Australian vaccine preventable disease epidemiological review series: Influenza 2006 to 2015
DOI:
https://doi.org/10.33321/cdi.2016.40.54Keywords:
influenza, epidemiology, review, Australia, hospitalisation, notifications, deaths, IndigenousAbstract
Introduction: Influenza is a major contributor to the preventable health burden of Australians each year. The National Immunisation Program provides influenza vaccine for those at highest risk of severe disease. This review of influenza epidemiology examines current data on influenza disease burden in Australia, in the context of several comparable countries having programs with much broader eligibility for influenza vaccine in children.
Methods: Influenza notifications (2006–2015), hospitalisations, and deaths (2006–2013) were sourced and age-specific rates calculated. Comparisons were made across age groups in the pre-pandemic, pandemic, and post-pandemic periods and by Indigenous and non-Indigenous status.
Results: The 2009 pandemic year and the 2012 non-pandemic season resulted in the highest rates of notification, hospitalisation and death. Influenza notification rates were 4.0 times higher and hospitalisation rates 2.1 times higher during 2011–2013 compared with 2006–2008. Death rates varied widely, but peaks corresponded to high-activity seasons. Influenza hospitalisation rates were highest among those aged <5 and ≥65 years, but influenza-attributable deaths were identified primarily in those aged ≥75 years. Significantly higher notification and hospitalisation rates were seen for all Indigenous people, but higher death rates were largely restricted to the 2009 pandemic year.
Conclusions: Based on notifications, hospitalisations and deaths, burden of disease from influenza is highest at the extremes of life and is significantly higher among Indigenous people of all ages. This pattern of disease burden warrants consideration of widened eligibility for influenza vaccine under the National Immunisation Program to all Indigenous people and all children less than 5 years of age. Commun Dis Intell 2016;40(4):E482–E495.
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References
World Health Organization. Influenza (Seasonal) Fact sheet. March 2014. Accessed on 9 February 2016. Available from: http://www.who.int/mediacentre/factsheets/fs211/en/
Chiu C, Dey A, Wang H, Menzies R, Deeks S, Mahajan D, et al. Vaccine preventable diseases in Australia, 2005 to 2007. Commun Dis Intell 2010;34 Suppl:S1–S167.
Dey A, Knox S, Wang H, Beard FH, McIntyre PB. Summary of National Surveillance Data on Vaccine Preventable Diseases in Australia, 2008–2011. Commun Dis Intell 2016;40 Suppl:S1–S70.
Australian Government Department of Health. Australian Technical Advisory Group. Immunisation advice for immunisation providers regarding the administration of seasonal influenza vaccines in 2016. Accessed on 17 April 2016. Available from: http://www.immunise.health.gov.au/internet/immunise/publishing.nsf/Content/DA045106A3499384CA257E2D001A1FA3/$File/ATAGI-annual-Influenza-Vaccine-providers-2016.pdf
Pebody RG, Green HK, Andrews N, Boddington NL, Zhao H, Yonova I, et al. Uptake and impact of vaccinating school age children against influenza during a season with circulation of drifted influenza A and B strains, England, 2014/15. Euro Surveill 2015;20(39):pii=30029.
Australian Government Department of Health. Surveillance case definition for influenza (laboratory-confirmed). 2016. Accessed on 28 June 2016. Available from: http://www1.health.gov.au/internet/main/publishing.nsf/Content/cda-surveil-nndss-casedefs-cd_flu.htm
Australian Institute of Health and Welfare. Indigenous identification in hospital separations data: quality report. Cat. no. AIHW 90. Canberra 2013.
