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. 2019 May 14;19(1):415.
doi: 10.1186/s12879-019-4017-0.

Influenza epidemiology and influenza vaccine effectiveness during the 2015-2016 season: results from the Global Influenza Hospital Surveillance Network

Joan Puig-Barberà  1 , Ainara Mira-Iglesias  2 , Elena Burtseva  3 , Benjamin J Cowling  4 , Unal Serhat  5 , Guillermo Miguel Ruiz-Palacios  6 , Odile Launay  7 , Jan Kyncl  8 , Parvaiz Koul  9 , Marilda M Siqueira  10 , Anna Sominina  11 ; Global Influenza Hospital Surveillance Network
Collaborators, Affiliations

Influenza epidemiology and influenza vaccine effectiveness during the 2015-2016 season: results from the Global Influenza Hospital Surveillance Network

Joan Puig-Barberà et al. BMC Infect Dis. .

Abstract

Background: The Global Influenza Hospital Surveillance Network is an international platform whose primary objective is to study severe cases of influenza requiring hospitalization.

Methods: During the 2015-2016 influenza season, 11 sites in the Global Influenza Hospital Surveillance Network in nine countries (Russian Federation, Czech Republic, Turkey, France, China, Spain, Mexico, India, and Brazil) participated in a prospective, active-surveillance, hospital-based epidemiological study. Influenza infection was confirmed by reverse transcription-polymerase chain reaction. Influenza vaccine effectiveness (IVE) against laboratory-confirmed influenza was estimated using a test-negative approach.

Results: 9882 patients with laboratory results were included of which 2415 (24.4%) were positive for influenza, including 1415 (14.3%) for A(H1N1)pdm09, 235 (2.4%) for A(H3N2), 180 (1.8%) for A not subtyped, 45 (0.5%) for B/Yamagata-lineage, 532 (5.4%) for B/Victoria-lineage, and 33 (0.3%) for B not subtyped. Of included admissions, 39% were < 5 years of age and 67% had no underlying conditions. The odds of being admitted with influenza were higher among pregnant than non-pregnant women (odds ratio, 2.82 [95% confidence interval (CI), 1.90 to 4.19]). Adjusted IVE against influenza-related hospitalization was 16.3% (95% CI, 0.4 to 29.7). Among patients targeted for influenza vaccination, adjusted IVE against hospital admission with influenza was 16.2% (95% CI, - 3.6 to 32.2) overall, 23.0% (95% CI, - 3.3 to 42.6) against A(H1N1)pdm09, and - 25.6% (95% CI, - 86.3 to 15.4) against B/Victoria lineage.

Conclusions: The 2015-2016 influenza season was dominated by A(H1N1)pdm09 and B/Victoria-lineage. Hospitalization with influenza often occurred in healthy and young individuals, and pregnant women were at increased risk of influenza-related hospitalization. Influenza vaccines provided low to moderate protection against hospitalization with influenza and no protection against the predominant circulating B lineage, highlighting the need for more effective and broader influenza vaccines.

Keywords: Epidemiological study; Hospitalization; Influenza; Surveillance; Vaccine; Virus.

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Conflict of interest statement

Ethics approval and consent to participate

The GIHSN study protocol was approved by the institutional review board of each participating site: in India, the Institutional Ethics Committee of the Sher-i-Kashmir Institute of Medical Sciences, Srinagar; in Beijing, China, “The Institutional Review Board of the University of Hong Kong/Hospital Authority Hong Kong West Cluster”; in France, “CPP Ile de France IV, Saint-Louis hospital in Paris”; in the Czech Republic, the “Ethics Committee of the Hospital Na Bulovce”; in Turkey, the “Hacettepe University Non-interventional Clinical Research Ethics Board”; in Moscow, Russia, “The local Ethic Committee of Hospital #1 for Infectious Diseases of Moscow Health Department”; in Brazil (Fortaleza & Curitiba), the “Ethical Committee of the Evandro Chagas National Institute of Infectology (INI-Fiocruz)”; in Mexico, the “Research Ethics Committee of the National Institute of Medical Science and Nutrition Salvador Zubirán” & “Research Committee of the National Institute of Medical Science and Nutrition Salvador Zubirán”; in St Petersburg, Russia, “Local Ethical Committee under the FGBU ‘Research Institute of Influenza’ of the Ministry of Health of the Russian Federation”; and in Spain, the “Research Ethics Committee of the General Directorate of Public Health and High Center for Public Health Research (CEI DGSP-CSISP)”. All subjects or legal representatives provided written or (if approved by the associated institutional review board) oral informed consent; consent to participate was collected from the parents/guardians of any participants under 16 years of age.

Consent for publication

Not applicable.

Competing interests

BJC received grants from Sanofi Pasteur unrelated to the submitted work. PK has served as a consultant to Sanofi, Zydus, and Cadila. All other authors declare no competing interests.

Publisher’s Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Figures

Fig. 1
Fig. 1
Admissions with influenza by epidemiological week and virus type, subtype, or lineage overall and by site
Fig. 2
Fig. 2
Admissions with influenza by age and underlying conditions. Adjusted by the interaction of age with chronic conditions, influenza immunization, and site clustering effects
Fig. 3
Fig. 3
Adjusted odds ratio (aOR) by age group and strain. Adjusted by age, sex, socioeconomic class, number of chronic conditions, vaccination status, time from onset of symptoms to swabbing, and site. Abbreviation: CI, confidence interval
Fig. 4
Fig. 4
Adjusted odds ratio (aOR) by strain in admissions with underlying conditions. Adjusted by age, sex, socioeconomic class, obesity status, vaccination status, time from onset of symptoms to swabbing, and site. Abbreviation: CI, confidence interval
Fig. 5
Fig. 5
Adjusted odds ratio (aOR) by strain in pregnant admissions 15 to 45 years of age. Adjusted by presence of comorbidities. Only in women aged 15–45 years. Abbreviation: CI, confidence interval
Fig. 6
Fig. 6
Adjusted influenza vaccine effectiveness (IVE) by site. Adjusted by age, sex, number of chronic conditions, time from onset of symptoms to swabbing and epidemiological week at admission. Abbreviation: CI, confidence interval
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