France 2013/2014

[Anne]

http://www.invs.sante.fr/Dossiers-t...demiologique-grippe.-Point-au-22-janvier-2014


Rate of admission to the ICU for influenza while the threshold number
epidemic has not yet been achieved: 75 severe cases
► Increase in other indicators
► Dominance of virus with an equivalent proportion of A ( H1N1) and pdm09
A ( H3N2) in outpatient


At the hospital
> Passages to emergencies and hospitalizations for influenza
In week 3, the Oscour ? network (which represents 67% of all ED visits
in France ) reported 556 passages for influenza , including 30 hospitalizations. the passage number was up from the previous week in which 32 of the
499 passages were hospitalized for influenza .
> Monitoring of severe influenza admitted to intensive care
In week 3 , 26 new severe cases of influenza admitted to intensive care were reported to InVS
a total of 75 serious cases since 1 November 2013 ( Figure 2). The age ranged from 10 months to 97 years with a median of 60 years. Patients were predominantly adults , with risk factors, unvaccinated and infected with influenza A ( Table 1). Among them, five cases are died.
The number of severe cases admitted to intensive care is higher than the expected number before beginning of the epidemic . In comparison with data from previous years , patients admitted
does not seem to have more severe forms . This number may be increased by a better detection of influenza in ICUs but probably reflects the movement virus A ( H1N1) pdm09 . As a result , vaccination and rapid support of people at risk of complications of influenza are most relevant

 

[Anne]

Re: France 2013/2014

some charts at the link

http://www.invs.sante.fr/Dossiers-t...demiologique-grippe.-Point-au-29-janvier-2014

At the hospital
> Passages to emergencies and hospitalizations for influenza
In week 4, the Oscour ? network (which represents 67% of all ED visits in France) reported 813 passages for influenza, including 50 hospitalizations. The effectifs passage were in significant increase compared to the previous week, during which 34 of 597 passages were hospitalized for influenza. The proportion of children under 15 years among the passages and hospitalizations for influenza has increased since 4 weeks
Surveillance for severe influenza cases admitted to intensive care
In week 4, 16 new severe cases of influenza admitted to intensive care were reported at InVS : a total of 91 serious cases since 1 November 2013. The weekly number seems to be decreasing since week 1 but are not consolidated data for the last 2 weeks (Figure 1). The ages ranged from 10 months to 97 years with a median of 59 years. Patients were predominantly adults, with risk factors, not vaccinated and infected with a virus (Table 1). Among them, 8 cases had died, a fatality of 9%.

15% : no risk factor
1 % pregnant only
5% obesity only
58% are 15-64 years old

 

[Anne]

Re: France 2013/2014

http://www.invs.sante.fr/Dossiers-t...demiologique-grippe.-Point-au-26-fevrier-2014

Passages to emergencies and hospitalizations for influenza
In week 8, the Oscour ® network (which Represented 67% of all ED visits in France ) reported 1664 passages in ED with 146 hospitalizations [ . The number of passages are stable in comparison with the previous week , while the increase in the number of hospitalizations continues, even if it seems to slow down this week.
Children under 5 years accounted for approximately 30% of passages and hospitalizations for influenza while those aged 65 and over accounted for 3 % of crossings and 15% of consecutive admissions to ED visits for influenza .
Focus of the week : Surveillance of severe cases of influenza admitted in ICU
Since 1 November 2013 , 338 influenza cases admitted to intensive care units were so - NAWEG InVS , including 68 new cases reported in week 8

After a first wave occurred in early January , the weekly number of severe cases of influenza admitted to intensive care is rising again in week 5 , thus following the evolution of the incidence rate of consultations for influenza-like illness in ambulatory care (Figure 2) .
Severe cases were overwhelmingly infected with virus type A ( 95%). Among the cases infected with influenza A , influenza A (H1N1) pdm09 seems predominant (86% of 149 influenza A subtyped ) but the lack of tools for the detection of influenza A ( H3N2) in some hospitals overestimates from the A ( H1N1) pdm09 . At the end of the season, a greater proportion of virus should probably be sub- typed and help clarify this preliminary result .

The age of cases ranged from 1 month to 97 years with a median of 59 years .
86 % of severe cases had a risk factor (Table 1). Among the risk factors other than age , lung diseases ( including asthma ) were the most frequent ( 37%), followed by obesity with and without other comorbidities (22% ), heart disease ( 18%) and diabetes ( 17 % ) . At least 62% of the cases had not been vaccinated .
More than half ( 56 %) had acute respiratory distress syndrome (ARDS ) and 7 % of severe cases have received extracorporeal membrane oxygenation ( ECMO) .
Twenty -seven deaths were reported . The ages ranged from 3 months to 85 years (median 61 years). Among the patients who died , 23 had one risk factor , 24 were infected with a virus and a virus - cun B. The lethality is 8 %, but a vast majority of patients are still hospitalized . [ / b ]
The cumulative number of severe cases (n = 338 ) is higher than that recorded last year at the peak (n = 296 ) , probably in connection with the wave of the new year. The proportion of people without risk factors (14%) is the lowest observed since the establishment of monitoring severe cases in 2009 , since when it has varied from 19% to 35% the seasons. The proportion of obese joined observed the first two years of surveillance values ​​during which the virus A ( H1N1) circulated widely pdm09 . The proportion of patients with ARDS (56%) is close to the values ​​observed in 2010-11 season during which she was particularly high (68%) [/ b] . For cons , the proportion of severe cases treated with ECMO ( 7%) is lower than in 2010-11 ( 11%) and the same season data not see. The number of deaths is small at the moment.
At this stage , the monitoring of severe cases showed no evidence for a gravity greater than that observed in the last 5 seasons epidemic.