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Estimating the undetected burden of influenza hospitalizations in children

  • C. G. GRIJALVA (a1), G. A. WEINBERG (a2), N. M. BENNETT (a3) (a4), M. A. STAAT (a5), A. S. CRAIG (a1) (a6), W. D. DUPONT (a7), M. K. IWANE (a8), A. S. POSTEMA (a9), W. SCHAFFNER (a1) (a10), K. M. EDWARDS (a11) and M. R. GRIFFIN (a1) (a10) (a12)...
Abstract
SUMMARY

During the 2004–2005 influenza season two independent influenza surveillance systems operated simultaneously in three United States counties. The New Vaccine Surveillance Network (NVSN) prospectively enrolled children hospitalized for respiratory symptoms/fever and tested them using culture and RT–PCR. The Emerging Infections Program (EIP) and a similar clinical-laboratory surveillance system identified hospitalized children who had positive influenza tests obtained as part of their usual medical care. Using data from these systems, we applied capture–recapture analyses to estimate the burden of influenza related-hospitalizations in children aged <5 years. During the 2004–2005 influenza season the influenza-related hospitalization rate estimated by capture–recapture analysis was 8·6/10 000 children aged <5 years. When compared to this estimate, the sensitivity of the prospective surveillance system was 69% and the sensitivity of the clinical-laboratory based system was 39%. In the face of limited resources and an increasing need for influenza surveillance, capture–recapture analysis provides better estimates than either system alone.

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Corresponding author
*Author for correspondence: M. R. Griffin, M.D., M.P.H., A-1110 Medical Center North, Preventive Medicine Department, Vanderbilt University Medical Center, Nashville, TN37232-2637, USA. (Email: marie.griffin@vanderbilt.edu)
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1. MR Hilleman . Realities and enigmas of human viral influenza: pathogenesis, epidemiology and control. Vaccine 2002; 20: 30683087.

2. D Lavanchy . The importance of global surveillance of influenza. Vaccine 1999; 17 (Suppl. 1): S24S25.

3. A Klimov , Surveillance and impact of influenza in the United States. Vaccine 1999; 17 (Suppl. 1): S42S46.

4. I Stephenson , M Zambon . The epidemiology of influenza. Occupational Medicine (London) 2002; 52: 241247.

5. MK Iwane , Population-based surveillance for hospitalizations associated with respiratory syncytial virus, influenza virus, and parainfluenza viruses among young children. Pediatrics 2004; 113: 17581764.

6. WW Thompson , Influenza-associated hospitalizations in the United States. Journal of the American Medical Association 2004; 292: 13331340.

7. GS Goldman . Using capture-recapture methods to assess varicella incidence in a community under active surveillance. Vaccine 2003; 21: 42504255.

9. A Chao , The applications of capture-recapture models to epidemiological data. Statistics in Medicine 2001; 20: 31233157.

11. CG Grijalva , Estimating the burden of influenza hospitalizations in young children using two independent surveillance systems. Emerging Infectious Diseases 2006; 12: 103109.

12. MR Griffin , Epidemiology of respiratory infections in young children: insights from the new vaccine surveillance network. Pediatric Infectious Disease Journal 2004; 23 (11 Suppl.): S188S192.

13. KA Poehling , The underrecognized burden of influenza in young children. New England Journal of Medicine 2006; 355: 3140.

19. JT Wittes . Note: on the bias and estimated variance of Chapman's two-sample capture-recapture population estimate. Biometrics 1972; 28: 592597.

20. RR Regal , EB Hook . Goodness-of-fit based confidence intervals for estimates of the size of a closed population. Statistics in Medicine 1984; 3: 287291.

21. GA Weinberg , Superiority of reverse-transcription polymerase chain reaction to conventional viral culture in the diagnosis of acute respiratory tract infections in children. Journal of Infectious Diseases 2004; 189: 706710.

22. A Schuchat , Active bacterial core surveillance of the emerging infections program network. Emerging Infectious Diseases 2001; 7: 9299.

23. A Ruest , Comparison of the Directigen flu A+B test, the QuickVue influenza test, and clinical case definition to viral culture and reverse transcription-PCR for rapid diagnosis of influenza virus infection. Journal of Clinical Microbiology 2003; 41: 34873493.

24. WJ Rodriguez , RH Schwartz , MM Thorne . Evaluation of diagnostic tests for influenza in a pediatric practice. Pediatric Infectious Disease Journal 2002; 21: 193196.

25. KA Poehling , Bedside diagnosis of influenzavirus infections in hospitalized children. Pediatrics 2002; 110: 8388.

26. AC Cazacu , Comparison of the directigen flu A+B membrane enzyme immunoassay with viral culture for rapid detection of influenza A and B viruses in respiratory specimens. Journal of Clinical Microbiology 2004; 42: 37073710.

27. ME Halloran , IM Longini Jr. Using validation sets for outcomes and exposure to infection in vaccine field studies. American Journal of Epidemiology 2001; 154: 391398.

29. WP Glezen , RB Couch . Interpandemic influenza in the Houston area, 1974–76. New England Journal of Medicine 1978; 298: 587592.

30. KM Neuzil , The effect of influenza on hospitalizations, outpatient visits, and courses of antibiotics in children. New England Journal of Medicine 2000; 342: 225231.

31. MB Rennels , HC Meissner . Technical report: reduction of the influenza burden in children. Pediatrics 2002; 110: e80.

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Epidemiology & Infection
  • ISSN: 0950-2688
  • EISSN: 1469-4409
  • URL: /core/journals/epidemiology-and-infection
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