Browsing by Author "Penttinen, Pasi"
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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.
- Dominant influenza A(H3N2) and B/Yamagata virus circulation in EU/EEA, 2016/17 and 2017/18 seasons, respectivelyPublication . Adlhoch, Cornelia; Snacken, René; Melidou, Angeliki; Ionescu, Silviu; Penttinen, Pasi; The European Influenza Surveillance NetworkThe yearly influenza epidemics during each winter season vary in burden and severity. During the 2016/17 and 2017/18 seasons, all-cause excess mortality was observed during periods of high influenza virus circulation. Our aim is to describe and compare the pattern of influenza virus circulation and related disease severity by number of patients and fatal cases in intensive care units (ICUs) across European Union/European Economic Area (EU/EEA) countries for the seasons 2016/17 and 2017/18. As influenza circulation progressed from a west to east direction across Europe in 2017/18, a better understanding of the current epidemiological situation might help to prepare countries in the eastern part of the World Health Organization (WHO) European Region for high influenza activity and severity.
- Effectiveness of influenza vaccine against influenza A in Europe in seasons of different A(H1N1)pdm09 and the same A(H3N2) vaccine components (2016-17 and 2017-18)Publication . Kissling, Esther; Pozo, Francisco; Buda, Silke; Vilcu, Ana-Maria; Rizzo, Caterina; Gherasim, Alin; Krisztina Horváth, Judit; Brytting, Mia; Domegan, Lisa; Meijer, Adam; Paradowska-Stankiewicz, Iwona; Machado, Ausenda; Višekruna Vučina, Vesna; Lazar, Mihaela; Johansen, Kari; Dürrwald, Ralf; van der Werf, Sylvie; Bella, Antonino; Larrauri, Amparo; Ferenczi, Annamária; Zakikhany, Katherina; O'Donnell, Joan; Dijkstra, Frederika; Bogusz, Joanna; Guiomar, Raquel; Kurečić Filipović, Sanja; Pitigoi, Daniela; Penttinen, Pasi; Valenciano, Marta; Gomez, Veronica; Kislaya, Irina; Nunes, Baltazar; I-MOVE/I-MOVE+ study teamIntroduction: Influenza A(H3N2) viruses predominated in Europe in 2016–17. In 2017–18 A(H3N2) and A(H1N1)pdm09 viruses co-circulated. The A(H3N2) vaccine component was the same in both seasons; while the A(H1N1)pdm09 component changed in 2017–18. In both seasons, vaccine seed A(H3N2) viruses developed adaptations/alterations during propagation in eggs, impacting antigenicity. Methods: We used the test-negative design in a multicentre primary care case-control study in 12 European countries to measure 2016–17 and 2017–18 influenza vaccine effectiveness (VE) against laboratory-confirmed influenza A(H1N1)pdm09 and A(H3N2) overall and by age group. Results: During the 2017–18 season, the overall VE against influenza A(H1N1)pdm09 was 59% (95% CI: 47–69). Among those aged 0–14, 15–64 and ≥65 years, VE against A(H1N1)pdm09 was 64% (95% CI: 37–79), 50% (95% CI: 28–66) and 66% (95% CI: 42–80), respectively. Overall VE against influenza A(H3N2) was 28% (95% CI: 17–38) in 2016–17 and 13% (95% CI: -15 to 34) in 2017–18. Among 0–14-year-olds VE against A(H3N2) was 28% (95%CI: -10 to 53) and 29% (95% CI: -87 to 73), among 15–64-year-olds 34% (95% CI: 18–46) and 33% (95% CI: -3 to 56) and among those aged ≥65 years 15% (95% CI: -10 to 34) and -9% (95% CI: -74 to 32) in 2016–17 and 2017–18, respectively. Conclusions: Our study suggests the new A(H1N1)pdm09 vaccine component conferred good protection against circulating strains, while VE against A(H3N2) was <35% in 2016–17 and 2017–18. The egg propagation derived antigenic mismatch of the vaccine seed virus with circulating strains may have contributed to this low effectiveness. A(H3N2) seed viruses for vaccines in subsequent seasons may be subject to the same adaptations; in years with lower than expected VE, recommendations of preventive measures other than vaccination should be given in a timely manner.
- Excess all-cause and influenza-attributable mortality in Europe, December 2016 to February 2017Publication . Vestergaard, Lasse S; Nielsen, Jens; Krause, Tyra G; Espenhain, Laura; Tersago, Katrien; Bustos Sierra, Natalia; Denissov, Gleb; Innos, Kaire; Virtanen, Mikko J; Fouillet, Anne; Lytras, Theodore; Paldy, Anna; Bobvos, Janos; Domegan, Lisa; O’Donnell, Joan; Scortichini, Matteo; de Martino, Annamaria; England, Kathleen; Calleja, Neville; van Asten, Liselotte; Teirlinck, Anne C; Tønnessen, Ragnhild; White, Richard A; Silva, Susana Pereira; Rodrigues, Ana Paula; Larrauri, Amparo; Leon, Inmaculada; Farah, Ahmed; Junker, Christoph; Sinnathamby, Mary; Pebody, Richard G; Reynolds, Arlene; Bishop, Jennifer; Gross, Diane; Adlhoch, Cornelia; Penttinen, Pasi; Mølbak, KåreSince December 2016, excess all-cause mortality was observed in many European countries, especially among people aged ≥ 65 years. We estimated all-cause and influenza-attributable mortality in 19 European countries/regions. Excess mortality was primarily explained by circulation of influenza virus A(H3N2). Cold weather snaps contributed in some countries. The pattern was similar to the last major influenza A(H3N2) season in 2014/15 in Europe, although starting earlier in line with the early influenza season start.
