Browsing by Author "Virtanen, M.J."
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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.
- Excess mortality among the elderly in 12 European countries, February and March 2012Publication . Mazick, A.; Gergonne, B.; Nielsen, J.; Wuillaume, F.; Virtanen, M.J.; Fouillet, A.; Uphoff, H.; Sideroglou, T.; Paldy, A.; Oza, A.; Nunes, Baltazar; Flores-Segovia, V.M.; Junker, C.; McDonald, S.A.; Green, H.K.; Pebody, R.; Mølbak, K.In February and March 2012, excess deaths among the elderly have been observed in 12 European countries that carry out weekly monitoring of all-cause mortality. These preliminary data indicate that the impact of influenza in Europe differs from the recent pandemic and post-pandemic seasons. The current excess mortality among the elderly may be related to the return of influenza A(H3N2) virus, potentially with added effects of a cold snap.
- Pooling European all-cause mortality: methodology and findings for the seasons 2008/2009 to 2010/2011.Publication . Nielsen, J.; Mazick, A.; Andrews, N.; Detsis, M.; Fenech, T.M.; Flores, V.M.; Foulliet, A.; Gergonne, B.; Green, H.K.; Junker, C.; Nunes, Baltazar; O'Donnell, J.; Oza, A.; Paldy, A.; Pebody, R.; Reynolds, A.; Sideroglou, T.; Snijders, B.E.; Simon-Soria, F.; Uphoff, H.; VAN Asten, L.; Virtanen, M.J.; Wuillaume, F.; Mølbak, K.Several European countries have timely all-cause mortality monitoring. However, small changes in mortality may not give rise to signals at the national level. Pooling data across countries may overcome this, particularly if changes in mortality occur simultaneously. Additionally, pooling may increase the power of monitoring populations with small numbers of expected deaths, e.g. younger age groups or fertile women. Finally, pooled analyses may reveal patterns of diseases across Europe. We describe a pooled analysis of all-cause mortality across 16 European countries. Two approaches were explored. In the ‘summarized’ approach, data across countries were summarized and analysed as one overall country. In the ‘stratified’ approach, heterogeneities between countries were taken into account. Pooling using the ‘stratified’ approach was the most appropriate as it reflects variations in mortality. Excess mortality was observed in all winter seasons albeit slightly higher in 2008/09 than 2009/10 and 2010/11. In the 2008/09 season, excess mortality was mainly in elderly adults. In 2009/10, when pandemic influenza A(H1N1) dominated, excess mortality was mainly in children. The 2010/11 season reflected a similar pattern, although increased mortality in children came later. These patterns were less clear in analyses based on data from individual countries. We have demonstrated that with stratified pooling we can combine local mortality monitoring systems and enhance monitoring of mortality across Europe.