Patterns and determinants of influenza and pneumococcal immunisation among adults with chronic disease living in Queensland, Australia

Using findings from a random, computer assisted telephone survey of households, this paper examines influenza and pneumococcal immunisation coverage and predictors of immunisation in 2203 adults with asthma, diabetes or a cardiovascular condition living in Queensland, Australia. 47% and 31% of high-risk persons were immunised against influenza and pnemococcus respectively. Immunisation coverage varied across chronic conditions and increased with age, being significantly higher for those aged 65 years and older and consequently eligible for free vaccination. Poor self reported health status was an independent predictor of pneumococcal vaccination status for people with asthma, diabetes or a cardiovascular condition; however it was only an independent predictor of influenza immunisation status for people with diabetes. Extending free vaccination to all people at risk may increase immunisation rates for younger people with a chronic condition     

2015-2017年贵阳市流感流行病学特征分析

目的　了解2015-2017年贵阳市流感病例的流行病学规律和特点。方法　流感样本来源于流感样病例,利用逆转录聚合酶链反应确定阳性病例以及流感分型。应用描述性流行病学方法分析2015-2017年流感病例的流行病学特征,包括病例的时间、人群、地区等。采用Excel 2007整理数据和SPSS 13. 0进行统计分整理数据。结果　2015-2017年共监测流感样病例12484例,其中阳性1433例,阳性分离率为11.48%,三年网络报告流感病例男性1792例,占54.17%,女性1576例,占45.83%,年龄段,25岁以下年龄段病例最多,中位年龄均为22.5岁,从职业构成看,三年里大多数为散居儿童,占36.54 %。2015年流感高峰期在秋冬季, 9月为小高峰 , 12月为大高峰2016年流感持续2015年冬季的流行,1-3月为全年的高峰期,4月份后趋于平稳;2017年流感高峰期在春季和冬季,1月为小高峰,11-12月为全年的大高峰。结论　贵阳市流感流行具有冬春季流行的特征,散居儿童是流感的危险人群,应当注重对普通市民的流感知识宣传,加强持续流感样病例监测工作尤其是暴发疫情的监测工作。     

广州市2004-2008年流行性感冒流行特征分析

目的分析广州市2004-2008年流行性感冒（简称流感）流行特征。方法收集2004-2008年广州市流感监测系统流感样病例（ILI）监测资料,对病毒分离与鉴定结果以及暴发疫情信息进行分析,用季节解构、互相关等方法揭示广州市流感流行特征。结果 2004-2008年广州市流感样病例就诊百分比（ILI%）夏季最高,季节指数为1.637;流行季节与非流行季节ILI%差异有统计学意义（P〈0.05）;2004、2005、2007年以H3N2型为主要毒株;2006、2008年以H1N1型为主要毒株。暴发疫情的发生强度以小学最大（P〈0.05）。对暴发疫情序列分别与ILI%、病毒分离率两条序列进行互相关分析,当lag=-1、-2、-3时,病毒分离率与暴发疫情、ILI%与暴发疫情相关系数均有统计学意义。结论 2004-2008年,广州市流感的流行季节为夏季（5～7月）。H3N2和H1N1交替为流感主要毒株,小学是流感暴发疫情的高发地点。广州市流感监测系统可以客观地反映本市流感的流行特点。     

Epidemiology of hepatitis B infection in Finland: Implications for immunisation policy