Australian Bureau of Statistics. Australian Demographic Statistics, September 2015 (updated 24 March 2016). ABS cat no. 3101.0. Accessed on 12 February 2016. Available from: http://www.abs.gov.au/ausstats/abs@.nsf/mf/3101.0
Australian Bureau of Statistics. Estimates and Projections, Aboriginal and Torres Strait Islander Australians, 2001 to 2026. (Updated on 30 April 2014.) ABS cat no. 3238.0. Accessed on 12 February 2016. Available from: http://www.abs.gov.au/ausstats/abs@.nsf/mf/3238.0
Australian Bureau of Statistics. Experimental Estimates and Projections, Aboriginal and Torres Strait Islander Australians, 1991 to 2021. (Updated on 8 September 2009.) ABS cat no. 3238.0. Accessed on 12 February 2016. Available from: http://www.abs.gov.au/AUSSTATS/abs@.nsf/allprimarymainfeatures/497290ADDF187134CA257CC900143EAA?opendocument
Australian Government Department of Health. Australian Influenza Surveillance Report. No. 10, 2012, reporting period: 29 September to 12 October 2012. Accessed on 25 April 2016. Available from: http://www1.health.gov.au/internet/main/publishing.nsf/Content/cda-ozflu-no10-12.htm
Mazick A, Gergonne B, Nielsen J, Wuillaume F, Virtanen MJ, Fouillet A, et al. Excess mortality among the elderly in 12 European countries, February and March 2012. Euro Surveill 2012;17(14). pii: 20138.
Lee BE, Mukhi SN, Drews SJ. Association between patient age and influenza A subtype during influenza outbreaks. Infect Control Hosp Epidemiol 2010;31(5):535–537.
Win MK, Chen MI, Barkham T, Lin C, Tan A, Lin R, et al. Influenza disease burden in adults by subtypes following the initial epidemic of pandemic H1N1 in Singapore. Influenza Other Respir Viruses 2011;5(6):e563–e567.
Kelly HA, Grant KA, Tay EL, Franklin L, Hurt AC. The significance of increased influenza notifications during spring and summer of 2010–11 in Australia. Influenza Other Respir Viruses 2013;7(6):1136–1141.
Kaczmarek MC, Ware RS, Lambert SB. The contribution of PCR testing to influenza and pertussis notifications in Australia. Epidemiol Infect 2016;144(2):306–314.
Kumar A, Zarychanski R, Pinto R, Cook DJ, Marshall J, Lacroix J, et al. Critically ill patients with 2009 influenza A(H1N1) infection in Canada. JAMA 2009;302(17):1872–1879.
Louie JK, Acosta M, Winter K, Jean C, Gavali S, Schechter R, et al. Factors associated with death or hospitalization due to pandemic 2009 influenza A(H1N1) infection in California. JAMA 2009;302(17):1896–1902.
ANZIC Influenza Investigators I, Webb SA, Pettila V, Seppelt I, Bellomo R, Bailey M, et al. Critical care services and 2009 H1N1 influenza in Australia and New Zealand. N Engl J Med 2009;361(20):1925–1934.
Hancock K, Veguilla V, Lu X, Zhong W, Butler EN, Sun H, et al. Cross-reactive antibody responses to the 2009 pandemic H1N1 influenza virus. N Engl J Med 2009;361(20):1945–1952.
Vaillant L, La Ruche G, Tarantola A, Barboza P, Epidemic intelligence team at Institut de Veille Sanitaire. Epidemiology of fatal cases associated with pandemic H1N1 influenza 2009. Euro Surveill 2009;14(33). pii: 19309.
WHO Strategic Advisory Group of Experts on Immunization (SAGE). Vaccines against influenza WHO position paper – November 2012. Wkly Epidemiol Rec 2012;87(47):461–476.
Li-Kim-Moy J, Blyth CC, Kesson A, Booy R, Cheng AC, Macartney K. Influenza in Australian children. Epidemiol Infect 2016. Submitted.
Blyth CC, Macartney KK, Hewagama S, Senenayake S, Friedman ND, Simpson G, et al. Influenza epidemiology, vaccine coverage and vaccine effectiveness in children admitted to sentinel Australian hospitals in 2014: the Influenza Complications Alert Network (FluCAN). Euro Surveill 2016;21(30):pii=30301.
Cheng AC, Dwyer DE, Holmes M, Irving LB, Brown SG, Waterer GW, et al. Influenza epidemiology, vaccine coverage and vaccine effectiveness in sentinel Australian hospitals in 2013: the Influenza Complications Alert Network. Commun Dis intell 2014;38(2):E143–E149.
