Burden of Seasonal and Pandemic Influenza-Associated Hospitalization during and after 2009 A(H1N1)pdm09 Pandemic in a Rural Community in India
Open Access
- 15 May 2013
- journal article
- research article
- Published by Public Library of Science (PLoS) in PLOS ONE
- Vol. 8 (5), e55918
- https://doi.org/10.1371/journal.pone.0055918
Abstract
Background Influenza is vaccine-preventable; however, the burden of severe influenza in India remains unknown. We conducted a population-based study to estimate the incidence of laboratory confirmed influenza-associated hospitalizations in a rural community in western India. Methods We conducted active surveillance for hospitalized patients with acute medical illnesses or acute chronic disease exacerbations in Pune during pandemic and post pandemic periods (May 2009–April 2011). Nasal and throat swabs were tested for influenza viruses. A community health utilization survey estimated the proportion of residents hospitalized with respiratory illness at non-study facilities and was used to adjust incidence estimates from facility-based surveillance. Results Among 9,426 hospitalizations, 3,391 (36%) patients were enrolled; 665 of 3,179 (20.9%) tested positive for influenza. Of 665 influenza positives, 340 (51%) were pandemic A(H1N1)pdm09 and 327 (49%) were seasonal, including A/H3 (16%), A/H1 (3%) and influenza B (30%). The proportion of patients with influenza peaked during August 2009 (39%) and 2010 (42%). The adjusted annual incidence of influenza hospitalizations was 46.8/10,000 during pandemic and 40.5/10,000 during post-pandemic period with comparable incidence of A(H1N1)pdm09 during both periods (18.8 and 20.3, respectively). The incidence of both pH1N1 and seasonal hospitalized influenza disease was highest in the 5–29 year olds. Conclusions We document the previously unrecognized burden of influenza hospitalization in a rural community following the emergence of influenza A(H1N1)pdm09 viruses in India. During peak periods of influenza activity circulation i.e during the monsoon period, 20% of all hospital admissions in the community had influenza positivity. These findings can inform development of influenza prevention and control strategies in India.Keywords
This publication has 24 references indexed in Scilit:
- Multisite virological influenza surveillance in India: 2004–2008Influenza and Other Respiratory Viruses, 2011
- Epidemiology of Respiratory Infections in Young ChildrenThe Pediatric Infectious Disease Journal, 2004
- Influenza-Associated Hospitalizations in the United StatesJAMA, 2004
- Excess hospital admissions for pneumonia, chronic obstructive pulmonary disease, and heart failure during influenza seasons in Hong KongJournal of Medical Virology, 2004
- Influenza-Related Hospitalizations among Children in Hong KongNew England Journal of Medicine, 2002
- The Effect of Influenza on Hospitalizations, Outpatient Visits, and Courses of Antibiotics in ChildrenNew England Journal of Medicine, 2000
- Influenza surveillance in Pune, India, 1978-90.1993
- Excess pneumonia and influenza associated hospitalization during influenza epidemics in the United States, 1970-78.American Journal of Public Health, 1986
- SERIOUS MORBIDITY AND MORTALITY ASSOCIATED WITH INFLUENZA EPIDEMICSEpidemiologic Reviews, 1982
- IMPACT OF EPIDEMIC TYPE A INFLUENZA IN A DEFINED ADULT POPULATIONAmerican Journal of Epidemiology, 1980