- Low 2018/19 vaccine effectiveness against influenza A(H3N2) among 15-64-year-olds in Europe: exploration by birth cohortPublication . Kissling, Esther; Pozo, Francisco; Buda, Silke; Vilcu, Ana-Maria; Gherasim, Alin; Brytting, Mia; Domegan, Lisa; Gómez, Verónica; Meijer, Adam; Lazar, Mihaela; Vučina, Vesna Višekruna; Dürrwald, Ralf; van der Werf, Sylvie; Larrauri, Amparo; Enkirch, Theresa; O’Donnell, Joan; Guiomar, Raquel; Hooiveld, Mariëtte; Petrović, Goranka; Stoian, Elena; Penttinen, Pasi; Valenciano, Marta; I-MOVE primary care study teamIntroduction: Influenza A(H3N2) clades 3C.2a and 3C.3a co-circulated in Europe in 2018/19. Immunological imprinting by first childhood influenza infection may induce future birth cohort differences in vaccine effectiveness (VE). Aim: The I-MOVE multicentre primary care test-negative study assessed 2018/19 influenza A(H3N2) VE by age and genetic subgroups to explore VE by birth cohort. Methods: We measured VE against influenza A(H3N2) and (sub)clades. We stratified VE by usual age groups (0–14, 15–64, ≥ 65-years). To assess the imprint-regulated effect of vaccine (I-REV) hypothesis, we further stratified the middle-aged group, notably including 32–54-year-olds (1964–86) sharing potential childhood imprinting to serine at haemagglutinin position 159. Results: Influenza A(H3N2) VE among all ages was −1% (95% confidence interval (CI): −24 to 18) and 46% (95% CI: 8–68), −26% (95% CI: −66 to 4) and 20% (95% CI: −20 to 46) among 0–14, 15–64 and ≥ 65-year-olds, respectively. Among 15–64-year-olds, VE against clades 3C.2a1b and 3C.3a was 15% (95% CI: −34 to 50) and −74% (95% CI: −259 to 16), respectively. VE was −18% (95% CI: −140 to 41), −53% (95% CI: −131 to −2) and −12% (95% CI: −74 to 28) among 15–31-year-olds (1987–2003), 32–54-yearolds (1964–86) and 55–64-year-olds (1954–63), respectively. Discussion: The lowest 2018/19 influenza A(H3N2) VE was against clade 3C.3a and among those born 1964–86, corresponding to the I-REV hypothesis. The low influenza A(H3N2) VE in 15–64-year-olds and the public health impact of the I-REV hypothesis warrant further study.
- New perspectives on respiratory syncytial virus surveillance at the national level: lessons from the COVID-19 pandemicPublication . Teirlinck, Anne C.; Johannesen, Caroline K.; Broberg, Eeva K.; Penttinen, Pasi; Campbell, Harry; Nair, Harish; Reeves, Rachel M.; Bøås, Håkon; Brytting, Mia; Cai, Wei; Carnahan, AnnaSara; Casalegno, Jean-Sebastien; Danis, Kostas; De Gascun, Cillian; Ellis, Joanna; Emborg, Hanne-Dorthe; Gijon, Manuel; Guiomar, Raquel; Hirve, Siddhivinayak S.; Jiřincová, Helena; Nohynek, Hanna; Oliva, Jesus Angel; Osei-Yeboah, Richard; Paget, John; Pakarna, Gatis; Pebody, Richard; Presser, Lance; Rapp, Marie; Reiche, Janine; Rodrigues, Ana Paula; Seppälä, Elina; Socan, Maja; Szymanski, Karol; Trebbien, Ramona; Večeřová, Jaromíra; van der Werf, Sylvie; Zambon, Maria; Meijer, Adam; Fischer, Thea K.Learning from the COVID-19 pandemic and considering the effects of this pandemic, we provide recommendations that can guide towards sustainable RSV surveillance with the potential to be integrated into the broader perspective of respiratory surveillance.
