Skip to main content
    • Aa
    • Aa
  • Get access
    Check if you have access via personal or institutional login
  • Cited by 26
  • Cited by
    This article has been cited by the following publications. This list is generated based on data provided by CrossRef.

    Bahramsoltani, Roodabeh Sodagari, Hamid Reza Farzaei, Mohammad Hosein Abdolghaffari, Amir Hossein Gooshe, Maziar and Rezaei, Nima 2016. The preventive and therapeutic potential of natural polyphenols on influenza. Expert Review of Anti-infective Therapy, Vol. 14, Issue. 1, p. 57.

    Phadke, Varun K. and Omer, Saad B. 2016. Maternal vaccination for the prevention of influenza: current status and hopes for the future. Expert Review of Vaccines, p. 1.

    SULLIVAN, S. G. CARVILLE, K. S. CHILVER, M. FIELDING, J. E. GRANT, K. A. KELLY, H. LEVY, A. STOCKS, N. P. TEMPONE, S. S. and REGAN, A. K. 2016. Pooled influenza vaccine effectiveness estimates for Australia, 2012–2014. Epidemiology and Infection, Vol. 144, Issue. 11, p. 2317.

    Bellido-Blasco, Juan B. Pardo-Serrano, Francisco Ballester-Rodríguez, Isabel Arnedo-Pena, Alberto Tirado-Balaguer, M. Dolores Romeu-García, M. Ángeles Silvestre-Silvestre, Ester Meseguer-Ferrer, Noemí Herrero-Carot, Concha and Caylà-Buqueres, Joan A. 2015. An Estimate of the Incidence of Influenza-Like Illness During the Influenza Pandemic of 2009. Archivos de Bronconeumología (English Edition), Vol. 51, Issue. 8, p. 373.

    Bellido-Blasco, Juan B. Pardo-Serrano, Francisco Ballester-Rodríguez, Isabel Arnedo-Pena, Alberto Tirado-Balaguer, M. Dolores Romeu-García, M. Ángeles Silvestre-Silvestre, Ester Meseguer-Ferrer, Noemí Herrero-Carot, Concha and Caylà-Buqueres, Joan A. 2015. Estimación de la incidencia de síndrome gripal durante la pandemia de gripe de 2009. Archivos de Bronconeumología, Vol. 51, Issue. 8, p. 373.

    Hadler, James L. Danila, Richard N. Cieslak, Paul R. Meek, James I. Schaffner, William Smith, Kirk E. Cartter, Matthew L. Harrison, Lee H. Vugia, Duc J. and Lynfield, Ruth 2015. Emerging Infections Program—State Health Department Perspective. Emerging Infectious Diseases, Vol. 21, Issue. 9, p. 1510.

    Howard, Leigh M. Johnson, Monika Williams, John V. Zhu, Yuwei Gil, Ana I. Edwards, Kathryn M. Griffin, Marie R. Lanata, Claudio F. and Grijalva, Carlos G. 2015. Respiratory Viral Detections During Symptomatic and Asymptomatic Periods in Young Andean Children. The Pediatric Infectious Disease Journal, Vol. 34, Issue. 10, p. 1074.

    Lee, G. E. Fisher, B. T. Xiao, R. Coffin, S. E. Feemster, K. Seif, A. E. Bagatell, R. Li, Y. Huang, Y.-S. V. and Aplenc, R. 2015. Burden of Influenza-Related Hospitalizations and Attributable Mortality in Pediatric Acute Lymphoblastic Leukemia. Journal of the Pediatric Infectious Diseases Society, Vol. 4, Issue. 4, p. 290.

    Ortiz, Justin R. Neuzil, Kathleen M. Shay, David K. Rue, Tessa C. Neradilek, Moni B. Zhou, Hong Seymour, Christopher W. Hooper, Laura G. Cheng, Po-Yung Goss, Christopher H. and Cooke, Colin R. 2014. The Burden of Influenza-Associated Critical Illness Hospitalizations*. Critical Care Medicine, Vol. 42, Issue. 11, p. 2325.

    Yu, Hongjie Huang, Jigui Huai, Yang Guan, Xuhua Klena, John Liu, Shali Peng, Youxing Yang, Hui Luo, Jun Zheng, Jiandong Chen, Maoyi Peng, Zhibin Xiang, Nijuan Huo, Xixiang Xiao, Lin Jiang, Hui Chen, Hui Zhang, Yuzhi Xing, Xuesen Xu, Zhen Feng, Zijian Zhan, Faxian Yang, Weizhong Uyeki, Timothy M. Wang, Yu and Varma, Jay K. 2014. The substantial hospitalization burden of influenza in central China: surveillance for severe, acute respiratory infection, and influenza viruses, 2010-2012. Influenza and Other Respiratory Viruses, Vol. 8, Issue. 1, p. 53.

    Hoefer, Dina Cherry, Bryan Kacica, Marilyn McClamroch, Kristi and Kilby, Kimberly 2012. Pediatric Influenza-Associated Deaths in New York State: Death Certificate Coding and Comparison to Laboratory-Confirmed Deaths. Influenza Research and Treatment, Vol. 2012, p. 1.

