Browsing by Author "Melillo, Tanya"
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- Determinants of fatal outcome in patients admitted to intensive care units with influenza, European Union 2009–2017Publication . Penttinen, Pasi; Snacken, René; Lyytikäinen, Outi; Ikonen, Niina; Melillo, Tanya; Melillo, Jackie M.; Staroňová, Edita; Mikas, Ján; Popow-Kraupp, Theresia; Orta Gomes, Carlos M.; Guiomar, Raquel; Slezák, Pavel; Kynčl, Jan; Meijer, Adam; Van Gageldonk-Lafeber, Arianne B.; Domegan, Lisa; O’Donnell, Joan; Lupulescu, Emilia; Popovici, Odette; Carnahan, Annasara; Brytting, Mia; Delgado-Sanz, Concepción; Oliva Domínguez, Jesús A.; Larrauri, Amparo; Hubert, Bruno; Bonmarin, Isabelle; Gomes Dias, Joana; Adlhoch, CorneliaBackground: Morbidity, severity, and mortality associated with annual influenza epidemics are of public health concern. We analyzed surveillance data on hospitalized laboratory-confirmed influenza cases admitted to intensive care units to identify common determinants for fatal outcome and inform and target public health prevention strategies, including risk communication. Methods: We performed a descriptive analysis and used Poisson regression models with robust variance to estimate the association of age, sex, virus (sub)type, and underlying medical condition with fatal outcome using European Union data from 2009 to 2017. Results: Of 13 368 cases included in the basic dataset, 2806 (21%) were fatal. Age ≥40 years and infection with influenza A virus were associated with fatal outcome. Of 5886 cases with known underlying medical conditions and virus A subtype included in a more detailed analysis, 1349 (23%) were fatal. Influenza virus A(H1N1)pdm09 or A(H3N2) infection, age ≥60 years, cancer, human immunodeficiency virus infection and/or other immune deficiency, and heart, kidney, and liver disease were associated with fatal outcome; the risk of death was lower for patients with chronic lung disease and for pregnant women. Conclusions: This study re-emphasises the importance of preventing influenza in the elderly and tailoring strategies to risk groups with underlying medical conditions.
- Estimated number of lives directly saved by COVID-19 vaccination programmes in the WHO European Region from December, 2020, to March, 2023: a retrospective surveillance studyPublication . Meslé, Margaux M.I.; Brown, Jeremy; Mook, Piers; Katz, Mark A.; Hagan, José; Pastore, Roberta; Benka, Bernhard; Redlberger-Fritz, Monika; Bossuyt, Nathalie; Stouten, Veerle; Vernemmen, Catharina; Constantinou, Elisabet; Maly, Marek; Kynčl, Jan; Sanca, Ondrej; Krause, Tyra Grove; Vestergaard, Lasse Skafte; Leino, Tuija; Poukka, Eero; Gkolfinopoulou, Kassiani; Mellou, Kassiani; Tsintziloni, Maria; Molnár, Zsuzsanna; Aspelund, Gudrun; Thordardottir, Marianna; Domegan, Lisa; Kelly, Eva; O'Donell, Joan; Urdiales, Alberto-Mateo; Riccardo, Flavia; Sacco, Chiara; Bumšteinas, Viktoras; Liausediene, Rasa; Mossong, Joël; Vergison, Anne; Borg, Maria-Louise; Melillo, Tanya; Kocinski, Dragan; Pollozhani, Enkela; Meijerink, Hinta; Costa, Diana; Gomes, João Paulo; Leite, Pedro Pinto; Druc, Alina; Gutu, Veaceslav; Mita, Valentin; Lazar, Mihaela; Popescu, Rodica; Popovici, Odette; Musilová, Monika; Mrzel, Maja; Socan, Maja; Učakar, Veronika; Limia, Aurora; Mazagatos, Clara; Olmedo, Carmen; Dabrera, Gavin; Kall, Meaghan; Sinnathamby, Mary; McGowan, Graham; McMenamin, Jim; Morrison, Kirsty; Nitzan, Dorit; Widdowson, Marc-Alain; Smallwood, Catherine; Pebody, Richard; WHO European Respiratory Surveillance NetworkBackground: By March, 2023, 54 countries, areas, and territories (hereafter CAT) in the WHO European Region had reported more than 2·2 million COVID-19-related deaths to the WHO Regional Office for Europe. Here, we estimated how many lives were directly saved by vaccinating adults in the WHO European Region from December, 2020, to March, 2023. Methods: In this retrospective surveillance study, we estimated the number of lives directly saved by age group, vaccine dose, and circulating variant-of-concern (VOC) period, regionally and nationally, using