ObjectivesWe describe the current epidemiology of acute and chronic hepatitis B infections in Finland. We estimate the total incidence of chronic hepatitis B following from the current incidence of acute infections and the influx of chronic carriers of hepatitis B associated with net immigration. We evaluate the incidence of hepatitis B infections preventable by a universal vaccination programme among infants.MethodsWe analysed hepatitis B cases reported to the National Infectious Disease Register during 2004–2012 and used pre-developed methods to adjust for acute asymptomatic infections. We estimated the projected incidence of chronic infection by applying age-specific risks of chronic infection to the estimated incidence of acute infection. We estimated the influx of chronic carriers associated with immigration by utilising data on immigration during 2004–2012 and the WHO regional estimates of carriage prevalence.ResultsThe estimated incidence of acute hepatitis B infection in Finland, adjusted for asymptomatic infections, was 1.67 per 100,000 per year (95% Crl 1.43–1.94) which is 4.2-fold to the register-based incidence. The estimated lifetime risks of acute and chronic hepatitis B infections were 0.13% and 0.01%, respectively. We estimated that annually seven new chronic infections would result from infections acquired in Finland. These new chronic infections accounted for 1.2% of the total incidence of chronic infections. We estimated that eventually three chronic infections per year would be potentially preventable by a universal infant vaccination programme.ConclusionsPartly due to the fact that hepatitis B infections in neonates and in children are rare, a very limited number of chronic hepatitis B infections resulted from infection acquired within the country. A vast majority of chronic hepatitis B infections occurred among foreign-born persons and were therefore not preventable by a universal infant immunisation programme in Finland. Even with a targeted immunisation programme, the incidence of hepatitis B infection has remained low.     

Prevalence of raynaud phenomenon in the adult population of South Carolina

A prevalence estimate for Raynaud phenomenon among adult residents of South Carolina was based on data obtained from respondents in a statewide health survey, followed by face-to-face interviews and clinical screening for Raynaud phenomenon, using a screening procedure developed by the authors. The survey obtained 5246 personal interviews from a probability sample of over 3000 households, and 494 survey subjects participated in the clinical screening. The prevalence estimates and their standard errors were computed using survey case weights, design-based estimation, and logistic modelling techniques.

The prevalence of Raynaud phenomenon among adult residents of South Carolina was determined to be 3.5%, with a standard error of 0.6%. Prevalence was higher for females (4.3%, SE = 0.7%) than for males (2.7%, SE = 0.6%), These figures are much lower than most estimates in the existing literature on Raynaud phenomenon.     

Prevalence and determinants of influenza vaccine coverage at tertiary pediatric hospitals

Despite long-standing recommendations, the uptake of influenza vaccination in children with high risk medical conditions is low. This study aimed to examine the uptake of influenza vaccination amongst a cohort of Australian children and factors associated with vaccine acceptance. Three hundred and sixteen parents of children attending outpatient clinics at the two pediatric hospitals in Sydney were recruited. The reported vaccination coverage rate was 41% among children with high risk conditions and 14% among standard risk children. There was a median of three clinic visits per high risk child at which an opportunity to vaccinate was apparently missed. Healthcare worker recommendation, having a high risk condition and parental beliefs about influenza and influenza vaccination were the most important determinants of vaccine uptake. Further studies on the beliefs and practices of doctors in this area will help guide interventions to improve vaccination rates in high risk children.     

Fiscal consequences of changes in morbidity and mortality attributed to rotavirus immunisation

Changes in population health status are known to influence government fiscal transfers both in terms of lost tax revenue and increased expenditure for health and social services. To estimate the fiscal impact of changes in morbidity and mortality attributed to rotavirus immunisation, we developed a government perspective model to estimate discounted net tax revenue for Ghana and Vietnam. The model derived the impact of rotavirus morbidity and mortality on lifetime productive capacity and related tax transfers, and demand for government transfers in relation to education and healthcare in immunised and non-immunised cohorts. The discounted age-specific net tax revenue was derived by deducting transfers from gross taxes and discounting for time preference. In Ghana, taking into account immunisation costs, tax and transfers, the estimated net discounted tax for the immunised cohort was estimated to generate $2.6 billion in net taxes up to age 65. In Vietnam, the net revenue attributed to the immunised cohort reached $55.17 billion suggesting an incremental benefit of approximately $29 million. We posit that the government perspective fiscal framework described here is a valid approach for estimating how governments benefit from investments in immunisation that can be considered supplementary to conventional cost-effectiveness approaches for defining value.     

