European all-cause excess and influenza-attributable mortality in the 2017/18 season: should the burden of influenza B be reconsidered?
Year: 2019
Type: article
Study design: Observational Study
Abstract: OBJECTIVES: Weekly monitoring of European all-cause excess mortality, the EuroMOMO network, observed high excess mortality during the influenza B/Yamagata dominated 2017/18 winter season, especially among elderly. We describe all-cause excess and influenza-attributable mortality during the season 2017/18 in Europe. METHODS: Based on weekly reporting of mortality from 24 European countries or sub-national regions, representing 60% of the European population excluding the Russian and Turkish parts of Europe, we estimated age stratified all-cause excess morality using the EuroMOMO model. In addition, age stratified all-cause influenza-attributable mortality was estimated using the FluMOMO algorithm, incorporating influenza activity based on clinical and virological surveillance data, and adjusting for extreme temperatures. RESULTS: Excess mortality was mainly attributable to influenza activity from December 2017 to April 2018, but also due to exceptionally low temperatures in February-March 2018. The pattern and extent of mortality excess was similar to the previous A(H3N2) dominated seasons, 2014/15 and 2016/17. The 2017/18 overall all-cause influenza-attributable mortality was estimated to be 25.4 (95%CI 25.0-25.8) per 100,000 population; 118.2 (116.4-119.9) for persons aged 65. Extending to the European population this translates into over-all 152,000 deaths. CONCLUSIONS: The high mortality among elderly was unexpected in an influenza B dominated season, which commonly are considered to cause mild illness, mainly among children. Even though A(H3N2) also circulated in the 2017/18 season and may have contributed to the excess mortality among the elderly, the common perception of influenza B only having a modest impact on excess mortality in the older population may need to be reconsidered.
Authors: J. Nielsen, L.S. Vestergaard, L. Richter, D. Schmid, N. Bustos, T. Asikainen, R. Trebbien, G. Denissov, K. Innos, M.J. Virtanen, A. Fouillet, T. Lytras, K. Gkolfinopoulou, M. an der Heiden, L. Grabenhenrich, H. Uphoff, A. Paldy, J. Bobvos, L. Domegan, J. O'Donnell, M. Scortichini, A. de Martino, J. Mossong, K. England, J. Melillo, L. van Asten, M. MA de Lange, R. Tønnessen, R.A. White, S.P. da Silva, A.P. Rodrigues, A. Larrauri, C. Mazagatos, A. Farah, A.D. Carnahan, C. Junker, M. Sinnathamby, R.G. Pebody, N. Andrews, A. Reynolds, J. McMenamin, C.S. Brown, C. Adlhoch, P. Penttinen, K. Mølbak, T.G. Krause
Institutions: Statens Serum Institut, Austrian Agency for Health and Food Safety, Sciensano (Belgium), National Institute for Health Development, Finnish Institute for Health and Welfare, Santé Publique France, Hellenic Center for Disease Control & Prevention, Robert Koch Institute, Ministry of Human Capacities, Health Service Executive, Health Protection Surveillance Centre, ASL Roma, Ministero della Salute, Laboratoire National de Santé, National Institute for Public Health and the Environment, Norwegian Institute of Public Health, National Institute of Health Dr. Ricardo Jorge, Instituto de Salud Carlos III, Centro Nacional de Epidemiología, Centro de Investigación Biomédica en Red de Epidemiología y Salud Pública, Public Health Agency of Sweden, Federal Statistical Office, Public Health England, Health Protection Scotland, World Health Organization Regional Office for Europe, European Centre for Disease Prevention and Control, University of Copenhagen
Language: English
Subfield: Epidemiology
Field: Medicine
Domain: Health Sciences
Open Access status: hybrid
Estimated APC paid: $3,200
Award: G2286538979
OpenAlex ID: W2912848554