weekly data on COVID-19 mortality and infection, COVID-19 vaccination uptake, and SARS-CoV-2 virus characterisations by lineage downloaded from The European Surveillance System on June 11, 2023, as well as vaccine effectiveness data from the literature. We included data for six age groups (25-49 years, 50-59 years, ≥60 years, 60-69 years, 70-79 years, and ≥80 years). To be included in the analysis, CAT needed to have reported both COVID-19 vaccination and mortality data for at least one of the four older age groups. Only CAT that reported weekly data for both COVID-19 vaccination and mortality by age group for 90% of study weeks or more in the full study period were included. We calculated the percentage reduction in the number of expected and reported deaths. Findings: Between December, 2020, and March, 2023, in 34 of 54 CAT included in the analysis, COVID-19 vaccines reduced deaths by 59% overall (CAT range 17-82%), representing approximately 1·6 million lives saved (range 1·5-1·7 million) in those aged 25 years or older: 96% of lives saved were aged 60 years or older and 52% were aged 80 years or older; first boosters saved 51% of lives, and 60% were saved during the Omicron period. Interpretation: Over nearly 2·5 years, most lives saved by COVID-19 vaccination were in older adults by first booster dose and during the Omicron period, reinforcing the importance of up-to-date vaccination among the most at-risk individuals. Further modelling work should evaluate indirect effects of vaccination and public health and social measures.
- National immunization strategies targeting migrants in six European countriesPublication . Giambi, Cristina; Del Manso, Martina; Dalla Zuanna, Teresa; Riccardo, Flavia; Bella, Antonino; Caporali, Maria Grazia; Baka, Agoritsa; Caks-Jager, Nuska; Melillo, Tanya; Mexia, Ricardo; Petrović, Goranka; Declich, Silvia; Ali, Karam Adel; Dente, Maria Grazia; Iannazzo, Stefania; Kaić, Bernard; Napoli, Christian; Panagiotopoulos, Takis; Pereira, Filipa; CARE working group for the National Immunization SurveyOver the last three years an unprecedented flow of migrants arrived in Europe. There is evidence that vaccine preventable diseases have caused outbreaks in migrant holding centres. These outbreaks can be favored by a combination of factors including low immunization coverage, bad conditions that migrants face during their exhausting journey and overcrowding within holding facilities. In 2017, we conducted an online survey in Croatia, Greece, Italy, Malta, Portugal and Slovenia to explore the national immunization strategies targeting irregular migrants, refugees and asylum seekers. All countries stated that a national regulation supporting vaccination offer to migrants is available. Croatia, Italy, Portugal and Slovenia offer to migrant children and adolescents all vaccinations included in the National Immunization Plan; Greece and Malta offer only certain vaccinations, including those against diphtheria-tetanus-pertussis, poliomyelitis and measles-mumps-rubella. Croatia, Italy, Malta and Portugal also extend the vaccination offer to adults. All countries deliver vaccinations in holding centres and/or community health services, no one delivers vaccinations at entry site. Operating procedures that guarantee the migrants' access to vaccination at the community level are available only in Portugal. Data on administered vaccines is available at the national level in four countries: individual data in Malta and Croatia, aggregated data in Greece and Portugal. Data on vaccination uptake among migrants is available at national level only in Malta. Concluding, although diversified, strategies for migrant vaccination are in place in all the surveyed countries and generally in line with WHO and ECDC indications. Development of procedures to keep track of migrants' immunization data across countries, development of strategies to facilitate and monitor migrants' access to vaccinations at the community level and collection of data on vaccination uptake among migrants should be promoted to meet existing gaps.
