | | | - Gleb Denissov
- National Institute for Health Development, Tallinn, Estonia
| | | | - Oskari Luomala
- Finnish National Institute for Health and Welfare, Helsinki, Finland
| | - Teemu Möttönen
- Finnish National Institute for Health and Welfare, Helsinki, Finland
| | - Anne Fouillet
- French Public Health Agency (Santé Publique France), Saint-Maurice, France
| | | | | | - Helmut Uphoff
- Hessisches Landesprüfungs- und Untersuchungsamt im Gesundheitswesen, Dillenburg, Germany
| | | | | | - Anna Paldy
- National Public Health Institute, Budapest, Hungary
| | - Lisa Domegan
- European Programme for Intervention Epidemiology Training (EPIET), European Centre for Disease Prevention and Control (ECDC), Stockholm, Sweden.,Health Service Executive - Health Protection Surveillance Centre, Dublin, Ireland
| | - Joan O'Donnell
- Health Service Executive - Health Protection Surveillance Centre, Dublin, Ireland
| | | | | | - Patrick Hoffmann
- Health Directorate Luxembourg - Division de l'inspection sanitaire, Luxembourg
| | - Telma Velez
- Health Directorate Luxembourg - Division de l'inspection sanitaire, Luxembourg
| | - Kathleen England
- Directorate for Health Information and Research, Ministry for Health, Malta
| | - Liselotte van Asten
- National Institute for Public Health and the Environment (RIVM), Bilthoven, The Netherlands
| | | | | | | | - Ana P Rodrigues
- Instituto Nacional de Saúde Doutor Ricardo Jorge, Lisbon, Portugal
| | - Amparo Larrauri
- National Centre of Epidemiology, CIBER Epidemiología y Salud Pública (CIBERESP), Carlos III Health Institute, Madrid, Spain
| | - Concepción Delgado-Sanz
- National Centre of Epidemiology, CIBER Epidemiología y Salud Pública (CIBERESP), Carlos III Health Institute, Madrid, Spain
| | - Ahmed Farah
- Public Health Agency of Sweden, Stockholm, Sweden
| | | | | | - Damir Perisa
- Federal Office of Public Health, Bern, Switzerland
| | | | - Nick Andrews
- Public Health England, Colindale, United Kingdom
| | | | | | | | - Sonja J Olsen
- World Health Organization, Regional Office for Europe, Copenhagen, Denmark
| | - Richard Pebody
- World Health Organization, Regional Office for Europe, Copenhagen, Denmark
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- The members of the ECDC Public Health Emergency Team for COVID-19 are listed below
| | | | - Kåre Mølbak
- Department of Veterinary and Animal Science, Faculty of Health and Medical Science, University of Copenhagen, Copenhagen, Denmark.,Statens Serum Institut, Copenhagen, Denmark
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16
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Adlhoch C, Gomes Dias J, Bonmarin I, Hubert B, Larrauri A, Oliva Domínguez JA, Delgado-Sanz C, Brytting M, Carnahan A, Popovici O, Lupulescu E, O'Donnell J, Domegan L, Van Gageldonk-Lafeber AB, Meijer A, Kynčl J, Slezák P, Guiomar R, Orta Gomes CM, Popow-Kraupp T, Mikas J, Staroňová E, Melillo JM, Melillo T, Ikonen N, Lyytikäinen O, Snacken R, Penttinen P. Determinants of Fatal Outcome in Patients Admitted to Intensive Care Units With Influenza, European Union 2009-2017. Open Forum Infect Dis 2019; 6:ofz462. [PMID: 32258201 PMCID: PMC7105050 DOI: 10.1093/ofid/ofz462] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2018] [Accepted: 10/23/2019] [Indexed: 01/13/2023] Open
Abstract
Background Morbidity, severity, and mortality associated with annual influenza epidemics are of public health concern. We analyzed surveillance data on hospitalized laboratory-confirmed influenza cases admitted to intensive care units to identify common determinants for fatal outcome and inform and target public health prevention strategies, including risk communication. Methods We performed a descriptive analysis and used Poisson regression models with robust variance to estimate the association of age, sex, virus (sub)type, and underlying medical condition with fatal outcome using European Union data from 2009 to 2017. Results Of 13 368 cases included in the basic dataset, 2806 (21%) were fatal. Age ≥40 years and infection with influenza A virus were associated with fatal outcome. Of 5886 cases with known underlying medical conditions and virus A subtype included in a more detailed analysis, 1349 (23%) were fatal. Influenza virus A(H1N1)pdm09 or A(H3N2) infection, age ≥60 years, cancer, human immunodeficiency virus infection and/or other immune deficiency, and heart, kidney, and liver disease were associated with fatal outcome; the risk of death was lower for patients with chronic lung disease and for pregnant women. Conclusions This study re-emphasises the importance of preventing influenza in the elderly and tailoring strategies to risk groups with underlying medical conditions.
