Skip to main content
×
×
Home

Surges of advanced medical support associated with influenza outbreaks

  • J. C. KING (a1), J. E. SCHWEINLE (a1), R. J. HATCHETT (a2), Y. GAO (a1), R. LICHENSTEIN (a3) and J. ZHOU (a1)...
Summary

We utilized de-identified data to evaluate increases in four outcomes during influenza outbreak periods (IOPs) including: hospitalization, intensive care unit admission, mechanical ventilation or death for adults aged 18 years or older with medically attended acute respiratory illnesses (MAARI) admitted to any of Maryland's 50 acute-care hospitals over 12 years. Weekly numbers of positive influenza tests in the Maryland area were obtained from the US Center for Disease Control and Prevention interactive website. The fewest consecutive weeks around the peak week containing at least 85% of the positive tests defined the IOP. Weekly counts of individual study outcomes were positively correlated with regional weekly counts of positive influenza tests during all the IOPs over 12 years. Also, rate ratios comparing daily occurrences of each study outcome between the IOP and non-IOP were significantly elevated. These results confirm conclusions of previous studies that influenza outbreaks are clearly associated with deaths and increased use of advanced medical resources by patients with MAARI. These data analyses suggest that increased efforts to develop more effective influenza vaccines and therapeutics should be a priority.

Copyright
Corresponding author
*Author for correspondence: J. C. King Jr., M.D., US Department of Health and Human Services, Assistant Secretary for Preparedness and Response, Biomedical Advanced Research and Development Authority, Washington, DC 20201, USA. (Email: james.king@hhs.gov)
References
Hide All
1. Molinari, NA, et al. The annual impact of seasonal influenza in the US: measuring disease burden and costs. Vaccine 2007; 25: 50865096.
2. Reed, C, et al. Estimating influenza disease burden from population-based surveillance data in the United States. PLoS ONE 2015; 10(3) (http://dx.doi.org/10.1371/journal.pone.0118369).
3. Cox, NJ, Subbarao, K. Global epidemiology of influenza: past and present. Annual Review of Medicine 2000; 51: 407421.
4. World Health Organization. Influenza (http://www.who.int/mediacentre/factsheets/2003/fs211/en/). Accessed 12 December 2016.
5. Karve, S, et al. Annual all-cause healthcare costs among influenza patients with and without influenza-related complications: analysis of a United States managed care database. Applied Health Economics and Health Policy 2013; 11: 119128.
6. Selwyns, DC. Excess mortality from causes other than influenza and pneumonia during influenza epidemics. Public Health Reports 1932; 47: 21592189.
7. Thompson, WW, et al. Influenza-associated hospitalizations in the United States. Journal of the American Medical Association 2004; 292: 13331340.
8. Goldstein, E, et al. Improving the estimation of influenza-related mortality over a seasonal baseline. Epidemiology 2012; 23: 829838.
9. Schaffer, A, et al. The impact of influenza A (H1N1) pdm09 compared with seasonal influenza on intensive care admissions in New South Wales, Australia, 2007 to 2010: a time series analysis. BMC Public Health 2012; 12: 869. doi: 10.1186/1471-2458-12-869.
10. King, JC, et al. Surge in ventilator use during influenza outbreaks. Disaster Medicine Public Health Preparedness 2014; 8: 136142.
11. Thompson, WW, et al. Mortality associated with influenza and respiratory syncytial virus in the United States. Journal of the American Medical Association 2003; 289: 179186.
12. Maryland Health Care Commission. Annual Report on Selected Maryland Acute Care and Special Services. Fiscal Year 2013. Effective 1 July 2012 (http://mhcc.maryland.gov/mhcc/pages/hcfs/hcfs_hospital/documents/acute_care/con_acute_special_hospital_rpt_2013.pdf). Accessed 3 January 2017.
13. The, Maryland Health Services Cost Commission (http://www.hscrc.state.md.us). Accessed 3 January 2017.
14. Lichenstein, R, et al. The relationship between influenza outbreaks and acute ischemic heart disease in Maryland residents over a 7-year period. Journal of Infectious Diseases 2012; 206: 821827.
15. MMWR Weeks-CDC (https://wwwn.cdc.gov/nndss/document/MMWR_week_overview.pdf). Accessed 3 January 2017.
16.New Mexico's Indicator-Based Information System (NM-IBIS). MMWR Week Description and Corresponding Calendar Dates (2006–2020) (https://ibis.health.state.nm.us/resource/MMWRWeekCalendar.html). Accessed 3 January 2017.
17. Center for Disease Control and Prevention. Interactive site: National and Regional Level Outpatient Visits and Viral Surveillance (http://www.cdc.gov/flu/weekly/fluviewinteractive.htm). Accessed 3 January 2017.
18. Simonson, L, et al. The impact of influenza epidemics on hospitalizations. Journal of Infectious Diseases 2000; 181: 831837.
19. Chaves, SS, et al. Patients hospitalized with laboratory-confirmed influenza during the 2010–2011 influenza season. Journal of Infectious Diseases 2013; 208: 13051314.
20. Armstrong, GL, Brammer, L, Fineli, L. Timely assessment of the severity of the 2009 H1N1 pandemic. Clinical Infectious Diseases 2011; 52(S1): S83S89.
21. Centers for Disease Control and Prevention. Epidemiology of vaccine preventable diseases (http://www.cdc.gov/vaccines/pubs/pinkbook/flu.html). Accessed 1 November 2016.
22. Su, S, et al. Comparing clinical characteristics between hospitalized adults with laboratory-confirmed influenza A and B virus infections. Clinical Infectious Diseases 2014; 59: 252255.
23. Center for Disease Control and Prevention. Don't take influenza B lightly in adults (http://www.cidrap.umn.edu/news-perspective/2014/os/cdc-dont-take-influenza-b-lightly-adults). Accessed 3 January 2017.
24. Gutiérrez-Pizarraya, A, et al. Unexpected severity of cases of influenza B infection in patients that required hospitalization during the first post pandemic wave. Journal of Infection 2012; 65: 423430.
25. Mandell, LA, et al. Infectious Disease Society of America/Thoracic Society Consensus guidelines on the management of community-acquired pneumonia in adults. Clinical Infectious Diseases 2007; 44: S2772.
26. Donabedian, A. The Quest for More Effective Influenza Vaccines (https://www.medicalcountermeasures.gov/media/36865/donabedian_quest-for-more-effective-influenza-vaccines-bid2105-508.pdf). Accessed 3 January 2017.
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? *
×

Keywords:

Metrics

Altmetric attention score

Full text views

Total number of HTML views: 7
Total number of PDF views: 52 *
Loading metrics...

Abstract views

Total abstract views: 185 *
Loading metrics...

* Views captured on Cambridge Core between 9th June 2017 - 12th June 2018. This data will be updated every 24 hours.