Browsing by Author "Kyncl, Jan"
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- Estimates of global seasonal influenza-associated respiratory mortality: a modelling studyPublication . Iuliano, A. Danielle; Roguski, Katherine M.; Chang, Howard H.; Muscatello, David J.; Palekar, Rakhee; Tempia, Stefano; Cohen, Cheryl; Gran, Jon Michael; Schanzer, Dena; Cowling, Benjamin J.; Wu, Peng; Kyncl, Jan; Ang, Li Wei; Park, Minah; Redlberger-Fritz, Monika; Yu, Hongjie; Espenhain, Laura; Krishnan, Anand; Emukule, Gideon; van Asten, Liselotte; Silva, Susana Pereira; Aungkulanon, Suchunya; Buchholz, Udo; Widdowson, Marc-Alain; Bresee, Joseph S.; Global Seasonal Influenza-associated Mortality Collaborator NetworkBACKGROUND: Estimates of influenza-associated mortality are important for national and international decision making on public health priorities. Previous estimates of 250 000-500 000 annual influenza deaths are outdated. We updated the estimated number of global annual influenza-associated respiratory deaths using country-specific influenza-associated excess respiratory mortality estimates from 1999-2015. METHODS: We estimated country-specific influenza-associated respiratory excess mortality rates (EMR) for 33 countries using time series log-linear regression models with vital death records and influenza surveillance data. To extrapolate estimates to countries without data, we divided countries into three analytic divisions for three age groups (<65 years, 65-74 years, and ≥75 years) using WHO Global Health Estimate (GHE) respiratory infection mortality rates. We calculated mortality rate ratios (MRR) to account for differences in risk of influenza death across countries by comparing GHE respiratory infection mortality rates from countries without EMR estimates with those with estimates. To calculate death estimates for individual countries within each age-specific analytic division, we multiplied randomly selected mean annual EMRs by the country's MRR and population. Global 95% credible interval (CrI) estimates were obtained from the posterior distribution of the sum of country-specific estimates to represent the range of possible influenza-associated deaths in a season or year. We calculated influenza-associated deaths for children younger than 5 years for 92 countries with high rates of mortality due to respiratory infection using the same methods. FINDINGS: EMR-contributing countries represented 57% of the global population. The estimated mean annual influenza-associated respiratory EMR ranged from 0·1 to 6·4 per 100 000 individuals for people younger than 65 years, 2·9 to 44·0 per 100 000 individuals for people aged between 65 and 74 years, and 17·9 to 223·5 per 100 000 for people older than 75 years. We estimated that 291 243-645 832 seasonal influenza-associated respiratory deaths (4·0-8·8 per 100 000 individuals) occur annually. The highest mortality rates were estimated in sub-Saharan Africa (2·8-16·5 per 100 000 individuals), southeast Asia (3·5-9·2 per 100 000 individuals), and among people aged 75 years or older (51·3-99·4 per 100 000 individuals). For 92 countries, we estimated that among children younger than 5 years, 9243-105 690 influenza-associated respiratory deaths occur annually. INTERPRETATION: These global influenza-associated respiratory mortality estimates are higher than previously reported, suggesting that previous estimates might have underestimated disease burden. The contribution of non-respiratory causes of death to global influenza-associated mortality should be investigated.
- Vaccination of healthcare personnel in Europe: update to current policiesPublication . Maltezou, Helena C.; Botelho-Nevers, Elisabeth; Brantsæter, Arne B.; Carlsson, Rose-Marie; Heininger, Ulrich; Hübschen, Judith M.; Josefsdottir, Kamilla S.; Kassianos, George; Kyncl, Jan; Ledda, Caterina; Medić, Snežana; Nitsch-Osuch, Aneta; de Lejarazu, Raul Ortiz; Theodoridou, Maria; Van Damme, Pierre; van Essen, Gerrit A.; Wicker, Sabine; Wiedermann, Ursula; Poland, Gregory A.; Bino, Silvia; Wiedermann, Ursula; Van Damme, Pierre; Filipova, Radosveta; Draženović, Vladimir; Koliou, Maria; Fabianova, Katerina; Kyncl, Jan; Heilmann Jensen, Lise; Filippova, Irina; Elonsalo, Ulpu; Botelho-Nevers, Elisabeth; Wicker, Sabine; Maltezou, Helena C.; Theodoridou, Maria; Molnár, Zsuzsanna; Sigridur Josefsdottir, Kamilla; Sisson, Lynda; Ledda, Caterina; Perevoscikovs, Jurijs; Savrasova, Larisa; Caplinskas, Saulius; Berthet, Françoise; Hübschen, Judith M; Borg, Michael; Cirstea, Olga; Essen, Gerrit A. van; Brantsæter, Arne B.; Nitsch-Osuch, Aneta; Graça, Silva; Falup-Pecurariu, Oana; Mikheeva, Irina; Medić, Snežana; Kollárová, Dagmar; Mrvic, Tatjana; de Lejarazu, Raúl Ortiz; Carlsson, Rose-Marie; Roth, Adam; Heininger, Ulrich; Chernyshova, Liudmyla; Lapiy, Fedir; Kassianos, George; Poland, Gregory A.; Vaccination Policies for HCP in Europe Study GroupWe investigated and compared current national vaccination policies for health-care personnel (HCP) in Europe with results from our previous survey. Data from 36 European countries were collected using the same methodology as in 2011. National policies for HCP immunization were in place in all countries. There were significant differences in terms of number of vaccinations, target HCP and healthcare settings, and implementation regulations (recommended or mandatory vaccinations). Vaccination policies against hepatitis B and seasonal influenza were present in 35 countries each. Policies for vaccination of HCP against measles, mumps, rubella and varicella existed in 28, 24, 25 and 19 countries, respectively; and against tetanus, diphtheria, pertussis and poliomyelitis in 21, 20, 19, and 18 countries, respectively. Recommendations for hepatitis A immunization existed in 17 countries, and against meningococcus B, meningococcus C, meningococcus A, C, W, Y, and tuberculosis in 10, 8, 17, and 7 countries, respectively. Mandatory vaccination policies were found in 13 countries and were a pre-requisite for employment in ten. Comparing the vaccination programs of the 30 European countries that participated in the 2011 survey, we found that more countries had national vaccination policies against measles, mumps, rubella, hepatitis A, diphtheria, tetanus, poliomyelitis, pertussis, meningococcus C and/or meningococcus A, C, W, Y; and more of these implemented mandatory vaccination policies for HCP. In conclusion, European countries now have more comprehensive national vaccination programs for HCP, however there are still gaps. Given the recent large outbreaks of vaccine-preventable diseases in Europe and the occupational risk for HCP, vaccination policies need to be expanded and strengthened in several European countries. Overall, vaccination policies for HCP in Europe should be periodically re-evaluated in order to provide optimal protection against vaccine-preventable diseases and infection control within healthcare facilities for HCP and patients.