广东省2005—2007年流行性感冒流行特征分析

目的分析广东省2005—2007年流感流行特征，为科学防治流感提供依据。方法对2005—2007年广东省流感监测系统的监测资料进行描述性流行病学分析，监测资料包括广东省13个地级市的14家城市综合医院或儿童医院、16所社区门诊部、16所中小学校和6家县级综合医院等的哨点医院收集门诊流感样病例（以下简称ILI）就诊信息；各地暴发疫情监测信息；来自哨点医院监测系统和暴发疫情收集的ILI标本的病原学监测资料。结果2005—2007年的哨点医院监测结果显示14家城市医院的流感样病例占门诊就诊人数百分比（以下简称ILI％）周平均为5．17％；3年中ILI％在3—7月达到高峰，而每年ILI％的高峰有所不同；2005年流感活动在3—5月有1个高峰，这个高峰是A型流感病毒（H3N2亚型）和A型流感病毒H1N1亚型共同引起的；2006年在3—4月和6月有2个流行高峰，这2个高峰分别是由B型流感病毒（Victoria系）和A型流感病毒（H1N1亚型）引起；而2007年只在6月有1个高峰，是由A型流感病毒（H3N2）引起。2005—2007年分别报告的ILI暴发疫情分别为121、172和40起，发病人数累计17310人，暴发疫情中的流感病毒毒株的流行和变化趋势与定点医院监测到的毒株流行和变化趋势一致。92％的暴发疫情发生在学校和托幼机构，而学校监测哨点的ILI％的高峰出现也较其他监测哨点医院要早1周。结论广东省流感流行的季节性高峰在春夏季，呈单峰或双峰型。中小学校和托幼机构是广东省流感防控的重点。     

Influenza vaccination of hospital staff in Germany: a five-year survey on vaccination coverage and policies: identified deficits in influenza immunisation campaigns for hospital employees

Summary. Objectives: Influenza vaccination of hospital staff is recommended by STIKO, the German committee for vaccination. A survey was conducted to assess compliance with this recommendation. The occupational health services of 25 hospitals participated in a survey and provided data by questionnaire on influenza vaccination and on hospital policies to promote coverage of employees.Methods: Vaccination activities were monitored by occupational health services (OHS) for five consecutive years from 1997 to 2002. The hospital sample covered a total of 17089 beds (3.23% of the hospital capacity in Germany) and a total number of 41969 employees (4.39% of hospital staff).Results: The proportion of hospitals actively offering influenza vaccination increased from 48% in 1997/98 to 92% in 2001/02. Vaccination coverage of all staff in 1997 was only 3.3% and reached 8.4% in 2001/02. Coverage of vaccinating hospitals increased from 5.0% to 10.4%. Poster campaigns and managing board commitment had significant impact.Conclusions: Considerable progress has been made to involve more hospitals and to increase coverage for vaccination of hospital employees. Nevertheless, coverage levels remain unacceptably low. Recommendations are ignored extensively.

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Zusammenfassung. Influenzaimpfung von Krankenhauspersonal in Deutschland: eine Fünfjahresuntersuchung zu Durchimpfungsraten, Impfpolitik und -defiziten in 25 deutschen KrankenhäusernFragestellung: Die Impfung von Krankenhauspersonal gegen Influenza wird von der Ständigen Impfkommission (STIKO) empfohlen. Die Umsetzung dieser Empfehlung in deutschen Krankenhäusern wurde untersucht. Die Betriebsärzte von 25 Krankenhäusern nahmen an einer Umfrage teil, für die sie Daten ihres jeweiligen Hauses zur Influenzaimpfung und Impfpolitik bereitstellten.Methode: Die Untersuchung fand in fünf aufeinander folgenden Jahren (1997–2002) statt. Die Stichprobe umfasste insgesamt 17089 Betten (3,23% der gesamten deutschen Bettenkapazität) und 41969 Angestellten (4,39% des deutschen Krankenhauspersonals).Ergebnisse: Der Anteil der impfenden Krankenhäuser stieg von 48% in der Saison 1997/98 auf 92% in 2001/02. Die Durchimpfungsrate lag 1997 bei nur 3,3% und 2001/02 erreichte sie 8,4%. Die Impfrate in impfenden Krankenhäusern stieg im gleichen Zeitraum von 5,0% auf 10,4%. Poster-Kampagnen und Einbeziehung der Krankenhausleitung haben signifikanten Einfluss.Schlussfolgerung: Es zeigt sich eine deutliche Steigerung sowohl der Krankenhäuser mit Impfangebot als auch der Durchimpfungsrate des Krankenhauspersonals. Nichtsdestotrotz bleibt diese aber auf einem nicht akzeptabel niedrigem Niveau.