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Affiliation(s)
- Cornelia Adlhoch
- Surveillance and Response Support, European Centre for Disease Prevention and Control (ECDC), Solna, Sweden
| | - Joana Gomes Dias
- Surveillance and Response Support, European Centre for Disease Prevention and Control (ECDC), Solna, Sweden
| | | | - Bruno Hubert
- Bruno Hubert, Santé Public France, Saint-Maurice Cedex, France
| | - Amparo Larrauri
- National Centre of Epidemiology, CIBER Epidemiología y Salud Pública, Institute of Health Carlos III (ISCIII), Madrid, Spain
| | - Jesús A Oliva Domínguez
- National Centre of Epidemiology, CIBER Epidemiología y Salud Pública, Institute of Health Carlos III (ISCIII), Madrid, Spain
| | - Concepción Delgado-Sanz
- National Centre of Epidemiology, CIBER Epidemiología y Salud Pública, Institute of Health Carlos III (ISCIII), Madrid, Spain
| | - Mia Brytting
- The Public Health Agency of Sweden, Solna, Sweden
| | | | - Odette Popovici
- National Institute of Public Health, Romania National Centre for Communicable Diseases Surveillance and Control, Bucuresti, Romania
| | - Emilia Lupulescu
- National Institute of Public Health, Romania National Centre for Communicable Diseases Surveillance and Control, Bucuresti, Romania
| | - Joan O'Donnell
- Health Service Executive-Health Protection Surveillance Centre, Dublin, Ireland
| | - Lisa Domegan
- Health Service Executive-Health Protection Surveillance Centre, Dublin, Ireland
| | | | - Adam Meijer
- National Institute for Public Health and the Environment (RIVM), Bilthoven, The Netherlands
| | - Jan Kynčl
- Department of Infectious Diseases Epidemiology, National Institute of Public Health, Prague, Czech Republic
| | - Pavel Slezák
- Department of Infectious Diseases Epidemiology, National Institute of Public Health, Prague, Czech Republic
| | - Raquel Guiomar
- Instituto Nacional de Saúde Doutor Ricardo Jorge (National Institute of Health Dr. Ricardo Jorge), Lisboa, Portugal
| | - Carlos M Orta Gomes
- Department of Public Health of Regional Health Administration of Lisbon and Tagus Valley, Lisboa, Portugal
| | | | - Ján Mikas
- Public Health Authority of the Slovak Republic, Bratislava, Slovakia
| | - Edita Staroňová
- Public Health Authority of the Slovak Republic, Bratislava, Slovakia
| | - Jackie M Melillo
- Infectious Disease Prevention and Control Unit, Health Regulation, Malta
| | - Tanya Melillo
- Infectious Disease Prevention and Control Unit, Health Regulation, Malta
| | - Niina Ikonen
- Department of Health Security, National Institute for Health and Welfare (THL), Helsinki, Finland
| | - Outi Lyytikäinen
- Department of Health Security, National Institute for Health and Welfare (THL), Helsinki, Finland
| | - René Snacken
- Surveillance and Response Support, European Centre for Disease Prevention and Control (ECDC), Solna, Sweden
| | - Pasi Penttinen
- Office of the Chief Scientist, European Centre for Disease Prevention and Control (ECDC), Solna, Sweden
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17
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Mazagatos C, Delgado-Sanz C, Oliva J, Gherasim A, Larrauri A. Exploring the risk of severe outcomes and the role of seasonal influenza vaccination in pregnant women hospitalized with confirmed influenza, Spain, 2010/11-2015/16. PLoS One 2018; 13:e0200934. [PMID: 30089148 PMCID: PMC6082521 DOI: 10.1371/journal.pone.0200934] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2017] [Accepted: 07/05/2018] [Indexed: 11/19/2022] Open
Abstract
