- Isabelle Bonmarin1, Emmanuel Belchior1, Jean Bergounioux2, Christian Brun-Buisson3, Bruno Mégarbane4, Jean Loup Chappert5, Bruno Hubert5, Yann Le Strat1, Daniel Lévy-Bruhl1
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View Affiliations Hide AffiliationsAffiliations: 1 Institut de Veille sanitaire (InVS), Saint-Maurice, France 2 Paediatric Intensive Care Unit, Raymond Poincaré Hospital, Garches, France 3 Intensive Care Unit, CHU Henri-Mondor, Créteil, France 4 Intensive care unit and toxicological department, Lariboisière Hospital, Paris-Diderot University, INSERM, Paris, France 5 On behalf of the Cellules de l’InVS en région (Cire), the InVS regional offices, FranceIsabelle Bonmarini.bonmarin invs.sante.fr
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Citation style for this article: Bonmarin Isabelle, Belchior Emmanuel, Bergounioux Jean, Brun-Buisson Christian, Mégarbane Bruno, Chappert Jean Loup, Hubert Bruno, Le Strat Yann, Lévy-Bruhl Daniel. Intensive care unit surveillance of influenza infection in France: the 2009/10 pandemic and the three subsequent seasons. Euro Surveill. 2015;20(46):pii=30066. https://doi.org/10.2807/1560-7917.ES.2015.20.46.30066 Received: 13 Nov 2014; Accepted: 30 Mar 2015
Intensive care unit surveillance of influenza infection in France: the 2009/10 pandemic and the three subsequent seasons
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Abstract
During the 2009/10 pandemic, a national surveillance system for severe influenza cases was set up in France. We present results from the system's first four years. All severe influenza cases admitted to intensive care units (ICU) were reported to the Institut de Veille Sanitaire using a standardised form: data on demographics, immunisation and virological status, risk factors, severity (e.g. acute respiratory distress syndrome (ARDS) onset, mechanical ventilation, extracorporeal life support) and outcome. Multivariate analysis was performed to identify factors associated with ARDS and death. The number of confirmed influenza cases varied from 1,210 in 2009/10 to 321 in 2011/12. Most ICU patients were infected with A(H1N1)pdm09, except during the 2011/12 winter season when A(H3N2)-related infections predominated. Patients' characteristics varied according to the predominant strain. Based on multivariate analysis, risk factors associated with death were age ≥ 65 years, patients with any of the usual recommended indications for vaccination and clinical severity. ARDS occurred more frequently in patients who were middle-aged (36–55 years), pregnant, obese, or infected with A(H1N1)pdm09. Female sex and influenza vaccination were protective. These data confirm the persistent virulence of A(H1N1)pdm09 after the pandemic and the heterogeneity of influenza seasons, and reinforce the need for surveillance of severe influenza cases.

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