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Résumé. Vaccination contre la grippe du personnel hospitalier en Allemagne: une recherche de cinq ans sur les taux de vaccination et la politique appliquée en matière de vaccination dans 25 hôpitaux allemandsObjectifs: La vaccination du personnel hospitalier contre la grippe est recommandée par la Commission permanente de la vaccination du Robert Koch Institut. Cette étude a porté sur lapplication de cette recommandation dans les hôpitaux allemands. Les médecins du travail de 25 hôpitaux ont participé à une enquête dans le cadre de laquelle ils ont fourni les données suivantes: prévalence de la vaccination contre la grippe et méthodes de promotion de la vaccination.Méthodes: Lenquête a eu lieu cinq années consécutives (1997–2002). Elle a porté sur 25 hôpitaux, soit sur 41969 employés (4,39% du personnel hospitalier allemand).Résultats: La proportion dhôpitaux pratiquant la vaccination est passée de 48% pour la période 1997/98 à 92% pour 2001/02. En 1997, le taux de vaccination ne sélevait quà 3,3% pour atteindre 8,4% en 2001/02. Le taux de vaccination dans les hôpitaux pratiquant déjà la vaccination en 1997 est passé durant la même période de 5,0% à 10,4%. Limplication de la direction hospitalière ainsi que le recours à des affiches ont eu un impact significatif.Conclusions: Le nombre dhôpitaux proposant la vaccination, ainsi que le taux de vaccination ont nettement augmenté. Néanmoins, ce taux reste à un niveau inacceptablement bas.

     

Surveillance of influenza A and B viruses in Italy between 1984 and 1987

Antigenically heterogeneous strains and new variants of influenza A viruses, both A (H₃N₂) and (H₁N₁) subtypes, as well as influenza B strains were detected in Italy in a period, between 1984–1987, characterized by a moderate degree of influenza activity. Each year the evaluation, by SRH technique, of antibodies, in the population, to currently circulating viruses, has confirmed the extent of infection and often the prevalent virus.     

2009-2010年河南省流感监测分析

目的分析2009-2010年河南省流感流行特征与病毒亚型分布情况,为制订流感防控策略提供依据。方法搜集国家流感监测网络数据进行分析;对核酸检测阳性的流感样病例(Influenza Like Illness,ILI)咽拭进行病毒分离。结果2009年ILI就诊率为5.1%,2010年ILI就诊率为1.2%,就诊高峰出现在2009年11月。2009-2010年共采集ILI咽拭子6 574份,分离到阳性毒株220株,分离率为3.3%。其中季节性H1N1流感(57株)和新型甲型H1N1流感(104株)为主要分离株,BV型流感次之(48株),分离高峰与ILI就诊高峰一致。结论2009年上半年先后出现季节性H1流感和BV型流感病毒的流行,8月至2010年1月为甲型H1N1流感大流行阶段,12月份到2010年3月份甲型H1N1流感流行峰快速下降而BV型流感呈小幅上升趋势。     

广东省2005-2007年流行性感冒流行特征分析

目的 分析广东省2005-2007年流感流行特征,为科学防治流感提供依据.方法 对2005-2007年广东省流感监测系统的监测资料进行描述性流行病学分析,监测资料包括广东省13个地级市的14家城市综合医院或儿童医院、16所社区门诊部、16所中小学校和6家县级综合医院等的哨点医院收集门诊流感样病例(以下简称ILI)就诊信息;各地暴发疫情监测信息;来自哨点医院监测系统和暴发疫情收集的ILI标本的病原学监测资料.结果 2005-2007年的哨点医院监测结果 显示14家城市医院的流感样病例占门诊就诊人数百分比(以下简称ILI%)周平均为5.17%;3年中ILl%在3-7月达到高峰,而每年ILI%的高峰有所不同;2005年流感活动在3-5月有1个高峰,这个高峰是A型流感病毒(H3N2亚型)和A型流感病毒H1N1亚型共同引起的;2006年在3-4月和6月有2个流行高峰,这2个高峰分别是由B型流感病毒(Victoria系)和A型流感病毒(H1N1亚型)引起;而2007年只在6月有1个高峰,是由A型流感病毒(H3N2)引起.2005-2007年分别报告的ILI暴发疫情分别为121、172和40起,发病人数累计17310人,暴发疫情中的流感病毒毒株的流行和变化趋势与定点医院监测到的毒株流行和变化趋势一致.92%的暴发疫情发生在学校和托幼机构,而学校监测哨点的ILI%的高峰出现也较其他监测哨点医院要早1周.结论 广东省流感流行的季节性高峰在春夏季,呈单峰或双峰型.中小学校和托幼机构是广东省流感防控的重点.     

