Author(s):
Nielsen, Jens ; Vestergaard, Lasse ; Richter, L. ; Schmid, D. ; Bustos, N. ; Asikainen, T. ; Trebbien, R. ; Denissov, G. ; Innos, K. ; Virtanen, M.J. ; Fouillet, A. ; Lytras, T. ; Gkolfinopoulou, K. ; Heiden, M. an der ; Grabenhenrich, L. ; Uphoff, H. ; Paldy, A. ; Bobvos, J. ; Domegan, L. ; O'Donnell, J. ; Scortichini, M. ; de Martino, A. ; Mossong, J. ; England, K. ; Melillo, J. ; van Asten, L. ; de Lange, M. MA ; Tønnessen, R. ; White, R.A. ; Silva, Susana Pereira ; Rodrigues, Ana Paula ; Larrauri, Amparo ; Mazagatos, Clara ; Farah, A. ; Carnahan, A.D. ; Junker, C. ; Sinnathamby, M. ; Pebody, R.G. ; Andrews, N. ; Reynolds, A. ; McMenamin, J. ; Brown, C.S. ; Adlhoch, C. ; Penttinen, P. ; Mølbak, K. ; Krause, T.G.
Date: 2019
Persistent ID: http://hdl.handle.net/10400.18/6499
Origin: Repositório Científico do Instituto Nacional de Saúde
Subject(s): Mortality; VDM; B/Yamagata; B/Yamagata; EuroMOMO; FluMOMO; Influenza; Mortality; Mortalidade; EuroMOMO; FluMOMO; Influenza; Estados de Saúde e de Doença
Description
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.