- Pregnancy during COVID-19: social contact patterns and vaccine coverage of pregnant women from CoMix in 19 European countriesPublication . Wong, Kerry L.M.; Gimma, Amy; Paixao, Enny; Paolotti, Daniela; Karch, André; Jäger, Veronika; Baruch, Joaquin; Melillo, Tanya; Hudeckova, Henrieta; Rosińska-Bukowska, Magdalena; Niedźwiedzka-Stadnik, Marta; Fischer, Krista; Vorobjov, Sigrid; Sõnajalg, Hanna; Althaus, Christian; Low, Nicola; Reichmuth, Martina L.; Auranen, Kari; Nurhonen, Markku; Petrović, Goranka; Makaric, Zvjezdana Lovric; Namorado, Sónia; Caetano, Constantino; Santos, Ana João; Röst, Gergely; Oroszi, Beatrix; Karsai, Márton; Fafangel, Mario; Klepac, Petra; Kranjec, Natalija; Vilaplana, Cristina; Casabona-Barbarà, Jordi; FAES, Christel; Beutels, Philippe; Hens, Niel; Jarvis, Christopher; Edmunds, JohnBackground: Evidence and advice for pregnant women evolved during the COVID-19 pandemic. We studied social contact behaviour and vaccine uptake in pregnant women between March 2020 and September 2021 in 19 European countries. Methods: In each country, repeated online survey data were collected from a panel of nationally-representative participants. We calculated the adjusted mean number of contacts reported with an individual-level generalized additive mixed model, modelled using the negative binomial distribution and a log link function. Mean proportion of people in isolation or quarantine, and vaccination coverage by pregnancy status and gender were calculated using a clustered bootstrap. Findings: We recorded 4,129 observations from 1,041 pregnant women, and 115,359 observations from 29,860 non-pregnant individuals aged 18-49. Pregnant women made slightly fewer contacts (3.6, 95%CI = 3.5-3.7) than non-pregnant women (4.0, 95%CI = 3.9-4.0), driven by fewer work contacts but marginally more contacts in non-essential social settings. Approximately 15-20% pregnant and 5% of non-pregnant individuals reported to be in isolation and quarantine for large parts of the study period. COVID-19 vaccine coverage was higher in pregnant women than in non-pregnant women between January and April 2021. Since May 2021, vaccination in non-pregnant women began to increase and surpassed that in pregnant women. Interpretation: Limited social contact to avoid pathogen exposure during the COVID-19 pandemic has been a challenge to many, especially women going through pregnancy. More recognition of maternal social support desire is needed in the ongoing pandemic. As COVID-19 vaccination continues to remain an important pillar of outbreak response, strategies to promote correct information can provide reassurance and facilitate informed pregnancy vaccine decisions in this vulnerable group.
- Social contact patterns during the COVID-19 pandemic in 21 European countries - evidence from a two-year studyPublication . Wong, Kerry L.M.; Gimma, Amy; Coletti, Pietro; Paolotti, Daniela; Tizzani, Michele; Cattuto, Ciro; Schmidt, Andrea; Gredinger, Gerald; Stumpfl, Sophie; Baruch, Joaquin; Melillo, Tanya; Hudeckova, Henrieta; Zibolenova, Jana; Chladna, Zuzana; Rosinska, Magdalena; Niedzwiedzka-Stadnik, Marta; Fischer, Krista; Vorobjov, Sigrid; Sõnajalg, Hanna; Althaus, Christian; Low, Nicola; Reichmuth, Martina; Auranen, Kari; Nurhonen, Markku; Petrović, Goranka; Makaric, Zvjezdana Lovric; Namorado, Sónia; Caetano, Constantino; Santos, Ana João; Röst, Gergely; Oroszi, Beatrix; Karsai, Márton; Fafangel, Mario; Klepac, Petra; Kranjec, Natalija; Vilaplana, Cristina; Casabona, Jordi; Faes, Christel; Beutels, Philippe; Hens, Niel; Jaeger, Veronika K.; Karch, Andre; Johnson, Helen; Jarvis, Christopher I.Background: Most countries have enacted some restrictions to reduce social contacts to slow down disease transmission during the COVID-19 pandemic. For nearly two years, individuals likely also adopted new behaviours to avoid pathogen exposure based on personal circumstances. We aimed to understand the way in which different factors affect social contacts - a critical step to improving future pandemic responses. Methods: The analysis was based on repeated cross-sectional contact survey data collected in a standardized international study from 21 European countries between March 2020 and March 2022. We calculated the mean daily contacts reported using a clustered bootstrap by country and by settings (at home, at work, or in other settings). Where data were available, contact rates during the study period were compared with rates recorded prior to the pandemic. We fitted censored individual-level generalized additive mixed models to examine the effects of various factors on the number of social contacts. Results: The survey recorded 463,336 observations from 96,456 participants. In all countries where comparison data were available, contact rates over the previous two years were substantially lower than those seen prior to the pandemic (approximately from over 10 to < 5), predominantly due to fewer contacts outside the home. Government restrictions imposed immediate effect on contacts, and these effects lingered after the restrictions were lifted. Across countries, the relationships between national policy, individual perceptions, or personal circumstances determining contacts varied. Conclusions: Our study, coordinated at the regional level, provides important insights into the understanding of the factors associated with social contacts to support future infectious disease outbreak responses.