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Abstract

The Influenza Complications Alert Network (FluCAN) is a sentinel hospital-based surveillance programme operating in all states and territories in Australia. We summarise the epidemiology of children hospitalised with laboratory-confirmed influenza in 2014 and reports on the effectiveness of inactivated trivalent inactivated vaccine (TIV) in children. In this observational study, cases were defined as children admitted with acute respiratory illness (ARI) with influenza confirmed by PCR. Controls were hospitalised children with ARI testing negative for influenza. Vaccine effectiveness (VE) was estimated as 1 minus the odds ratio of vaccination in influenza positive cases compared with test-negative controls using conditional logistic regression models. From April until October 2014, 402 children were admitted with PCR-confirmed influenza. Of these, 28% were aged < 1 year, 16% were Indigenous, and 39% had underlying conditions predisposing to severe influenza. Influenza A was detected in 90% of cases of influenza; influenza A(H1N1)pdm09 was the most frequent subtype (109/141 of subtyped cases) followed by A(H3N2) (32/141). Only 15% of children with influenza received antiviral therapy. The adjusted VE of one or more doses of TIV for preventing hospitalised influenza was estimated at 55.5% (95% confidence intervals (CI): 11.6–77.6%). Effectiveness against influenza A(H1N1)pdm09 was high (91.6% , 95% CI: 36.0–98.9%) yet appeared poor against H3N2. In summary, the 2014 southern hemisphere TIV was moderately effective against severe influenza in children. Significant VE was observed against influenza A(H1N1)pdm09.

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/content/10.2807/1560-7917.ES.2016.21.30.30301
2016-07-28
2024-03-28
http://instance.metastore.ingenta.com/content/10.2807/1560-7917.ES.2016.21.30.30301
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References