Based on previous observations during pandemics and seasonal epidemics, pregnant women are considered at risk of developing severe influenza outcomes after influenza infection. With the aim of preventing severe influenza illness, the World Health Organization (WHO) includes pregnant women as a target group for seasonal influenza vaccination. However, influenza vaccine uptake during pregnancy remains low in many countries, including Spain. The objectives of this study were to increase the evidence of pregnancy as a risk factor for severe influenza illness and to study the potential role of seasonal influenza vaccination in the prevention of severe outcomes in infected pregnant women. Using information from the surveillance of Severe Hospitalized Confirmed Influenza Cases (SHCIC) in Spain, from seasons 2010/11 to 2015/16, we estimated that pregnant women in our study had a relative risk of hospitalization with severe influenza nearly 7.8 times higher than non-pregnant women of reproductive age. Only 5 out of 167 pregnant women with known vaccination status in our study had been vaccinated (3.6%). Such extremely low vaccination coverage only allowed obtaining crude estimates suggesting a protective effect of the vaccine against influenza complications (ICU admission or death). Our overall results support that pregnant women could benefit from seasonal influenza vaccination, in line with national and international recommendations.
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Affiliation(s)
- Clara Mazagatos
- CIBER Epidemiología y Salud Pública (CIBERESP), Institute of Health Carlos III (ISCIII), Madrid, Spain
- National Centre of Epidemiology, Institute of Health Carlos III (ISCIII), Madrid, Spain
| | - Concepción Delgado-Sanz
- CIBER Epidemiología y Salud Pública (CIBERESP), Institute of Health Carlos III (ISCIII), Madrid, Spain
- National Centre of Epidemiology, Institute of Health Carlos III (ISCIII), Madrid, Spain
| | - Jesús Oliva
- CIBER Epidemiología y Salud Pública (CIBERESP), Institute of Health Carlos III (ISCIII), Madrid, Spain
- National Centre of Epidemiology, Institute of Health Carlos III (ISCIII), Madrid, Spain
| | - Alin Gherasim
- CIBER Epidemiología y Salud Pública (CIBERESP), Institute of Health Carlos III (ISCIII), Madrid, Spain
- National Centre of Epidemiology, Institute of Health Carlos III (ISCIII), Madrid, Spain
| | - Amparo Larrauri
- CIBER Epidemiología y Salud Pública (CIBERESP), Institute of Health Carlos III (ISCIII), Madrid, Spain
- National Centre of Epidemiology, Institute of Health Carlos III (ISCIII), Madrid, Spain
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18
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Oliva J, Delgado-Sanz C, Larrauri A. Estimating the burden of seasonal influenza in Spain from surveillance of mild and severe influenza disease, 2010-2016. Influenza Other Respir Viruses 2017; 12:161-170. [PMID: 28960828 PMCID: PMC5818358 DOI: 10.1111/irv.12499] [Citation(s) in RCA: 40] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/09/2017] [Indexed: 11/27/2022] Open
Abstract
Background Estimating the national burden of influenza disease is challenging. We aimed to estimate the disease burden of seasonal influenza in Spain, at the primary care and hospital level, over the 6 influenza seasons after 2009 pandemic. Methods We used data from the Spanish Influenza Sentinel Surveillance System to estimate weekly influenza rates and the number of influenza‐like illness (ILI) and mild confirmed influenza cases (MCIC). From the surveillance of severe hospitalized confirmed influenza cases (SHCIC), we obtained hospitalization rates and total number of SHCIC, intensive care unit (ICU) admissions and deaths in influenza hospitalized patients. We estimated both mild and severe influenza cases, overall, and by age‐group (<5, 5‐14, 15‐64, and ≥65 years). Results The highest cumulative rates of MCIC were observed in <15 years (1395‐3155 cases/100 000 population in 5‐14 years) and the lowest in ≥65 years (141‐608 cases/100 000 population). SHCIC rates revealed a characteristic U‐shaped distribution, with annual average hospitalization rates of 16.5 and 18.9 SHCIC/100, 000 p in 0‐4 years, and ≥65 years, respectively. We estimated an annual average of 866 868 cases of ILI attended in primary care (55% were MCIC), 3616 SHCIC, 1232 ICU admissions, and 437 deaths in SHCIC. The percentage of ICU admission among SHCIC was highest at 15‐64 years (42%), while the hospitalization fatality rate ranged from 1% in 0‐4 years to 18% in ≥65 years. Conclusions The ongoing Spanish Influenza Surveillance System allowed obtaining crucial information regarding the impact of mild and severe influenza in Spain.
