The impact of influenza virus B in Italy: myth or reality?
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Keywords

Influenza impact
epidemiology
influenza B
vaccination
vaccine mismatch

Abstract

We describe the burden of influenza B infections in Italy during a 12-year study period. Influenza A and B viruses cocirculated throughout the period, with numbers of influenza B cases approaching or exceeding those of influenza A during three influenza seasons. Influenza B virus infections led to fewer admissions to an intensive care unit (ICU) and a lower mortality rate than influenza A from 2010 to 2015. However, a 16% of those admitted to ICU with influenza B had not been immunised. This highlights the need for consistent influenza vaccination for identified risk groups. Our study demonstrates that influenza B virus infections are associated with substantial morbidity and that influenza surveillance and interventions including vaccination and treatment are still suboptimal. Our findings have important public health implications. Incorporating virus and epidemiological data will help obtain more accurate estimates of influenza disease burden and result in a better selection of influenza prevention and control strategies.

https://doi.org/10.15167/2421-4248/jpmh2016.57.1.604
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References

Cromer D, Hoek, A.J. van , Jit M, Edmunds WJ, Fleming D, Miller E. The burden of influenza in England by age and clinical risk group: a statistical analysis to inform vaccine policy. J Infect 2014;68(4):363-371. Available from: http://linkinghub.elsevier.com/retrieve/pii/S0163-4453(13)00373-3 PubMed PMID: 24291062. doi: 10.1016/j.jinf.2013.11.013. [Google Scholar]

Keech M, Beardsworth P. The impact of influenza on working days lost: a review of the literature.. Pharmacoeconomics 2008;26(11):911-924. Available from: https://www.nlm.nih.gov/medlineplus/flu.html PubMed PMID: 18850761. doi: 10.2165/00019053-200826110-00004. [Google Scholar]

Reed C, Chaves SS, Daily Kirley P, Emerson R, Aragon D, Hancock EB, et al. Estimating influenza disease burden from population-based surveillance data in the United States.. PLoS One 2015 Mar;10(3). Available from: http://dx.plos.org/10.1371/journal.pone.0118369 PubMed PMID: 25738736. doi: 10.1371/journal.pone.0118369. [Google Scholar]

Nair H, Brooks WA, Katz M, Roca A, Berkley JA, Madhi SA, et al. Global burden of respiratory infections due to seasonal influenza in young children: a systematic review and meta-analysis.. . Available from: http://www.ncbi.nlm.nih.gov/pubmed/22078723 PubMed PMID: 22078723. doi: 10.1016/S0140-6736(11)61051-9. [Google Scholar]

Quandelacy TM, Viboud C, Charu V, Lipsitch M, Goldstein E. Age- and sex-related risk factors for influenza-associated mortality in the United States between 1997-2007. Am J Epidemiol 2014 Jan;179(2):156-167. Available from: http://aje.oxfordjournals.org/cgi/pmidlookup?view=long&pmid=24190951 PubMed PMID: 24190951. doi: 10.1093/aje/kwt235. [Google Scholar]

Matias G, Taylor R, Haguinet F, Schuck-Paim C, Lustig R, Shinde V. Estimates of mortality attributable to influenza and RSV in the United States during 1997-2009 by influenza type or subtype, age, cause of death, and risk status. Influenza Other Respir Viruses 2014;8(5):507-15. Available from: http://doi.wiley.com/10.1111/irv.12258 doi: 10.1111/irv.12258. [Google Scholar]

Chaves SS, Aragon D, Bennett N, Cooper T, Mello, T. D' , Farley M, et al. Patients hospitalized with laboratory-confirmed influenza during the 2010-2011 influenza season: exploring disease severity by virus type and subtype.. J Infect Dis 2013 Jul;208(8):1305-1314. Available from: http://www.jid.oxfordjournals.org/cgi/pmidlookup?view=long&pmid=23863950 PubMed PMID: 23863950. doi: 10.1093/infdis/jit316. [Google Scholar]

Mosnier A, Caini S, Daviaud I, Nauleau E, Bui TT, Debost E, et al. GROG network. Clinical Characteristics Are Similar across Type A and B Influenza Virus Infections. PLoS One. 2015;10(9). Available from: http://www.ncbi.nlm.nih.gov/pubmed/26325069 PubMed PMID: 26325069. doi: 10.1371/journal.pone.0136186. [Google Scholar]

Irving SA, Patel DC, Kieke BA, Donahue JG, Vandermause MF, Shay DK, et al. Comparison of clinical features and outcomes of medically attended influenza A and influenza B in a defined population over four seasons: 2004-2005 through 2007-2008. Influenza Other Respir Viruses 2012;6(1):37-43. Available from: http://doi.wiley.com/10.1111/j.1750-2659.2011.00263.x doi: 10.1111/j.1750-2659.2011.00263.x. [Google Scholar]