2011-2013年湖南省流行性感冒暴发疫情流行特征分析

目的了解湖南省2011-2013年流行性感冒(简称流感)暴发疫情的流行病学特征和毒株变异情况,评价预防控制措施效果,为流感防控提供科学依据。方法收集2011-2013年全省突发公共卫生事件管理信息系统报告的流感暴发疫情资料,进行描述性流行病学分析。结果 2011-2013年全省报告16起流感暴发疫情,发病999例,平均罹患率为5.85%(999/17 077),无死亡病例。暴发病原类型主要是新A(H1N1)亚型、A(H3N2)亚型和B型流感病毒;暴发时间以冬春季节为主(2-3月和11-12月);主要发生在中小学校(13起,占81.25%);9起(56.25%)发生在农村,7起(43.75%)发生在城市及县城;发病人群罹患率小学生高于中学生和成人;A(H3N2)亚型和B型流感病毒暴发疫情中首例发病时间至疾病预防控制机构接到报告、处置时间与疫情持续时间呈正相关(r=0.81,P=0.004)。结论中小学校是流感暴发的高发场所。加强学校流感样病例监测,提高事发单位报告敏感性,及早对事件采取相应的处理措施是控制流感暴发的关键。     

Antigenic and genetic characterization of current influenza strains

Annually the influenza centre receives more than 1000 virus isolates from around the world to monitor the changing pattern of viruses causing influenza throughout the year. These are characterized antigenically using both polyclonal and monoclonal antibodies and selected viruses are subjected to closer scrutiny by nucleotide sequence analyses of their HA genes. This information is used in making the annual recommendation of vaccine composition. As in the last 15 years, influenza A viruses of both H3N2 and H1N1 subtypes and influenza B viruses have been isolated during the recent influenza season. Outbreaks in the northern hemisphere were largely caused by influenza B viruses which are similar to the B/Panama/45/90 reference strain. The proportion of influenza A increased later in the season and was predominantly of the H3N2 subtype, viruses similar to the recent A/Beijing/32/92 variant being most prevalent. The observed changes taking place will be discussed in the context of recent trends.     

Low uptake of nasal influenza vaccine in Polish and other ethnic minority children in Edinburgh,Scotland

Failure to vaccinate is well-recognised in Europe as a contributing factor to outbreaks of infectious diseases. Low immunisation rates are often associated with religious, social and ethnic minorities, including refugees or migrant groups. Polish people form Scotland’s newest and largest migrant group. They have moved to Scotland since 2004, joining established ethnic minorities from China, the Indian subcontinent and Africa.Scotland has had a seasonal influenza nasal vaccination programme for all primary school children since 2013. We investigated three primary schools in Edinburgh, which had reported low influenza vaccination uptake rates in 2016 and 2017 and found that these schools contained many pupils from ethnic minorities, the majority of whom were Polish. Pupils were categorized as one of three ethnic groupings: White British, Polish and Other Identified Ethnic Minority (OIEM). We ascertained ethnicity using NHS and Education Department information sources and name recognition. We examined vaccine acceptance, declination and non-return of consent forms.In 2017, nasal influenza vaccine uptake was 70.7% (65.2–75.6%, p?<?0.001) in White British, 60.9% (53.9–67.6%%, p?<?0.001) in other identified ethnic minorities and 25.0% (20.9–29.6%, p?>?0.001) in Polish children. White British children were more likely to return completed forms (78.9%) than other groups (OIEM 68.2% and Polish 61.8%). 36.8% of Polish families completed a consent form declining vaccination compared to 6.2% of White British families.These findings demonstrate that significant differences exist in nasal influenza vaccination uptake rates, which have important implications for the trans-national study of vaccine hesitancy. Further qualitative work and an investigation of uptake rates of other childhood immunisations in Polish and other migrant groups is required to assess differences in uptake and behaviours.     