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Affiliation(s)
- Jesús Oliva
- National Centre of Epidemiology, CIBER Epidemiología y Salud Pública (CIBERESP), Institute of Health Carlos III (ISCIII), Madrid, Spain
| | - Concepción Delgado-Sanz
- National Centre of Epidemiology, CIBER Epidemiología y Salud Pública (CIBERESP), Institute of Health Carlos III (ISCIII), Madrid, Spain
| | - Amparo Larrauri
- National Centre of Epidemiology, CIBER Epidemiología y Salud Pública (CIBERESP), Institute of Health Carlos III (ISCIII), Madrid, Spain
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Gomez-Barroso D, León-Gómez I, Delgado-Sanz C, Larrauri A. Climatic Factors and Influenza Transmission, Spain, 2010-2015. Int J Environ Res Public Health 2017; 14:ijerph14121469. [PMID: 29182525 PMCID: PMC5750888 DOI: 10.3390/ijerph14121469] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/15/2017] [Revised: 11/23/2017] [Accepted: 11/24/2017] [Indexed: 11/16/2022]
Abstract
The spatio-temporal distribution of influenza is linked to variations in meteorological factors, like temperature, absolute humidity, or the amount of rainfall. The aim of this study was to analyse the association between influenza activity, and meteorological variables in Spain, across five influenza seasons: 2010–2011 through to 2014–2015 using generalized linear negative binomial mixed models that we calculated the weekly influenza proxies, defined as the weekly influenza-like illness rates, multiplied by the weekly proportion of respiratory specimens that tested positive for influenza. The results showed an association between influenza transmission and dew point and cumulative precipitation. In increase in the dew point temperature of 5 degrees produces a 7% decrease in the Weekly Influenza Proxy (RR 0.928, IC: 0.891–0.966), and while an increase of 10 mm in weekly rainfall equates to a 17% increase in the Weekly Influenza Proxy (RR 1.172, IC: 1.097–1.251). Influenza transmission in Spain is influenced by variations in meteorological variables as temperature, absolute humidity, or the amount of rainfall.
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Affiliation(s)
- Diana Gomez-Barroso
- National Centre for Epidemiology, Carlos III Institute of Health, Monforte de Lemos 5, 28029 Madrid, Spain.
- Consortium for Biomedical Research in Epidemiology and Public Health (CIBER Epidemiología y Salud Pública-CIBERESP), Monforte de Lemos 5, 28029 Madrid, Spain.
| | - Inmaculada León-Gómez
- National Centre for Epidemiology, Carlos III Institute of Health, Monforte de Lemos 5, 28029 Madrid, Spain.
- Consortium for Biomedical Research in Epidemiology and Public Health (CIBER Epidemiología y Salud Pública-CIBERESP), Monforte de Lemos 5, 28029 Madrid, Spain.
| | - Concepción Delgado-Sanz
- National Centre for Epidemiology, Carlos III Institute of Health, Monforte de Lemos 5, 28029 Madrid, Spain.
- Consortium for Biomedical Research in Epidemiology and Public Health (CIBER Epidemiología y Salud Pública-CIBERESP), Monforte de Lemos 5, 28029 Madrid, Spain.
| | - Amparo Larrauri
- National Centre for Epidemiology, Carlos III Institute of Health, Monforte de Lemos 5, 28029 Madrid, Spain.
