Goldstein Edward, Greene Sharon K, Olson Donald R, Hanage William P, Lipsitch Marc
Department of Epidemiology, Center for Communicable Disease Dynamics, Harvard School of Public Health, Boston, MA, USA.
Bureau of Communicable Disease, New York City Department of Health and Mental Hygiene, Queens, NY, USA.
Influenza Other Respir Viruses. 2015 Sep;9(5):225-33. doi: 10.1111/irv.12325.
Hospitalization burden associated with influenza and respiratory syncytial virus (RSV) is uncertain due to ambiguity in the inference methodologies employed for its estimation.
Utilization of a new method to quantitate the above burden.
Weekly hospitalization rates for several principal diagnoses from 2003 to 2011 in New York City by age group were regressed linearly against incidence proxies for the major influenza subtypes and RSV adjusting for temporal trends and seasonal baselines.
Average annual rates of influenza-associated respiratory hospitalizations per 100 000 were estimated to be 129 [95% CI (79, 179)] for age <1, 36·3 (21·6, 51·4) for ages 1-4, 10·6 (7·5, 13·7) for ages 5-17, 25·6 (21·3, 29·8) for ages 18-49, 65·5 (54·0, 76·9) for ages 50-64, 125 (105, 147) for ages 65-74, and 288 (244, 331) for ages ≥75. Additionally, influenza had a significant contribution to hospitalization rates with a principal diagnosis of septicemia for ages 5-17 [0·76 (0·1, 1·4)], 18-49 [1·02 (0·3, 1·7)], 50-64 [4·0 (1·7, 6·3)], 65-74 [8·8 (2·2, 15·6)], and ≥75 [38·7 (25·7, 52·9)]. RSV had a significant contribution to the rates of respiratory hospitalizations for age <1 [1900 (1740, 2060)], ages 1-4 [117 (70, 167)], and ≥75 [175 (44, 312)] [including chronic lower respiratory disease, 90 (43, 140)] as well as pneumonia & influenza hospitalizations for ages 18-49 [6·2 (1·1, 11·3)] and circulatory hospitalizations for ages ≥75 [199 (13, 375)].
The high burden of RSV hospitalizations among young children and seniors age ≥75 suggests the need for additional control measures such as vaccination to mitigate the impact of annual RSV epidemics. Our estimates for influenza-associated hospitalizations provide further evidence of the burden of morbidity associated with influenza, supporting current guidelines regarding influenza vaccination and antiviral treatment.
由于用于估计流感和呼吸道合胞病毒（RSV）相关住院负担的推断方法存在模糊性，其住院负担尚不确定。
运用一种新方法来量化上述负担。
将2003年至2011年纽约市按年龄组划分的几种主要诊断的每周住院率，针对主要流感亚型和RSV的发病率替代指标进行线性回归，并对时间趋势和季节性基线进行调整。
每10万人中与流感相关的呼吸道住院的年均率估计为：年龄<1岁者为129[95%可信区间（79, 179）]，1 - 4岁者为36.3（21.6, 51.4），5 - 17岁者为10.6（7.5, 13.7），18 - 49岁者为25.6（21.3, 29.8），50 - 64岁者为65.5（54.0, 76.9），65 - 74岁者为125（105, 147），≥75岁者为288（244, 331）。此外，流感对以败血症为主要诊断的住院率有显著贡献，5 - 17岁[0.76（0.1, 1.4）]，18 - 49岁[1.02（0.3, 1.7）]，50 - 64岁[4.0（1.7, 6.3）]，65 - 74岁[8.8（2.2, 15.6）]，≥75岁[38.7（25.7, 52.9）]。RSV对<1岁[1900（1740, 2060）]、1 - 4岁[117（70, 167）]和≥75岁[175（44, 312）][包括慢性下呼吸道疾病，90（43, 140）]的呼吸道住院率以及18 - 49岁的肺炎和流感住院率[6.2（1.1, 11.3）]和≥75岁的循环系统住院率[199（13, 375）]有显著贡献。
幼儿和≥75岁老年人中RSV住院负担较高，这表明需要采取额外的控制措施，如接种疫苗，以减轻每年RSV流行的影响。我们对流感相关住院的估计进一步证明了流感相关发病负担，支持了当前关于流感疫苗接种和抗病毒治疗的指南。