2013 - 2017年贵州省流感暴发疫情特征分析

目的 分析贵州省2013 - 2017年流感暴发疫情的流行病学特征,为流感防控提供科学依据。方法 收集2013 - 2017年全省报告的流感暴发疫情资料,对疫情的时间、场所及实验室检测结果进行描述性流行病学分析。结果 从2013 - 2017年,贵州省累计报告流感暴发疫情149起,累计报告病例2 276例。主要由B型流感（46起）、季节性H3N2流感（38起）和甲型H1N1流感（29起）引起。暴发疫情主要集中在每年的冬春季（11 - 12月份）,发生场所为中小学校,报告116起（占92.8%）,疫情规模以10～29例的起数最多,共128起。累计报告最多的地区是贵阳市（59起）。结论 贵州省流感暴发疫情冬春季高发,场所主要集中在学校,流感病毒流行优势株在贵州省交替出现,应及时做好流感监测和预测预报。     

Establishing the baseline burden of influenza in preparation for the evaluation of a countywide school-based influenza vaccination campaign

Background

School-based influenza vaccination campaigns could mitigate the effects of influenza epidemics. A large countywide school-based vaccination campaign was launched in Knox County, Tennessee, in 2005. Assessment of campaign effects requires identification of appropriate control populations. We hypothesized that contiguous counties would share similar pre-campaign patterns of influenza activity.

Methods

We compared the burden of influenza emergency department (ED) visits and hospitalizations between Knox County (Knox) and eight counties surrounding Knox (Knox-surrounding) during five consecutive pre-campaign influenza seasons (2000-01 through 2004-05). Laboratory-defined influenza seasons were used to measure the weekly incidence of medically attended acute respiratory illnesses (MAARI) attributable to influenza in school-aged children 5-17 years old (campaign target) as well as in other age groups. Seasonal rates of MAARI attributable to influenza for Knox and Knox-surrounding counties were compared using rate ratios.

Results

During five consecutive influenza seasons, MAARI attributable to influenza showed synchronous temporal patterns in school-aged children from Knox and Knox-surrounding counties. The average seasonal rates of ED visits attributable to influenza were 12.37 (95% CI: 10.32-14.42) and 13.14 (95% CI: 11.23-15.05) per 1000, respectively. The respective average seasonal influenza hospitalization rates for Knox and Knox-surrounding were 0.38 (95% CI: 0-0.79) and 0.46 (95% CI: 0.07-0.85) per 1000 children. Rate ratio analyses indicated no significant differences in the incidence of MAARI attributable to influenza between school-aged children from Knox and Knox-surrounding counties. Estimates for other age groups showed similar patterns.

Conclusion

Before the Knox school-based influenza vaccination campaign, influenza resulted in an average of about 12 ED visits and 0.4 hospitalizations per 1000 school-aged children annually in Knox County. Since similar morbidity was observed in surrounding counties, they could serve as a control population for the assessment of the campaign effects.     

Low vaccination coverage for seasonal influenza and pneumococcal disease among adults at-risk and health care workers in Ireland, 2013: The key role of GPs in recommending vaccination

