European all-cause excess and influenza-attributable mortality in the 2017/18 season: should the burden of influenza B be reconsidered?. (October 2019)

• Record Type: Journal Article
• Authors: Nielsen, J.; Vestergaard, L.S.; Richter, L.; Schmid, D.; Bustos, N.; Asikainen, T.; Trebbien, R.; Denissov, G.; Innos, K.; Virtanen, M.J.; Fouillet, A.; Lytras, T.; Gkolfinopoulou, K.; Heiden, M. an der; Grabenhenrich, L.; Uphoff, H.; Paldy, A.; Bobvos, J.; Domegan, L.; O'Donnell, J.; Scortichini, M.; de Martino, A.; Mossong, J.; England, K.; Melillo, J.; van Asten, L.; de Lange, M. MA; Tønnessen, R.; White, R.A.; da Silva, S.P.; Rodrigues, A.P.; Larrauri, A.; Mazagatos, C.; Farah, A.; Carnahan, A.D.; Junker, C.; Sinnathamby, M.; Pebody, R.G.; Andrews, N.; Reynolds, A.; McMenamin, J.; Brown, C.S.; Adlhoch, C.; Penttinen, P.; Mølbak, K.; Krause, T.G.;
• Is Part Of: Clinical microbiology and infection. Volume 25:Number 10(2019)
• Page Start: 1266
• Page End: 1276
• Publication Date: 2019-10
• Subjects: B/Yamagata -- EuroMOMO -- FluMOMO -- Influenza -- Mortality; Medical microbiology -- Periodicals; Diagnostic microbiology -- Periodicals; Communicable diseases -- Periodicals; Infection -- Periodicals; 616.01
• DOI: 10.1016/j.cmi.2019.02.011
• Languages: English
• ISSNs: 1198-743X

Abstract

Abstract: Objectives: Weekly monitoring of European all-cause excess mortality, the EuroMOMO network, observed high excess mortality during the influenza B/Yamagata dominated 2017/18 winter season, especially among elderly. We describe all-cause excess and influenza-attributable mortality during the season 2017/18 in Europe. Methods: Based on weekly reporting of mortality from 24 European countries or sub-national regions, representing 60% of the European population excluding the Russian and Turkish parts of Europe, we estimated age stratified all-cause excess morality using the EuroMOMO model. In addition, age stratified all-cause influenza-attributable mortality was estimated using the FluMOMO algorithm, incorporating influenza activity based on clinical and virological surveillance data, and adjusting for extreme temperatures. Results: Excess mortality was mainly attributable to influenza activity from December 2017 to April 2018, but also due to exceptionally low temperatures in February-March 2018. The pattern and extent of mortality excess was similar to the previous A(H3N2) dominated seasons, 2014/15 and 2016/17. The 2017/18 overall all-cause influenza-attributable mortality was estimated to be 25.4 (95%CI 25.0-25.8) per 100, 000 population; 118.2 (116.4-119.9) for persons aged 65. Extending to the European population this translates into over-all 152, 000 deaths. Conclusions: The high mortality among elderly was unexpected in an influenza B dominated season, which commonly are considered to cause mild illness, mainly among children. Even though A(H3N2) also circulated in the 2017/18 season and may have contributed to the excess mortality among the elderly, the common perception of influenza B only having a modest impact on excess mortality in the older population may need to be reconsidered.