- Consortium for Biomedical Research in Epidemiology and Public Health (CIBER Epidemiología y Salud Pública-CIBERESP), Monforte de Lemos 5, 28029 Madrid, Spain.
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20
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Jiménez-Jorge S, Delgado-Sanz C, de Mateo S, Pozo F, Casas I, Larrauri A. Vigilancia del virus respiratorio sincitial en el marco del Sistema de Vigilancia de la Gripe en España, 2006-2014. Enferm Infecc Microbiol Clin 2016; 34:117-20. [DOI: 10.1016/j.eimc.2014.12.012] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2014] [Accepted: 12/23/2014] [Indexed: 10/24/2022]
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21
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Jimenez-Jorge S, de Mateo S, Delgado-Sanz C, Pozo F, Casas I, Garcia-Cenoz M, Castilla J, Rodriguez C, Vega T, Quinones C, Martinez E, Vanrell JM, Gimenez J, Castrillejo D, Altzibar JM, Carril F, Ramos JM, Serrano MC, Martinez A, Torner N, Perez E, Gallardo V, Larrauri A. Estimating influenza vaccine effectiveness in Spain using sentinel surveillance data. ACTA ACUST UNITED AC 2015. [PMID: 26212144 DOI: 10.2807/1560-7917.es2015.20.28.21187] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
We aimed to estimate influenza vaccine effectiveness (VE) against laboratory-confirmed influenza during three influenza seasons (2010/11 to 2012/2013) in Spain using surveillance data and to compare the results with data obtained by the cycEVA study, the Spanish component of the Influenza Monitoring Vaccine Effectiveness (I-MOVE) network. We used the test-negative case–control design, with data from the Spanish Influenza Sentinel Surveillance System (SISS) or from the cycEVA study. Cases were laboratory-confirmed influenza patients with the predominant influenza virus of each season, and controls were those testing negative for any influenza virus. We calculated the overall and age-specific adjusted VE. Although the number of patients recorded in the SISS was three times higher than that in the cycEVA study, the quality of information for important variables, i.e. vaccination status and laboratory results, was high in both studies. Overall, the SISS and cycEVA influenza VE estimates were largely similar during the study period. For elderly patients (> 59 years), the SISS estimates were slightly lower than those of cycEVA, and estimates for children (0–14 years) were higher using SISS in two of the three seasons studied. Enhancing the SISS by collecting the date of influenza vaccination and reducing the percentage of patients with incomplete information would optimise the system to provide reliable annual influenza VE estimates to guide influenza vaccination policies.
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Affiliation(s)
- S Jimenez-Jorge
- National Centre of Epidemiology, Institute of Health Carlos III, Madrid, Spain
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22
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León-Gómez I, Delgado-Sanz C, Jiménez-Jorge S, Flores V, Simón F, Gómez-Barroso D, Larrauri A, de Mateo Ontañón S. [Excess mortality associated with influenza in Spain in winter 2012]. Gac Sanit 2015; 29:258-65. [PMID: 25770916 DOI: 10.1016/j.gaceta.2015.01.011] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/29/2014] [Revised: 01/23/2015] [Accepted: 01/26/2015] [Indexed: 11/26/2022]
Abstract
OBJECTIVE An excess of mortality was detected in Spain in February and March 2012 by the Spanish daily mortality surveillance system and the «European monitoring of excess mortality for public health action» program. The objective of this article was to determine whether this excess could be attributed to influenza in this period. METHODS Excess mortality from all causes from 2006 to 2012 were studied using time series in the Spanish daily mortality surveillance system, and Poisson regression in the European mortality surveillance system, as well as the FluMOMO model, which estimates the mortality attributable to influenza. Excess mortality due to influenza and pneumonia attributable to influenza were studied by a modification of the Serfling model. To detect the periods of excess, we compared observed and expected mortality. RESULTS In February and March 2012, both the Spanish daily mortality surveillance system and the European mortality surveillance system detected a mortality excess of 8,110 and 10,872 deaths (mortality ratio (MR): 1.22 (95% CI:1.21-1.23) and 1.32 (95% CI: 1.29-1.31), respectively). In the 2011-12 season, the FluMOMO model identified the maximum percentage (97%) of deaths attributable to influenza in people older than 64 years with respect to the mortality total associated with influenza (13,822 deaths). The rate of excess mortality due to influenza and pneumonia and respiratory causes in people older than 64 years, obtained by the Serfling model, also reached a peak in the 2011-2012 season: 18.07 and 77.20, deaths per 100,000 inhabitants, respectively. CONCLUSION A significant increase in mortality in elderly people in Spain was detected by the Spanish daily mortality surveillance system and by the European mortality surveillance system in the winter of 2012, coinciding with a late influenza season, with a predominance of the A(H3N2) virus, and a cold wave in Spain. This study suggests that influenza could have been one of the main factors contributing to the mortality excess observed in the winter of 2012 in Spain.