The World Health Organization (WHO), and European Agencies recommend influenza vaccination for individuals at-risk due to age (≥65 years), underlying diseases, pregnancy and for health care workers (HCWs) in Europe. Pneumococcal vaccine is recommended for those at-risk of pneumococcal disease. In Ireland, vaccination uptake among at-risk adults is not routinely available. In 2013, we conducted a national survey among Irish residents ≥18 years of age, to estimate size and vaccination coverage of at-risk groups, and identify predictive factors for influenza vaccination.We used computer assisted telephone interviews to collect self-reported information on health, vaccination status, attitudes towards vaccination. We calculated prevalence and prevalence ratios (PR) using binomial regression.Overall, 1770 individuals participated. For influenza, among those aged 18–64 years, 22% (325/1485) [95%CI: 17%–20%] were at-risk; 28% [95%CI: 23%–33%] were vaccinated. Among those aged ≥65 years, 60% [95%CI: 54%–66%] were vaccinated. Influenza vaccine uptake among HCWs was 28% [95%CI: 21%–35%]. For pneumococcal disease, among those aged 18–64 years, 18% [95%CI: 16%–20%] were at-risk; 16% [95%CI: 12%–21%] reported ever-vaccination; among those aged ≥65 years, 36% [95%CI: 30%–42%] reported ever-vaccination. Main reasons for not receiving influenza vaccine were perceptions of not being at-risk, or not thinking of it; and among HCWs thinking that vaccination was not necessary or they were not at-risk. At-risk individuals were more likely to be vaccinated if their doctor had recommended it (PR 3.2; [95%CI: 2.4%-4.4%]) or they had access to free medical care or free vaccination services (PR 2.0; [95%CI: 1.5%-2.8%]).Vaccination coverage for both influenza and pneumococcal vaccines in at-risk individuals aged 18–64 years was very low. Influenza vaccination coverage among individuals ≥65 years was moderate. Influenza vaccination status was associated with GP vaccination recommendation and free access to vaccination services. Doctors should identify and recommend vaccination to at-risk patients to improve uptake.     

Concurrent antigenic analysis of recent epidemic influenza A and B viruses and quantitation of antibodies in population serosurveys in Italy

Laboratory investigations of virus isolation and serum antibodies in a Mediterranean country (Italy) demonstrated that influenza A and B viruses, and often both, circulated every winter in Italy.The winter 1987/88 was characterized by a low level of influenza activity, as shown by the limited number (47) of influenza virus isolates, the majority of which (61%) belonged to the influenza B type. In contrast, the 1988/89 influenza season was exclusively associated with the circulation of influenza type A viruses. The A(HlH1) subtype was largely predominant (97%), as compared to the low incidence of the A(H3N2) subtype (3%). During the 1989/90 winter a cocirculation of A and B influenza viruses was observed, A(H3N2) strains being responsible for 96% of the virologically confirmed cases.Antigenic analysis of the virus isolates showed some antigenic variation in influenza A viruses of both HlN1 and H3N2 subtypes, whilst antigenic stability was found among the influenza B virus isolates.Overall, the above virological findings correlate with the data concerning the pattern of influenza virus circulation in Northern Europe and the UK during the three years surveyed.The results of serum antibody surveys conducted in each post-epidemic period are also reported.     

Understanding influenza vaccine protection in the community: An assessment of the 2013 influenza season in Victoria,Australia

BackgroundThe influenza virus undergoes frequent antigenic drift, necessitating annual review of the composition of the influenza vaccine. Vaccination is an important strategy for reducing the impact and burden of influenza, and estimating vaccine effectiveness (VE) each year informs surveillance and preventative measures. We aimed to describe the influenza season and to estimate the effectiveness of the influenza vaccine in Victoria, Australia, in 2013.MethodsRoutine laboratory notifications, general practitioner sentinel surveillance (including a medical deputising service) data, and sentinel hospital admission surveillance data for the influenza season (29 April to 27 October 2013) were collated in Victoria, Australia, to describe influenza-like illness or confirmed influenza during the season. General practitioner sentinel surveillance data were used to estimate VE against medically-attended laboratory confirmed influenza. VE was estimated using the case test negative design as 1 − adjusted odds ratio (odds of vaccination in cases compared with controls) × 100%. Cases tested positive for influenza while non-cases (controls) tested negative. Estimates were adjusted for age group, week of onset, time to swabbing and co-morbidities.ResultsThe 2013 influenza season was characterised by relatively low activity with a late peak. Influenza B circulation preceded that of influenza A(H1)pdm09, with very little influenza A(H3) circulation. Adjusted VE for all influenza was 55% (95%CI: −11, 82), for influenza A(H1)pdm09 was 43% (95%CI: −132, 86), and for influenza B was 56% (95%CI: −51, 87) Imputation of missing data raised the influenza VE point estimate to 64% (95%CI: 13, 85).ConclusionsClinicians can continue to promote a positive approach to influenza vaccination, understanding that inactivated influenza vaccines prevent at least 50% of laboratory-confirmed outcomes in hospitals and the community.