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. 2016 Sep 8;11(9):e0161301.
doi: 10.1371/journal.pone.0161301. eCollection 2016.

Morbidity, Mortality, and Seasonality of Influenza Hospitalizations in Egypt, November 2007-November 2014

Amr Kandeel  1 , Patrick Dawson  2   3 , Manal Labib  1 , Mayar Said  2 , Samir El-Refai  1 , Amani El-Gohari  1 , Maha Talaat  2   3
Affiliations

Morbidity, Mortality, and Seasonality of Influenza Hospitalizations in Egypt, November 2007-November 2014

Amr Kandeel et al. PLoS One. .

Abstract

Background: Influenza typically comprises a substantial portion of acute respiratory infections, a leading cause of mortality worldwide. However, influenza epidemiology data are lacking in Egypt. We describe seven years of Egypt's influenza hospitalizations from a multi-site influenza surveillance system.

Methods: Syndromic case definitions identified individuals with severe acute respiratory infection (SARI) admitted to eight hospitals in Egypt. Standardized demographic and clinical data were collected. Nasopharyngeal and oropharyngeal swabs were tested for influenza using real-time reverse transcription polymerase chain reaction and typed as influenza A or B, and influenza A specimens subtyped.

Results: From November 2007-November 2014, 2,936/17,441 (17%) SARI cases were influenza-positive. Influenza-positive patients were more likely to be older, female, pregnant, and have chronic condition(s) (all p<0.05). Among them, 53 (2%) died, and death was associated with older age, five or more days from symptom onset to hospitalization, chronic condition(s), and influenza A (all p<0.05). An annual seasonal influenza pattern occurred from July-June. Each season, the proportion of the season's influenza-positive cases peaked during November-May (19-41%).

Conclusions: In Egypt, influenza causes considerable morbidity and mortality and influenza SARI hospitalization patterns mirror those of the Northern Hemisphere. Additional assessment of influenza epidemiology in Egypt may better guide disease control activities and vaccine policy.

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Conflict of interest statement

The authors have declared that no competing interests exist.

Figures

Fig 1
Fig 1. Percentage of Season’s Influenza-Positive Specimens by Month, Egypt, July 2008-June 2014.
The percentage of each season’s influenza-positive specimens occurring in each month of the influenza season is displayed. Influenza seasons were defined as the one-year period from July to June.
Fig 2
Fig 2. Number and Percentage of Severe Acute Respiratory Infection (SARI) Surveillance Patient Specimens Positive for Influenza by Viral Influenza Etiology and Month, Egypt, November 2007-November 2014 (n = 2,396).
Vertical bars represent the raw number of influenza types and subtypes recorded each month (left vertical axis). The line represents the percentage of all patient specimens collected each month that were positive for any influenza type or subtype (right vertical axis).
See this image and copyright information in PMC

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