2015-2016 年度流感流行病学和流感疫苗效果：全球流感医院监测网络的结果。

Influenza epidemiology and influenza vaccine effectiveness during the 2015-2016 season: results from the Global Influenza Hospital Surveillance Network.

机构信息

Fundación para el Fomento de la Investigación Sanitaria y Biomédica de la Comunidad Valenciana, FISABIO, Valencia, Spain.

Ivanovsky Institute of Virology FSBI "N.F, Gamaleya NRCEM" Ministry of Health, Moscow, Russian Federation.

出版信息

BMC Infect Dis. 2019 May 14;19(1):415. doi: 10.1186/s12879-019-4017-0.

BACKGROUND

The Global Influenza Hospital Surveillance Network is an international platform whose primary objective is to study severe cases of influenza requiring hospitalization.

METHODS

During the 2015-2016 influenza season, 11 sites in the Global Influenza Hospital Surveillance Network in nine countries (Russian Federation, Czech Republic, Turkey, France, China, Spain, Mexico, India, and Brazil) participated in a prospective, active-surveillance, hospital-based epidemiological study. Influenza infection was confirmed by reverse transcription-polymerase chain reaction. Influenza vaccine effectiveness (IVE) against laboratory-confirmed influenza was estimated using a test-negative approach.

RESULTS

9882 patients with laboratory results were included of which 2415 (24.4%) were positive for influenza, including 1415 (14.3%) for A(H1N1)pdm09, 235 (2.4%) for A(H3N2), 180 (1.8%) for A not subtyped, 45 (0.5%) for B/Yamagata-lineage, 532 (5.4%) for B/Victoria-lineage, and 33 (0.3%) for B not subtyped. Of included admissions, 39% were < 5 years of age and 67% had no underlying conditions. The odds of being admitted with influenza were higher among pregnant than non-pregnant women (odds ratio, 2.82 [95% confidence interval (CI), 1.90 to 4.19]). Adjusted IVE against influenza-related hospitalization was 16.3% (95% CI, 0.4 to 29.7). Among patients targeted for influenza vaccination, adjusted IVE against hospital admission with influenza was 16.2% (95% CI, - 3.6 to 32.2) overall, 23.0% (95% CI, - 3.3 to 42.6) against A(H1N1)pdm09, and - 25.6% (95% CI, - 86.3 to 15.4) against B/Victoria lineage.

CONCLUSIONS

The 2015-2016 influenza season was dominated by A(H1N1)pdm09 and B/Victoria-lineage. Hospitalization with influenza often occurred in healthy and young individuals, and pregnant women were at increased risk of influenza-related hospitalization. Influenza vaccines provided low to moderate protection against hospitalization with influenza and no protection against the predominant circulating B lineage, highlighting the need for more effective and broader influenza vaccines.

背景

全球流感医院监测网络是一个国际性平台，其主要目标是研究需要住院的严重流感病例。

方法

在 2015-2016 年流感季节，来自全球流感医院监测网络的 11 个站点（俄罗斯联邦、捷克共和国、土耳其、法国、中国、西班牙、墨西哥、印度和巴西）参与了一项前瞻性、主动监测、基于医院的流行病学研究。通过逆转录聚合酶链反应（RT-PCR）确认流感感染。使用阴性检测方法估计针对实验室确诊流感的流感疫苗效力（IVE）。

结果

共纳入 9882 例有实验室结果的患者，其中 2415 例（24.4%）流感病毒检测呈阳性，包括 1415 例（14.3%）A（H1N1）pdm09、235 例（2.4%）A（H3N2）、180 例（1.8%）未分型 A、45 例（0.5%）B/Yamagata 谱系、532 例（5.4%）B/Victoria 谱系和 33 例（0.3%）未分型 B。纳入的住院患者中，39%的患者年龄小于 5 岁，67%的患者无基础疾病。与非孕妇相比，孕妇因流感住院的可能性更高（比值比，2.82[95%置信区间（CI），1.90 至 4.19]）。调整后的与流感相关的住院治疗的 IVE 为 16.3%（95%CI，0.4 至 29.7）。在接受流感疫苗接种的患者中，总体而言，针对流感住院的调整后 IVE 为 16.2%（95%CI，-3.6 至 32.2），针对 A（H1N1）pdm09 为 23.0%（95%CI，-3.3 至 42.6），针对 B/Victoria 谱系为-25.6%（95%CI，-86.3 至 15.4）。