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. 2019 Nov 12;19(1):967.
doi: 10.1186/s12879-019-4613-z.

The 2017-2018 influenza season in Bucharest, Romania: epidemiology and characteristics of hospital admissions for influenza-like illness

Anca Drăgănescu  1 , Oana Săndulescu  2   3 , Dragoș Florea  4   5 , Ovidiu Vlaicu  4 , Anca Streinu-Cercel  6   7 , Dan Oțelea  4 , Monica Luminița Luminos  1   8 , Victoria Aramă  7   9 , Sorin Abrudan  10 , Adrian Streinu-Cercel  6   7 , Daniela Pițigoi  11   12
Affiliations

The 2017-2018 influenza season in Bucharest, Romania: epidemiology and characteristics of hospital admissions for influenza-like illness

Anca Drăgănescu et al. BMC Infect Dis. .

Abstract

Background: Seasonal influenza causes a considerable burden to healthcare services every year. To better measure the impact of severe influenza cases in Romania, we analyzed active surveillance data collected during the 2017-2018 season from patients admitted for influenza-like illness (ILI) at a tertiary care hospital in Bucharest.

Methods: Patients admitted for acute ILI were included if they were resident in the Bucharest-Ilfov region, had been hospitalized for at least 24 h, and had onset of symptoms within 7 days before admission. Patient demographics, healthcare use, vaccination status, and outcome data were collected by questionnaire or by searching clinical records. Respiratory swabs were also obtained from each patient to confirm influenza A (A/H1 and A/H3 subtypes) or influenza B (Yamagata and Victoria lineages) infection by real-time reverse-transcription polymerase chain reaction assay.

Results: The study included 502 patients, many (45.2%) of whom were aged < 5 years. Overall, 108 patients (21.5%) had one or more comorbidities. Seventeen adults aged 18-64 years (3.4%) had been vaccinated against influenza. Patients were hospitalized for a median of 5 days and most (90.4%) were prescribed antiviral treatment. More than one-half of the patients (n = 259, 51.6%) were positive for influenza. Most influenza cases were caused by B viruses (172/259, 66.4%), which were mostly of the B/Yamagata lineage (85 of 94 characterized, 90.4%). Most of the subtyped A viruses were A/H1 (59/74, 79.7%). A/H1 viruses were frequently detected in influenza-positive admissions throughout the 2017-2018 season, whereas the predominant B/Yamagata viruses were detected around the middle of the season, with a peak in cases at week 7 of 2018. Eleven patients were admitted to an intensive care unit; of these, one patient with confirmed B/Yamagata infection died.

Conclusions: These results show that seasonal influenza results in considerable hospitalization in Bucharest-Ilfov, Romania and suggest vaccine coverage should be extended, especially to the youngest age groups. The data from this study should help inform and optimize national influenza healthcare policies.

Keywords: Children; Comorbidity; Epidemiology; Hospitalization; Influenza; Older adults; Romania.

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Conflict of interest statement

AD, OS, DF, OV, DO, Anca SC, MLL, VA, Adrian SC and DP work within the GIHSN project funded by the National Institute for Infectious Diseases 'Prof. Dr. Matei Balș', Bucharest, Romania, and the Foundation for Influenza Epidemiology, and within the DRIVE study supported by the EU/EFPIA Innovative Medicines Initiative 2 Joint Undertaking (DRIVE, grant n° 777363).

Anca SC and DP have been investigators in the I-MOVE+ study funded through the European Union’s HORIZON 2020 research and innovation.

OS, Anca SC, and Adrian SC have been investigators in influenza clinical trials by Shionogi and F. Hoffmann-La Roche.

SA is an employee of Sanofi Pasteur.

Figures

Fig. 1
Fig. 1
Patient flow chart
Fig. 2
Fig. 2
Admissions with influenza by epidemiologic week and virus type, subtype, or lineage
See this image and copyright information in PMC

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