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Affiliation(s)
- Inmaculada León-Gómez
- Centro Nacional de Epidemiología, Instituto de Salud Carlos III, Madrid, España; CIBER de Epidemiología y Salud Pública (CIBERESP), España.
| | - Concepción Delgado-Sanz
- Centro Nacional de Epidemiología, Instituto de Salud Carlos III, Madrid, España; CIBER de Epidemiología y Salud Pública (CIBERESP), España
| | - Silvia Jiménez-Jorge
- Centro Nacional de Epidemiología, Instituto de Salud Carlos III, Madrid, España; CIBER de Epidemiología y Salud Pública (CIBERESP), España
| | - Víctor Flores
- Centro Nacional de Epidemiología, Instituto de Salud Carlos III, Madrid, España
| | - Fernando Simón
- Centro Nacional de Epidemiología, Instituto de Salud Carlos III, Madrid, España; CIBER de Epidemiología y Salud Pública (CIBERESP), España
| | - Diana Gómez-Barroso
- Centro Nacional de Epidemiología, Instituto de Salud Carlos III, Madrid, España; CIBER de Epidemiología y Salud Pública (CIBERESP), España
| | - Amparo Larrauri
- Centro Nacional de Epidemiología, Instituto de Salud Carlos III, Madrid, España; CIBER de Epidemiología y Salud Pública (CIBERESP), España
| | - Salvador de Mateo Ontañón
- Centro Nacional de Epidemiología, Instituto de Salud Carlos III, Madrid, España; CIBER de Epidemiología y Salud Pública (CIBERESP), España
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Jiménez-Jorge S, Mateo Ontañón SD, Savulescu C, Delgado-Sanz C, Pozo Sánchez F, García-Cenoz M, Castilla Catalán J, Rodríguez Gay C, Vega Alonso T, Quiñones Rubio C, Martínez Ochoa E, Vanrell Berga JM, Giménez Durán J, Castrillejo Pérez D, Altzíbar Arotzena JM, González Carril F, Ramos Aceitero JM, Serrano Martin MDC, Martínez i Mateo A, Torner Gràcia N, Pérez Morilla E, Gallardo García V, Larrauri Cámara A. [cycEVA study: case control study measuring influenza vaccine effectiveness in Spain, 2008-2013]. Rev Esp Salud Publica 2014; 88:601-11. [PMID: 25327269 DOI: 10.4321/s1135-57272014000500005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022] Open
Abstract
BACKGROUND In Spain, influenza vaccine effectiveness (EV) is estimated since 2008-09 season through the cycEVA case-control study, the Spanish component of the European I-MOVE (Monitoring Influenza Vaccine Effectiveness in the EU/EEA) network. We aimed at describing cycEVA performance in its five consolidated editions 2008/09 -; 2012/13. METHODS During the study period the following indicators were analysed: 1) the participation of sentinel general practitioners and pediatricians (MP), 2) the population studied and the study period, 3) the data quality and 4) the dissemination of the cycEVA results. Trend analysis of the indicators was done using the Cochran-Armitage test to compute the Annual Percentage Change (PCA). RESULTS The number of participating MP increased from 164 in 2008-09 to 246 in the following editions. The percentage of MP recruiting at least one patient increased significantly annually (PCA = 15.33%). The percentage of recruited patients included into the analysis increased (PCA=5.91%) from 77% in 2008-09 to more than 95% in the following editions. The percentage of cycEVA patients contributing to the I-MOVE study ranged between 23% and 30% in the pilot and 2011-12 editions respectively.. Final results were disseminated in quartile 2 peer-reviewed journals and 2010-11 and 2011-12 preliminary EV estimates were published in quartile 1 journals. cycEVA publications received 97 citations. CONCLUSION cycEVA study achieved more quality information, timely EV estimates and a higher impact of the results.
