tetano
Editor, Senior Moderator
Eurosurveillance, Volume 20, Issue 46, 19 November 2015
Surveillance and outbreak report
Intensive care unit surveillance of influenza infection in France: the 2009/10 pandemic and the three subsequent seasons
I Bonmarin [SUP]1[/SUP] , E Belchior [SUP]1[/SUP] , J Bergounioux [SUP]2[/SUP] , C Brun-Buisson [SUP]3[/SUP] , B M?garbane [SUP]4[/SUP] , JL Chappert [SUP]5[/SUP] , B Hubert [SUP]5[/SUP] , Y Le Strat [SUP]1[/SUP] , D L?vy-Bruhl [SUP]1[/SUP]
+ Author affiliations
1. Institut de Veille sanitaire (InVS), Saint-Maurice, France
2. Paediatric Intensive Care Unit, Raymond Poincar? Hospital, Garches, France
3. Intensive Care Unit, CHU Henri-Mondor, Cr?teil, France
4. Intensive care unit and toxicological department, Lariboisi?re Hospital, Paris-Diderot University, INSERM, Paris, France
5. On behalf of the Cellules de l?InVS en r?gion (Cire), the InVS regional offices, France
Correspondence: Isabelle Bonmarin ()
Citation style for this article: Bonmarin I, Belchior E, Bergounioux J, Brun-Buisson C, M?garbane B, Chappert J, Hubert B, Le Strat Y, L?vy-Bruhl D. Intensive care unit surveillance of influenza infection in France: the 2009/10 pandemic and the three subsequent seasons. Euro Surveill. 2015;20(46)
ii=30066. DOI: http://dx.doi.org/10.2807/1560-7917.ES.2015.20.46.30066
Received:13 November 2014; Accepted:30 March 2015
[h=4][/h]
During the 2009/10 pandemic, a national surveillance system for severe influenza cases was set up in France. We present results from the system's first four years. All severe influenza cases admitted to intensive care units (ICU) were reported to the Institut de Veille Sanitaire using a standardised form: data on demographics, immunisation and virological status, risk factors, severity (e.g. acute respiratory distress syndrome (ARDS) onset, mechanical ventilation, extracorporeal life support) and outcome. Multivariate analysis was performed to identify factors associated with ARDS and death. The number of confirmed influenza cases varied from 1,210 in 2009/10 to 321 in 2011/12. Most ICU patients were infected with A(H1N1)pdm09, except during the 2011/12 winter season when A(H3N2)-related infections predominated. Patients' characteristics varied according to the predominant strain. Based on multivariate analysis, risk factors associated with death were age ≥ 65 years, patients with any of the usual recommended indications for vaccination and clinical severity. ARDS occurred more frequently in patients who were middle-aged (36?55 years), pregnant, obese, or infected with A(H1N1)pdm09. Female sex and influenza vaccination were protective. These data confirm the persistent virulence of A(H1N1)pdm09 after the pandemic and the heterogeneity of influenza seasons, and reinforce the need for surveillance of severe influenza cases.
http://www.eurosurveillance.org/ViewArticle.aspx?ArticleId=21310
Surveillance and outbreak report
Intensive care unit surveillance of influenza infection in France: the 2009/10 pandemic and the three subsequent seasons
I Bonmarin [SUP]1[/SUP] , E Belchior [SUP]1[/SUP] , J Bergounioux [SUP]2[/SUP] , C Brun-Buisson [SUP]3[/SUP] , B M?garbane [SUP]4[/SUP] , JL Chappert [SUP]5[/SUP] , B Hubert [SUP]5[/SUP] , Y Le Strat [SUP]1[/SUP] , D L?vy-Bruhl [SUP]1[/SUP]
+ Author affiliations
1. Institut de Veille sanitaire (InVS), Saint-Maurice, France
2. Paediatric Intensive Care Unit, Raymond Poincar? Hospital, Garches, France
3. Intensive Care Unit, CHU Henri-Mondor, Cr?teil, France
4. Intensive care unit and toxicological department, Lariboisi?re Hospital, Paris-Diderot University, INSERM, Paris, France
5. On behalf of the Cellules de l?InVS en r?gion (Cire), the InVS regional offices, France
Correspondence: Isabelle Bonmarin ()
Citation style for this article: Bonmarin I, Belchior E, Bergounioux J, Brun-Buisson C, M?garbane B, Chappert J, Hubert B, Le Strat Y, L?vy-Bruhl D. Intensive care unit surveillance of influenza infection in France: the 2009/10 pandemic and the three subsequent seasons. Euro Surveill. 2015;20(46)
ii=30066. DOI: http://dx.doi.org/10.2807/1560-7917.ES.2015.20.46.30066Received:13 November 2014; Accepted:30 March 2015
[h=4][/h]
During the 2009/10 pandemic, a national surveillance system for severe influenza cases was set up in France. We present results from the system's first four years. All severe influenza cases admitted to intensive care units (ICU) were reported to the Institut de Veille Sanitaire using a standardised form: data on demographics, immunisation and virological status, risk factors, severity (e.g. acute respiratory distress syndrome (ARDS) onset, mechanical ventilation, extracorporeal life support) and outcome. Multivariate analysis was performed to identify factors associated with ARDS and death. The number of confirmed influenza cases varied from 1,210 in 2009/10 to 321 in 2011/12. Most ICU patients were infected with A(H1N1)pdm09, except during the 2011/12 winter season when A(H3N2)-related infections predominated. Patients' characteristics varied according to the predominant strain. Based on multivariate analysis, risk factors associated with death were age ≥ 65 years, patients with any of the usual recommended indications for vaccination and clinical severity. ARDS occurred more frequently in patients who were middle-aged (36?55 years), pregnant, obese, or infected with A(H1N1)pdm09. Female sex and influenza vaccination were protective. These data confirm the persistent virulence of A(H1N1)pdm09 after the pandemic and the heterogeneity of influenza seasons, and reinforce the need for surveillance of severe influenza cases.
http://www.eurosurveillance.org/ViewArticle.aspx?ArticleId=21310