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Review
. 2021 Mar 15:39 Suppl 1:A6-A14.
doi: 10.1016/j.vaccine.2020.09.048. Epub 2020 Oct 9.

The disease burden of influenza beyond respiratory illness

Alejandro E Macias  1 , Janet E McElhaney  2 , Sandra S Chaves  3 , Joshua Nealon  4 , Marta C Nunes  5 , Sandrine I Samson  6 , Bruce T Seet  7 , Thomas Weinke  8 , Hongjie Yu  9
Affiliations
Review

The disease burden of influenza beyond respiratory illness

Alejandro E Macias et al. Vaccine. .

Abstract

Although influenza is primarily considered a respiratory infection and causes significant respiratory mortality, evidence suggests that influenza has an additional burden due to broader consequences of the illness. Some of these broader consequences include cardiovascular events, exacerbations of chronic underlying conditions, increased susceptibility to secondary bacterial infections, functional decline, and poor pregnancy outcomes, all of which may lead to an increased risk for hospitalization and death. Although it is methodologically difficult to measure these impacts, epidemiological and interventional study designs have evolved over recent decades to better take them into account. Recognizing these broader consequences of influenza virus infection is essential to determine the full burden of influenza among different subpopulations and the value of preventive approaches. In this review, we outline the main influenza complications and societal impacts beyond the classical respiratory symptoms of the disease.

Keywords: Burden of disease; Cardiovascular events; Comorbidity; Complications; Influenza virus; Vaccination.

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Conflict of interest statement

Declaration of Competing Interest The authors declare the following financial interests/personal relationships which may be considered as potential competing interests: JN, SSC, SIS, and BTS are employees of Sanofi Pasteur. AEM has received honoraria for lectures or advisory boards from Sanofi Pasteur, Stendhal Pharma, Roche, and Pfizer. JEM has received honoraria for participation in advisory boards or lectures and related travel support from Sanofi, and participation in data monitoring boards or advisory boards for GSK, Pfizer, Merck, and Medicago. MCN has received honoraria for lectures or advisory boards from Sanofi Pasteur and Pfizer, and research grants from MedImmune. TW has received honoraria for lectures or advisory boards from MSD, Sanofi Pasteur, and Seqirus. HY has received investigator-initiated research funding from Sanofi Pasteur, GlaxoSmithKline, Yichang HEC Changjiang Pharmaceutical Company, and Roche (Shanghai).

Figures

Fig. 1
Fig. 1
Domino effect of influenza. The influenza virus infection triggers various effects that can exacerbate underlying chronic medical conditions, leading to an increased risk for hospitalization and death , , , , , , , , , , , , , .
See this image and copyright information in PMC

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References

    1. Paules C., Subbarao K. Influenza. Lancet. 2017;390(10095):697–708. doi: 10.1016/s0140-6736(17)30129-0. - DOI - PubMed
    1. World Health Organization. Influenza (Seasonal). 2018; Available from: https://www.who.int/news-room/fact-sheets/detail/influenza-(seasonal). Accessed: 17 July 2019.
    1. Hayward A.C., Fragaszy E.B., Bermingham A., Wang L., Copas A., Edmunds W.J., et al. Comparative community burden and severity of seasonal and pandemic influenza: results of the Flu Watch cohort study. Lancet Respir Med. 2014;2(6):445–454. doi: 10.1016/S2213-2600(14)70034-7. - DOI - PMC - PubMed
    1. GBD 2017 Influenza Collaborators. Mortality, morbidity, and hospitalisations due to influenza lower respiratory tract infections, 2017: an analysis for the Global Burden of Disease Study 2017. Lancet Respir Med 2019;7(1):69-89. doi: 10.1016/s2213-2600(18)30496-x. - PMC - PubMed
    1. Nickol M.E., Kindrachuk J. A year of terror and a century of reflection: perspectives on the great influenza pandemic of 1918–1919. BMC Infect Dis. 2019;19(1):117. doi: 10.1186/s12879-019-3750-8. - DOI - PMC - PubMed

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