Poehling KA, Edwards KM, Griffin MR, Szilagyi PG, Staat MA, Iwane MK, et al. The burden of influenza in young children, 2004–2009. Pediatrics 2013;131(2):207–216.
Naidu L, Chiu C, Habig A, Lowbridge C, Jayasinghe S, Wang H, et al. Vaccine preventable diseases and vaccination coverage in Aboriginal and Torres Strait Islander people, Australia 2006–2010. Commun Dis Intell 2013;37 Suppl:S1–S95.
La Ruche G, Tarantola A, Barboza P, Vaillant L, Gueguen J, Gastellu-Etchegorry M, et al. The 2009 pandemic H1N1 influenza and indigenous populations of the Americas and the Pacific. Euro Surveill 2009;14(42). pii: 19366.
Flint SM, Davis JS, Su JY, Oliver-Landry EP, Rogers BA, Goldstein A, et al. Disproportionate impact of pandemic (H1N1) 2009 influenza on Indigenous people in the Top End of Australia’s Northern Territory. Med J Aust 2010;192(10):617–622.
Goggin LS, Carcione D, Mak DB, Dowse GK, Giele CM, Smith DW, et al. Chronic disease and hospitalisation for pandemic (H1N1) 2009 influenza in Indigenous and non-Indigenous Western Australians. Commun Dis Intell 2011;35(2):172–176.
Baguelin M, Camacho A, Flasche S, Edmunds WJ. Extending the elderly- and risk-group programme of vaccination against seasonal influenza in England and Wales: a cost-effectiveness study. BMC Med 2015;13:236.
Department of Health England. JCVI statement on the routine annual influenza vaccination programme 2012. Accessed on 28 April 2015. Available from: https://www.gov.uk/government/uploads/system/uploads/attachment_data/file/224775/JCVI-statement-on-the-annual-influenza-vaccination-programme-25-July-2012.pdf
Public Health England, Department of Health and NHS England. Flu plan: winter 2016 to 2017. Accessed on 14 June 2016. Available from: https://www.gov.uk/government/publications/flu-plan-winter-2016-to-2017
Beard F, McIntyre P, Gidding H, Watson M. Influenza related hospitalisations in Sydney, New South Wales, Australia. Arch Dis Child 2006;91(1):20–25.
Muscatello DJ, Amin J, MacIntyre CR, Newall AT, Rawlinson WD, Sintchenko V, et al. Inaccurate ascertainment of morbidity and mortality due to influenza in administrative databases: a population-based record linkage study. PLoS One 2014;9(5):e98446.
Australian Government Department of Health. Australian Influenza Surveillance Report and Activity Updates 2016. Accessed on 11 October 2016. Available from: http://www.health.gov.au/flureport
Australian Technical Advisory Group on Immunisation. The Australian Immunisation Handbook. 10th edn. Canberra, Australia: National Health and Medical Research Council and the Department of Health; 2013.
Grohskopf LA, Sokolow LZ, Olsen SJ, Bresee JS, Broder KR, Karron RA. Prevention and control of influenza with vaccines: Recommendations of the Advisory Committee on Immunization Practices, United States, 2015–16 influenza season. MMWR Morb Mortal Wkly Rep 2015;64(30):818–825.
National Advisory Committee on Immunization. Statement on Seasonal Influenza Vaccine for 2015–2016. Accessed on 19 April 2016. Available from: http://www.phac-aspc.gc.ca/naci-ccni/flu-2015-grippe-eng.php
Blyth CC, Jacoby P, Effler PV, Kelly H, Smith DW, Robins C, et al. Effectiveness of trivalent flu vaccine in healthy young children. Pediatrics 2014;133(5):e1218–e1225.
Blyth CC, Jacoby P, Effler PV, Kelly H, Smith DW, Borland ML, et al. Influenza vaccine effectiveness and uptake in children at risk of severe disease. Pediatr Infect Dis J 2016;35(3):309–315.
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