  1. Dawood FS, Iuliano AD, Reed C, Meltzer MI, Shay DK, Cheng PY, et al. Estimated global mortality associated with the first 12 months of 2009 pandemic influenza A H1N1 virus circulation: a modelling study. Lancet Infect Dis. 2012;12(9):687-95.  https://doi.org/10.1016/S1473-3099(12)70121-4  PMID: 22738893 
  2. Chiu C, Dey A, Wang H, Menzies R, Deeks S, Mahajan D, et al. Vaccine preventable diseases in Australia, 2005 to 2007. Commun Dis Intell Q Rep. 2010;34(Supp):S1-167. PMID: 21416762 
  3. Carr S. Seasonal and pandemic influenza: an overview with pediatric focus. Adv Pediatr. 2012;59(1):75-93.  https://doi.org/10.1016/j.yapd.2012.04.016  PMID: 22789575 
  4. Khandaker G, Zurynski Y, Ridley G, Buttery J, Marshall H, Richmond PC, et al. Clinical epidemiology and predictors of outcome in children hospitalised with influenza A(H1N1)pdm09 in 2009: a prospective national study. Influenza Other Respi Viruses. 2014;8(6):636-45.  https://doi.org/10.1111/irv.12286  PMID: 25263176 
  5. Zurynski Y, McIntyre P, Booy R, Elliott EJPAEDS Investigators Group. Paediatric active enhanced disease surveillance: a new surveillance system for Australia. J Paediatr Child Health. 2013;49(7):588-94.  https://doi.org/10.1111/jpc.12282  PMID: 23781900 
  6. Australian Technical Advisory Group on Immunisation. Australian Immunisation Handbook 10th Edition. Canberra: Department of Health; 2013. [Accessed Oct 2015]. Available from: http://www.immunise.health.gov.au/internet/immunise/publishing.nsf/Content/Handbook10-home
  7. Blyth CC, Jacoby P, Effler PV, Kelly H, Smith DW, Robins C, et al. WAIVE Study Team. Effectiveness of trivalent flu vaccine in healthy young children. Pediatrics. 2014;133(5):e1218-25.  https://doi.org/10.1542/peds.2013-3707  PMID: 24753525 
  8. Kelly H, Jacoby P, Dixon GA, Carcione D, Williams S, Moore HC, et al. WAIVE Study Team. Vaccine Effectiveness Against Laboratory-confirmed Influenza in Healthy Young Children: A Case-Control Study. Pediatr Infect Dis J. 2011;30(2):107-11.  https://doi.org/10.1097/INF.0b013e318201811c  PMID: 21079528 
  9. Dixon GA, Moore HC, Kelly H, Jacoby P, Carcione D, Williams S, et al. WAIVE study team. Lessons from the first year of the WAIVE study investigating the protective effect of influenza vaccine against laboratory-confirmed influenza in hospitalised children aged 6-59 months. Influenza Other Respi Viruses. 2010;4(4):231-4.  https://doi.org/10.1111/j.1750-2659.2010.00141.x  PMID: 20629773 
  10. Jefferson T, Rivetti A, Di Pietrantonj C, Demicheli V, Ferroni E. Vaccines for preventing influenza in healthy children. Cochrane Database Syst Rev. 2012;8(8):CD004879. PMID: 22895945 
  11. Osterholm MT, Kelley NS, Sommer A, Belongia EA. Efficacy and effectiveness of influenza vaccines: a systematic review and meta-analysis. Lancet Infect Dis. 2012;12(1):36-44.  https://doi.org/10.1016/S1473-3099(11)70295-X  PMID: 22032844 
  12. Cowling BJ, Chan KH, Feng S, Chan EL, Lo JY, Peiris JS, et al. The effectiveness of influenza vaccination in preventing hospitalizations in children in Hong Kong, 2009-2013. Vaccine. 2014;32(41):5278-84.  https://doi.org/10.1016/j.vaccine.2014.07.084  PMID: 25092636 
  13. Department of Health, Australian Government. National Notifiable Surveillance System Data; [Accessed 24 Sep 2015). Available from: http://www9.health.gov.au/cda/source/cda-index.cfm
  14. Department of Health, Australian Government. Australian Influenza Surveillance Report No 8 -27 September to 10 October 2014: [Accessed 23 Mar 2015]. Available from: http://www.health.gov.au/internet/main/publishing.nsf/Content/ozflu-surveil-no08-14.htm
  15. Kelly PM, Kotsimbos T, Reynolds A, Wood-Baker R, Hancox B, Brown SG, et al. FluCAN 2009: initial results from sentinel surveillance for adult influenza and pneumonia in eight Australian hospitals. Med J Aust. 2011;194(4):169-74. PMID: 21401456 
  16. Greenland S, Thomas DC. On the need for the rare disease assumption in case-control studies. Am J Epidemiol. 1982;116(3):547-53. PMID: 7124721 
  17. Rodrigues L, Kirkwood BR. Case-control designs in the study of common diseases: updates on the demise of the rare disease assumption and the choice of sampling scheme for controls. Int J Epidemiol. 1990;19(1):205-13.  https://doi.org/10.1093/ije/19.1.205  PMID: 2190942 
  18. Smith PG, Rodrigues LC, Fine PE. Assessment of the protective efficacy of vaccines against common diseases using case-control and cohort studies. Int J Epidemiol. 1984;13(1):87-93.  https://doi.org/10.1093/ije/13.1.87  PMID: 6698708 
  19. Cheng AC, Brown S, Waterer G, Holmes M, Senenayake S, Friedman ND, et al. Influenza epidemiology, vaccine coverage and vaccine effectiveness in sentinel Australian hospitals in 2012: the Influenza Complications Alert Network (FluCAN). Commun Dis Intell Q Rep. 2013;37(3):E246-52. PMID: 24890961 
  20. Cheng AC, Holmes M, Irving LB, Brown SG, Waterer GW, Korman TM, et al. Influenza vaccine effectiveness against hospitalisation with confirmed influenza in the 2010-11 seasons: a test-negative observational study. PLoS One. 2013;8(7):e68760.  https://doi.org/10.1371/journal.pone.0068760  PMID: 23874754 
  21. Naidu L, Chiu C, Habig A, Lowbridge C, Jayasinghe S, Wang H, et al. Vaccine preventable diseases and vaccination coverage in Aboriginal and Torres Strait Islander people, Australia 2006-2010. Commun Dis Intell Q Rep. 2013;37(Suppl):S1-95. PMID: 24410428 
  22. Australian Bureau of Statistics. ABS statistics. Canberra: Australian Government; 2015. [Accessed 24 Sep 2015]. Available from: http://www.abs.gov.au/
  23. Jefferson T, Jones M, Doshi P, Spencer EA, Onakpoya I, Heneghan CJ. Oseltamivir for influenza in adults and children: systematic review of clinical study reports and summary of regulatory comments. BMJ. 2014;348(apr09 2):g2545.  https://doi.org/10.1136/bmj.g2545  PMID: 24811411 
  24. Dobson J, Whitley RJ, Pocock S, Monto AS. Oseltamivir treatment for influenza in adults: a meta-analysis of randomised controlled trials. Lancet. 2015;385(9979):1729-37.  https://doi.org/10.1016/S0140-6736(14)62449-1  PMID: 25640810 
  25. Nguyen-Van-Tam JS, Venkatesan S, Muthuri SG, Myles PR. Neuraminidase inhibitors: who, when, where? Clin Microbiol Infect. 2015;21(3):222-5.  https://doi.org/10.1016/j.cmi.2014.11.020  PMID: 25703253 
  26. Turner N, Pierse N, Bissielo A, Huang Q, Radke S, Baker M, et al. SHIVERS investigation team. Effectiveness of seasonal trivalent inactivated influenza vaccine in preventing influenza hospitalisations and primary care visits in Auckland, New Zealand, in 2013. Euro Surveill. 2014;19(34):20884.  https://doi.org/10.2807/1560-7917.ES2014.19.34.20884  PMID: 25188614 
  27. Turner N, Pierse N, Bissielo A, Huang QS, Baker MG, Widdowson MA, et al. SHIVERS investigation team. The effectiveness of seasonal trivalent inactivated influenza vaccine in preventing laboratory confirmed influenza hospitalisations in Auckland, New Zealand in 2012. Vaccine. 2014;32(29):3687-93.  https://doi.org/10.1016/j.vaccine.2014.04.013  PMID: 24768730 
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