Open AccessRisk factors associated with fatal influenza, Romania, October 2009 – May 2011
Author(s) -
Zolotusca Laurentiu,
Jorgensen Pernille,
Popovici Odette,
Pistol Adriana,
Popovici Florin,
Widdowson MarcAlain,
Alexandrescu Viorel,
Ivanciuc Alina,
Cheng PoYung,
Gross Diane,
Brown Caroline S.,
Mott Joshua A.
Publication year - 2014
Publication title -
influenza and other respiratory viruses
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.743
H-Index - 57
eISSN - 1750-2659
pISSN - 1750-2640
DOI - 10.1111/irv.12209
Subject(s) - medicine , vaccination , logistic regression , multivariate analysis , retrospective cohort study , risk factor , influenza a virus , virus , immunology
Background Limited data are available from C entral and E astern E urope on risk factors for severe complications of influenza. Such data are essential to prioritize prevention and treatment resources and to adapt influenza vaccination recommendations. Objectives To use sentinel surveillance data to identify risk factors for fatal outcomes among hospitalized patients with severe acute respiratory infections ( SARI ) and among hospitalized patients with laboratory‐confirmed influenza. Methods Retrospective analysis of case‐based surveillance data collected from sentinel hospitals in Romania during the 2009/2010 and 2010/2011 winter influenza seasons was performed to evaluate risk factors for fatal outcomes using multivariate logistic regression. Results During 2009/2010 and 2010/2011, sentinel hospitals reported 661 SARI patients of which 230 (35%) tested positive for influenza. In the multivariate analyses, infection with influenza A(H1N1)pdm09 was the strongest risk factor for death among hospitalized SARI patients ( OR : 6·6; 95% CI : 3·3–13·1). Among patients positive for influenza A(H1N1)pdm09 virus infection ( n = 148), being pregnant ( OR : 7·1; 95% CI : 1·6–31·2), clinically obese ( OR : 2·9;95% CI : 1·6–31·2), and having an immunocompromising condition ( OR : 3·7;95% CI : 1·1–13·4) were significantly associated with fatal outcomes. Conclusion These findings are consistent with several other investigations of risk factors associated with influenza A(H1N1)pdm09 virus infections. They also support the more recent 2012 recommendations by the WHO S trategic A dvisory G roup of E xperts on I mmunization ( SAGE ) that pregnant women are an important risk group for influenza vaccination. Ongoing sentinel surveillance can be useful tool to monitor risk factors for complications of influenza virus infections during each influenza season, and pandemics as well.