- Predominance of influenza virus A(H3N2) 3C.2a1b and A(H1N1)pdm09 6B.1A5A genetic subclades in the WHO European Region, 2018–2019Publication . Melidou, Angeliki; Hungnes, Olav; Pereyaslov, Dmitriy; Adlhoch, Cornelia; Segaloff, Hannah; Robesyn, Emmanuel; Penttinen, Pasi; Olsen, Sonja J.; Redlberger-Fritz, Monika; Popow-Kraupp, Therese; Hasibra, Iris; Simaku, Artan; Thomas, Isabelle; Barbezange, Cyril; Dedeić-Ljubović, Amela; Rodić-Vukmir, Nina; Korsun, Neli; Angenova, Svetla; Draženović, Vladimir; Koliou, Maria; Pieridou, Despo; Havlickova, Martina; Nagy, Alexander; Trebbien, Ramona; Galiano, Monica; Thompson, Catherine; Ikonen, Niina; Haveri, Anu; Behillil, Sylvie; Enouf, Vincent; Valette, Martine; Lina, Bruno; Gavashelidze, Mari; Machablishvili, Ann; Gioula, Georgia; Exindari, Maria; Kossyvakis, Athanasios; Mentis, Andreas; Dürrwald, Ralf; Zsuzsanna, Molnar; Monika, Rozsa; Löve, Arthur; Erna, Gudrun; Dunford, Linda; Fitzpatrick, Sarah; Castrucci, Maria Rita; Puzelli, Simona; Sagymbay, Altynay; Nussupbayeva, Gaukhar; Zamjatina, Natalija; Pakarna, Gatis; Griskevičius, Algirdas; Skrickiene, Asta; Fournier, Guillaume; Mossong, Joel; Melillo, Jackie; Zahra, Graziella; Meijer, Adam; Fouchier, Ron; McCaughey, Conall; O'Doherty, Mark; Bragstad, Karoline; Guiomar, Raquel; Pechirra, Pedro; Apostol, Mariana; Alina, Druc; Lazar, Mihaela; Maria, Cherciu Carmen; Komissarov, Andrey; Burtseva, Elena; Gunson, Rory N.; Shepherd, Samantha; Tichá, Elena; Staronova, Edita; Prosenc, Katarina; Berginc, Nataša; Pozo, Francisco; Casas, Inmaculada; Brytting, Mia; Wiman, Åsa; Gonçalves, Ana Rita; Demchyshyna, Iryna; Mironenko, Alla; Moore, Catherine; Cottrell, Simon; European Region influenza surveillance networkBackground: The 2018/2019 influenza season in the WHO European Region was dominated by influenza A (H1N1)pdm09 and (H3N2) viruses, with very few influenza B viruses detected. Methods: Countries in the European Region reported virus characterization data to The European Surveillance System for weeks 40/2018 to 20/2019. These virus antigenic and genetic characterization and haemagglutinin (HA) sequence data were analysed to describe and assess circulating viruses relative to the 2018/2019 vaccine virus components for the northern hemisphere. Results: Thirty countries reported 4776 viruses characterized genetically and 3311 viruses antigenically. All genetically characterized A(H1N1)pdm09 viruses fell in subclade 6B.1A, of which 90% carried the amino acid substitution S183P in the HA gene. Antigenic data indicated that circulating A(H1N1)pdm09 viruses were similar to the 2018/2019 vaccine virus. Genetic data showed that A(H3N2) viruses mostly fell in clade 3C.2a (75%) and 90% of which were subclade 3C.2a1b. A lower proportion fell in clade 3C.3a (23%) and were antigenically distinct from the vaccine virus. All B/Victoria viruses belonged to clade 1A; 30% carried a double amino acid deletion in HA and were genetically and antigenically similar to the vaccine virus component, while 55% carried a triple amino acid deletion or no deletion in HA; these were antigenically distinct from each other and from the vaccine component. All B/Yamagata viruses belonged to clade 3 and were antigenically similar to the virus component in the quadrivalent vaccine for 2018/2019. Conclusions: A simultaneous circulation of genetically and antigenically diverse A(H3N2) and B/Victoria viruses was observed and represented a challenge to vaccine strain selection.
- Seasonality and geographical spread of respiratory syncytial virus epidemics in 15 European countries, 2010 to 2016Publication . Broberg, Eeva K.; Waris, Matti; Johansen, Kari; Snacken, René; Penttinen, Pasi; European Influenza Surveillance NetworkRespiratory syncytial virus (RSV) is considered the most common pathogen causing severe lower respiratory tract infections among infants and young children. We describe the seasonality and geographical spread of RSV infection in 15 countries of the European Union and European Economic Area. We performed a retrospective descriptive study of weekly laboratory-confirmed RSV detections between weeks 40/2010 and 20/2016, in patients investigated for influenza-like illness, acute respiratory infection or following the clinician's judgment. Six countries reported 4,230 sentinel RSV laboratory diagnoses from primary care and 14 countries reported 156,188 non-sentinel laboratory diagnoses from primary care or hospitals. The median length of the RSV season based on sentinel and non-sentinel surveillance was 16 (range: 9-24) and 18 (range: 8-24) weeks, respectively. The median peak weeks for sentinel and non-sentinel detections were week 4 (range: 48 to 11) and week 4.5 (range: 49 to 17), respectively. RSV detections peaked later (r = 0.56; p = 0.0360) and seasons lasted longer with increasing latitude (r = 0.57; p = 0.0329). Our data demonstrated regular seasonality with moderate correlation between timing of the epidemic and increasing latitude of the country. This study supports the use of RSV diagnostics within influenza or other surveillance systems to monitor RSV seasonality and geographical spread.