Li-Kim-Moy Jean, Yin Jiehui Kevin, Patel Cyra, Beard Frank H, Chiu Clayton, Macartney Kristine K, McIntyre Peter B
National Centre for Immunisation Research and Surveillance of Vaccine Preventable Diseases, The Children's Hospital at Westmead, Westmead, New South Wales.
Commun Dis Intell Q Rep. 2016 Dec 24;40(4):E482-E495.
Influenza is a major contributor to the preventable health burden of Australians each year. The National Immunisation Program provides influenza vaccine for those at highest risk of severe disease. This review of influenza epidemiology examines current data on influenza disease burden in Australia, in the context of several comparable countries having programs with much broader eligibility for influenza vaccine in children.
Influenza notifications (2006-2015), hospitalisations, and deaths (2006-2013) were sourced and age-specific rates calculated. Comparisons were made across age groups in the pre-pandemic, pandemic, and post-pandemic periods and by Indigenous and non-Indigenous status.
The 2009 pandemic year and the 2012 non-pandemic season resulted in the highest rates of notification, hospitalisation and death. Influenza notification rates were 4.0 times higher and hospitalisation rates 2.1 times higher during 2011-2013 compared with 2006-2008. Death rates varied widely, but peaks corresponded to high-activity seasons. Influenza hospitalisation rates were highest among those aged <5 and ≥65 years, but influenza-attributable deaths were identified primarily in those aged ≥75 years. Significantly higher notification and hospitalisation rates were seen for all Indigenous people, but higher death rates were largely restricted to the 2009 pandemic year.
Based on notifications, hospitalisations and deaths, burden of disease from influenza is highest at the extremes of life and is significantly higher among Indigenous people of all ages. This pattern of disease burden warrants consideration of widened eligibility for influenza vaccine under the National Immunisation Program to all Indigenous people and all children less than 5 years of age.
流感是每年澳大利亚可预防健康负担的主要因素。国家免疫规划为患重病风险最高的人群提供流感疫苗。本流感流行病学综述在几个儿童流感疫苗接种资格范围更广的可比国家的背景下,研究了澳大利亚流感疾病负担的当前数据。
获取流感报告(2006 - 2015年)、住院情况和死亡数据(2006 - 2013年),并计算特定年龄组的发病率。对大流行前、大流行期间和大流行后各年龄组以及按原住民和非原住民身份进行了比较。
2009年大流行年和2012年非大流行季节导致了最高的报告率、住院率和死亡率。与2006 - 2008年相比,2011 - 2013年期间流感报告率高出4.0倍,住院率高出2.1倍。死亡率差异很大,但峰值与高活动季节相对应。流感住院率在5岁以下和65岁及以上人群中最高,但流感所致死亡主要发生在75岁及以上人群中。所有原住民的报告率和住院率显著更高,但更高的死亡率主要限于2009年大流行年。
基于报告、住院情况和死亡数据,流感疾病负担在生命两端最高,且在各年龄段的原住民中显著更高。这种疾病负担模式值得考虑将国家免疫规划下流感疫苗的接种资格扩大到所有原住民和所有5岁以下儿童。