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

Publikation: Bidrag til tidsskriftTidsskriftartikelForskningfagfællebedømt

  • J. Nielsen
  • L. S. Vestergaard
  • L. Richter
  • D. Schmid
  • N. Bustos
  • T. Asikainen
  • R. Trebbien
  • G. Denissov
  • K. Innos
  • M. J. Virtanen
  • A. Fouillet
  • T. Lytras
  • K. Gkolfinopoulou
  • M. an der Heiden
  • L. Grabenhenrich
  • H. Uphoff
  • A. Paldy
  • J. Bobvos
  • L. Domegan
  • J. O'Donnell
  • M. Scortichini
  • A. de Martino
  • J. Mossong
  • K. England
  • J. Melillo
  • L. van Asten
  • M. MA de Lange
  • R. Tønnessen
  • R. A. White
  • S. P. da Silva
  • A. P. Rodrigues
  • A. Larrauri
  • C. Mazagatos
  • A. Farah
  • A. D. Carnahan
  • C. Junker
  • M. Sinnathamby
  • R. G. Pebody
  • N. Andrews
  • A. Reynolds
  • J. McMenamin
  • C. S. Brown
  • C. Adlhoch
  • P. Penttinen
  • T. G. Krause

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.

TidsskriftClinical Microbiology and Infection
Udgave nummer10
Sider (fra-til)1266-1276
Antal sider11
StatusUdgivet - 2019

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