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24
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Jimenez-Jorge S, Pozo F, de Mateo S, Delgado-Sanz C, Casas I, Garcia-Cenoz M, Castilla J, Sancho R, Etxebarriarteun-Aranzabal L, Quinones C, Martinez E, Vega T, Garcia A, Gimenez J, Vanrell JM, Castrillejo D, Larrauri A. Influenza vaccine effectiveness in Spain 2013/14: subtype-specific early estimates using the cycEVA study. ACTA ACUST UNITED AC 2014; 19. [PMID: 24626206 DOI: 10.2807/1560-7917.es2014.19.9.20727] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
Adjusted early estimates of the 2013/14 influenza vaccine effectiveness (VE) in Spain for all age groups was 35% (95% CI: -9 to 62), 33% (95% CI: -33 to 67) and 28% (95% CI: -33 to 61) against any influenza virus type, A(H1N1)pdm09 and A(H3N2) viruses, respectively. For the population targeted for vaccination, the adjusted VE was 44% (95% CI: -11 to 72), 36% (95% CI: -64 to 75) and 42% (95% CI: -29 to 74), respectively. These preliminary results in Spain suggest a suboptimal protective effect of the vaccine against circulating influenza viruses.
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Affiliation(s)
- S Jimenez-Jorge
- National Centre of Epidemiology, Institute of Health Carlos III, Madrid, Spain
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López-Abente G, Ardanaz E, Torrella-Ramos A, Mateos A, Delgado-Sanz C, Chirlaque MD. Changes in colorectal cancer incidence and mortality trends in Spain. Ann Oncol 2011; 21 Suppl 3:iii76-82. [PMID: 20427364 DOI: 10.1093/annonc/mdq091] [Citation(s) in RCA: 59] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/04/2023] Open
Abstract
BACKGROUND Some years ago, Spain registered a much lower colorectal cancer (CRC) incidence and mortality rate than did other European countries but the rates have since converged. This study sought to compare time trends for CRC incidence and mortality, identify change-points in these trends and thereby update available information in Spain. METHODS Incidence data were drawn from all population-based cancer registries in Spain which participated in the European Network of Cancer Registries and had been collecting data for at least 10 consecutive years during the period 1975-2004. Colorectal cancer corresponded to codes 153, 154 and 159.0 of the International Classification of Diseases ninth revision (ICD-9) and codes C18-C21 and C26.0 of the ICD-10. In all, the 13 registries included in this study cover approximately 26% of the total Spanish population. We evaluated the time trends in incidence and mortality using transition change-point and age-period-cohort models. RESULTS Our results revealed an important increase in CRC incidence in Spain, which held constant across the entire study period but became slightly attenuated in both sexes around 1995, when a change-point was detected. The annual increase in incidence, which had been 4.3% per annum in men up to this point, declined to 2.5% thereafter. In women, the increase in incidence, albeit also of considerable magnitude, was more moderate. The incidence trend contrasted sharply with that for mortality, inasmuch as the latter changed in 1997-98, after which point mortality rates in both sexes began to decline. CONCLUSIONS The divergence between incidence (upward trend) and mortality rates (downward trend from the mid-1990s onwards) would suggest that possible explanations may lie in improved accessibility to endoscopy increased early detection with a corresponding shift to an earlier disease stage and improvements in therapy. This trend is having important consequences insofar as disease prevalence and burden of care are concerned.
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Affiliation(s)
- G López-Abente
- Cancer and Environmental Epidemiology Area, National Centre for Epidemiology, Carlos III Institute of Health, Madrid, Spain.
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