Browsing by Author "Adlhoch, C."
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- European all-cause excess and influenza-attributable mortality in the 2017/18 season: should the burden of influenza B be reconsidered?Publication . Nielsen, Jens; Vestergaard, Lasse; Richter, L.; Schmid, D.; Bustos, N.; Asikainen, T.; Trebbien, R.; Denissov, G.; Innos, K.; Virtanen, M.J.; Fouillet, A.; Lytras, T.; Gkolfinopoulou, K.; Heiden, M. an der; Grabenhenrich, L.; Uphoff, H.; Paldy, A.; Bobvos, J.; Domegan, L.; O'Donnell, J.; Scortichini, M.; de Martino, A.; Mossong, J.; England, K.; Melillo, J.; van Asten, L.; de Lange, M. MA; Tønnessen, R.; White, R.A.; Silva, Susana Pereira; Rodrigues, Ana Paula; Larrauri, Amparo; Mazagatos, Clara; Farah, A.; Carnahan, A.D.; Junker, C.; Sinnathamby, M.; Pebody, R.G.; Andrews, N.; Reynolds, A.; McMenamin, J.; Brown, C.S.; Adlhoch, C.; Penttinen, P.; Mølbak, K.; Krause, T.G.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.
- Standardising surveillance of hepatitis E virus infection in the EU/EEA: a review of national practices and suggestions for the way forwardPublication . Adlhoch, C.; Mand'áková, Z.; Ethelberg, S.; Epštein, J.; Rimhanen-Finne, R.; Figoni, J.; Baylis, S.A.; Faber, M.; Mellou, K.; Murphy, N.; O'Gorman, J.; Tosti, M.E.; Ciccaglione, A.R.; Hofhuis, A.; Zaaijer, H.; Lange, H.; de Sousa, R.; Avellón, A.; Sundqvist, L.; Said, B.; Ijaz, S.Background: Hepatitis E virus (HEV) infection is not notifiable at EU/EEA level, therefore surveillance relies on national policies only. Between 2005 and 2015, more than 20,000 cases were reported in EU/EEA countries. HEV testing is established in 26 countries and 19 countries sequence HEV viruses. Objective and study design: WHO's European Action plan for viral hepatitis recommends harmonised surveillance objectives and case definitions. ECDC's HEV expert group developed minimal and optimal criteria for national hepatitis E surveillance to support EU/EEA countries in enhancing their capacity and to harmonise methods. Results: The experts agreed that the primary objectives of national surveillance for HEV infections should focus on the basic epidemiology of the disease: to monitor the incidence of acute cases and chronic infections. The secondary objectives should be to describe viral phylotypes or subtypes and to identify potential clusters/outbreaks and possible routes of transmission. Seventeen of 20 countries with existing surveillance systems collect the minimal data set required to describe the epidemiology of acute cases. Eleven countries test for chronic infections. Twelve countries collect data to identify potential clusters/outbreaks and information on possible routes of transmission. Discussion: Overall, the majority of EU/EEA countries collect the suggested data and meet the outlined requirements to confirm an acute case.
- Start of the 2014/15 influenza season in Europe: drifted influenza A(H3N2) viruses circulate as dominant subtypePublication . Broberg, E.; Snacken, R.; Adlhoch, C.; Beauté, J.; Galinska, M.; Pereyaslov, D.; Brown, C.; Penttinen, P.; WHO European Region and European Influenza Surveillance NetworkThe influenza season 2014/15 started in Europe in week 50 2014 with influenza A(H3N2) viruses predominating. The majority of the A(H3N2) viruses characterised antigenically and/or genetically differ from the northern hemisphere vaccine component which may result in reduced vaccine effectiveness for the season. We therefore anticipate that this season may be more severe than the 2013/14 season. Treating influenza with antivirals in addition to prevention with vaccination will be important.