    Vandermeer, M. L. Thomas, A. R. Kamimoto, L. Reingold, A. Gershman, K. Meek, J. Farley, M. M. Ryan, P. Lynfield, R. Baumbach, J. Schaffner, W. Bennett, N. and Zansky, S. 2012. Association Between Use of Statins and Mortality Among Patients Hospitalized With Laboratory-Confirmed Influenza Virus Infections: A Multistate Study. Journal of Infectious Diseases, Vol. 205, Issue. 1, p. 13.

    Zhou, H. Thompson, W. W. Viboud, C. G. Ringholz, C. M. Cheng, P.-Y. Steiner, C. Abedi, G. R. Anderson, L. J. Brammer, L. and Shay, D. K. 2012. Hospitalizations Associated With Influenza and Respiratory Syncytial Virus in the United States, 1993-2008. Clinical Infectious Diseases, Vol. 54, Issue. 10, p. 1427.

    Zhou, Hong Haber, Michael Ray, Susan Farley, Monica M. Panozzo, Catherine A. and Klugman, Keith P. 2012. Invasive Pneumococcal Pneumonia and Respiratory Virus Co-infections. Emerging Infectious Diseases, Vol. 18, Issue. 2, p. 294.

    Brown, Cedric Clayton-Boswell, Haley Chaves, Sandra S. Prill, Mila M. Iwane, Marika K. Szilagyi, Peter G. Edwards, Kathryn M. Staat, Mary A. Weinberg, Geoffrey A. Fairbrother, Gerry Hall, Caroline B. Zhu, Yuwei and Bridges, Carolyn B. 2011. Validity of parental report of influenza vaccination in young children seeking medical care. Vaccine, Vol. 29, Issue. 51, p. 9488.

    Dawood, Fatimah S. Fry, Alicia M. Muangchana, Charung Sanasuttipun, Wiwan Baggett, Henry C. Chunsuttiwat, Supamit Maloney, Susan A. and Simmerman, James Mark 2011. A method for estimating vaccine-preventable pediatric influenza pneumonia hospitalizations in developing countries: Thailand as a case study. Vaccine, Vol. 29, Issue. 26, p. 4416.

    Nair, Harish Brooks, W Abdullah Katz, Mark Roca, Anna Berkley, James A Madhi, Shabir A Simmerman, James Mark Gordon, Aubree Sato, Masatoki Howie, Stephen Krishnan, Anand Ope, Maurice Lindblade, Kim A Carosone-Link, Phyllis Lucero, Marilla Ochieng, Walter Kamimoto, Laurie Dueger, Erica Bhat, Niranjan Vong, Sirenda Theodoratou, Evropi Chittaganpitch, Malinee Chimah, Osaretin Balmaseda, Angel Buchy, Philippe Harris, Eva Evans, Valerie Katayose, Masahiko Gaur, Bharti O'Callaghan-Gordo, Cristina Goswami, Doli Arvelo, Wences Venter, Marietjie Briese, Thomas Tokarz, Rafal Widdowson, Marc-Alain Mounts, Anthony W Breiman, Robert F Feikin, Daniel R Klugman, Keith P Olsen, Sonja J Gessner, Bradford D Wright, Peter F Rudan, Igor Broor, Shobha Simões, Eric AF and Campbell, Harry 2011. Global burden of respiratory infections due to seasonal influenza in young children: a systematic review and meta-analysis. The Lancet, Vol. 378, Issue. 9807, p. 1917.

    Noyes, Kimberly A. Hoefer, Dina Barr, Christine Belflower, Ruth Malloy, Kevin and Cherry, Bryan 2011. Two Distinct Surveillance Methods to Track Hospitalized Influenza Patients in New York State During the 2009–2010 Influenza Season. Journal of Public Health Management and Practice, Vol. 17, Issue. 1, p. 12.

    Puig-Barberà, Joan Pérez-Vilar, Silvia and Díez-Domingo, Javier 2011. MF59™-adjuvanted seasonal influenza vaccine in young children. Expert Review of Vaccines, Vol. 10, Issue. 11, p. 1519.

    Sakkou, Z. Stripeli, F. Papadopoulos, N.G. Critselis, E. Georgiou, V. Mavrikou, M. Drossatou, P. Constantopoulos, A. Kafetzis, D. and Tsolia, M. 2011. Impact of influenza infection on children's hospital admissions during two seasons in Athens, Greece. Vaccine, Vol. 29, Issue. 6, p. 1167.


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)
  • DOI:
  • Published online: 01 December 2006

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.

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:
Linked references
Hide All

This list contains references from the content that can be linked to their source. For a full set of references and notes please see the PDF or HTML where available.

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.

Recommend this journal

Email your librarian or administrator to recommend adding this journal to your organisation's collection.

Epidemiology & Infection
  • ISSN: 0950-2688
  • EISSN: 1469-4409
  • URL: /core/journals/epidemiology-and-infection
Please enter your name
Please enter a valid email address
Who would you like to send this to? *