Cohen AL, Hellferscee O, Pretorius M, Treurnicht F, Walaza S, Madhi S, et al. Epidemiology of influenza virus types and subtypes in South Africa, 2009-2012.. Emerg Infect Dis 2014;20(7):1162-1169. Available from: http://dx.doi.org/10.3201/eid2007.131869 PubMed PMID: 24960314. doi: 10.3201/eid2007.131869. [Google Scholar]

Silvennoinen H, Huusko T, Vuorinen T, Heikkinen T. Comparative Burden of Influenza A/H1N1, A/H3N2 and B Infections in Children Treated as Outpatients. Pediatr Infect Dis J 2015;34(10):1081-5. Available from: http://content.wkhealth.com/linkback/openurl?sid=WKPTLP:landingpage&an=00006454-201510000-00011 doi: 10.1097/INF.0000000000000814. [Google Scholar]

Turbelin C, Souty C, Pelat C, Hanslik T, Sarazin M, Blanchon T, et al. Age distribution of influenza like illness cases during post-pandemic A(H3N2): comparison with the twelve previous seasons, in France.. PLoS One 2013 Jun;8(6). Available from: http://dx.plos.org/10.1371/journal.pone.0065919 PubMed PMID: 23755294. doi: 10.1371/journal.pone.0065919. [Google Scholar]

Caini S, Huang QS, Ciblak MA, Kusznierz G, Owen R, Wangchuk S, Henriques CM, Njouom R, Fasce RA, Yu H, Feng L, Zambon M, Clara AW, Kosasih H, Puzelli S, Kadjo HA, Emukule G, Heraud JM, Ang LW, Venter M, Mironenko A, Brammer L, Mai le TQ, Schellevis F, Plotkin S, Paget J, , Study GIB. Epidemiological and virological characteristics of influenza B: results of the Global Influenza B Study. Influenza Other Respir Viruses 2015;9 Suppl 1:3-12. [Google Scholar]

Ambrose CS, Levin MJ. The rationale for quadrivalent influenza vaccines. Hum Vaccin Immunother 2012;8(1):81-8. Available from: http://www.tandfonline.com/doi/abs/10.4161/hv.8.1.17623 doi: 10.4161/hv.8.1.17623. [Google Scholar]

Pariani E, Amendola A, Piatti A, Anselmi G, Ranghiero A, Bubba L, et al. Ten years (2004-2014) of influenza surveillance in Northern Italy.. Hum Vaccin Immunother 2014 Nov;11(1):198-205. Available from: http://europepmc.org/abstract/MED/25483536 PubMed PMID: 25483536. doi: 10.4161/hv.35863. [Google Scholar]

Ansaldi F, D'Agaro P, De Florentiis D, Puzelli S, Lin YP, Gregory V, et al. Molecular characterization of influenza B viruses circulating in northern Italy during the 2001-2002 epidemic season. J Med Virol 2003;70(3):463-469. Available from: http://www.scholaruniverse.com/ncbi-linkout?id=12767012 PubMed PMID: 12767012. doi: 10.1002/jmv.10418. [Google Scholar]

Ansaldi F, D . de Florentiis. Storia di un tentativo di fuga: l’epidemiologia del virus influenzale. Giornale della Vaccinazione 2012;VI(1):9-11. [Google Scholar]

World Health Organization FluNet website. Available at: http://www.who.int/influenza/gisrs_laboratory/flunet/en/. Accessed on September 26th, 2015.

US Central Intelligence Agency World Factbook website. Available at: https://www.cia.gov/library/publications/the-world-factbook/. Accessed on September 26th, 2015.

Lemaitre M, Carrat F. Comparative age distribution of influenza morbidity and mortality during seasonal influenza epidemics and the 2009 H1N1 pandemic. BMC Infect Dis 2010 Jun;10(1):162. Available from: http://www.biomedcentral.com/1471-2334/10/162 doi: 10.1186/1471-2334-10-162. [Google Scholar]

Goeyvaerts N, Willem L, Van Kerckhove K, Vandendijck Y, Hanquet G, Beutels P, et al. Estimating dynamic transmission model parameters for seasonal influenza by fitting to age and season-specific influenza-like illness incidence. Epidemics 2015;13:1-9. Available from: http://linkinghub.elsevier.com/retrieve/pii/S1755-4365(15)00050-X PubMed PMID: 26616037. doi: 10.1016/j.epidem.2015.04.002. [Google Scholar]

Harvala H, Smith D, Salvatierra K, Gunson R, Wissmann, B. von , Reynolds A, et al. Burden of influenza B virus infections in Scotland in 2012/13 and epidemiological investigations between 2000 and 2012. Euro Surveill 2014 Sep;19(37):20903. Available from: http://www.eurosurveillance.org/ViewArticle.aspx?ArticleId=20903 PubMed PMID: 25259532. doi: 10.2807/1560-7917.ES2014.19.37.20903. [Google Scholar]

Ministero della Salute. Prevenzione e controllo dell'influenza. Available at http://www.salute.gov.it/portale/news/p3_2_1_1_1.jsp?menu=notizie&p=dalministero&id=2218 (Accessed 31 March 2016).