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. 2019 Jul 24;13(5):517-521.
doi: 10.1111/irv.12666. Online ahead of print.

Estimation of influenza- and respiratory syncytial virus-attributable medically attended acute respiratory infections in Germany, 2010/11-2017/18

Matthias An der Heiden  1 , Udo Buchholz  1 , Silke Buda  1
Affiliations

Estimation of influenza- and respiratory syncytial virus-attributable medically attended acute respiratory infections in Germany, 2010/11-2017/18

Matthias An der Heiden et al. Influenza Other Respir Viruses. .

Abstract

Background: The burden of influenza in primary care is difficult to assess, since most patients with symptoms of a respiratory infection are not tested. The case definition of "medically attended acute respiratory infection" (MAARI) in the German physician sentinel is sensitive; however, it requires modelling techniques to derive estimates of disease attributable to influenza and respiratory syncytial virus (RSV).

Objectives: The objective of this paper was to review and extend our previously published model in order to estimate the burden of RSV and the differential burden of the two influenza B lineages (Victoria, Yamagata) as well as both influenza A subtypes on primary care visits.

Methods: Data on MAARI and virological results of respiratory samples (virological sentinel) were available from 2010/11 until 2017/18. We updated the previously published generalized additive regression model to include RSV.

Results: We found that the proportion of MAARI due to RSV is substantial only in the 0-1- and 2-4-year-old age groups (0-1 years old: median 7.5%, range 4.0%-14.8%; 2-4 years old: median 6.5%, range 4.0%-10.3%); in the 0-1 years old age group, RSV leads in almost all seasons to a higher burden than any influenza type or subtype, but this is reversed in the age group 2-4 years old.

Conclusions: We succeeded in rearranging our previously published model on MAARI to incorporate RSV as well as the two influenza B lineages (Victoria, Yamagata) in the time period 2010 to 2018.

Keywords: Germany; burden of disease; generalized additive model; influenza; influenza type/subtype; medically attended acute respiratory infection; respiratory syncytial virus.

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Figures

Figure 1
Figure 1
Age‐ and season‐specific attack rate of influenza and RSV‐attributable medically attended acute respiratory infections (irMAARI), in % of the age group with 95% confidence intervals
Figure 2
Figure 2
Age‐ and season‐specific attack rate of influenza‐attributable medically attended acute respiratory infections (iMAARI) by subtype/lineage, in % of the age group with 95% confidence intervals
Figure 3
Figure 3
Estimated number of influenza and RSV‐attributable medically attended acute respiratory infections (irMAARI) by influenza type/subtype/lineage and RSV per calendar week (CW 40/2010‐CW 20/2018)
Figure 4
Figure 4
Distribution of irMAARI accumulated for all seasons from 2010/11 until 2017/18, by influenza type/subtype/lineage and RSV
See this image and copyright information in PMC

References

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