While the effects of flu varies, it places a substantial burden on the health of people in the United States each year. The global death count of the flu today To have a context for the severity of influenza pandemics it might be helpful to know the death count of a typical flu season. COVID-19 epidemics in countries across Europe, Central Asia, and North America have been marked by a first peak during the spring, followed by significant reductions in COVID-19 cases in the summer months and a second wave in the fall. Statistical modeling across 92 countries estimated that previous WHO estimates of influenza-related mortality rates may be conservative. S2 Table. 6. For this analysis, published articles were limited in their inclusion of stratified testing data by year and age group. The burden of severe influenza-associated disease and hospitalizations among adults worldwide is substantial. In 2014, the influenza vaccination goals were achieved by only five countries for persons with chronic diseases and two countries for older adults . Virus type-specific models were restricted to datasets with at least 1 type-specific positive sample. Cheryl Cohen, Given the expected burden of influenza illness and the ongoing COVID-19 pandemic, the benefits of vaccination will likely be greater during the current respiratory viral season compared to those . For this analysis, published articles were limited in their inclusion of stratified testing data by year and age group. severe acute respiratory infection. Keywords included influenza and terms related to hospitalization (e.g., hospital* and inpatient) (S1 Table). . Recent estimates suggest that influenza is associated with 291,243645,832 deaths per year [9]. We generated this estimate using 2 sources of data: a systematic review of the literature and unpublished respiratory inpatient surveillance data from a global working group of partners. . A systematic subnational analysis for the Global Burden of Disease Study 2013. At the present, the H1- evolved H1N1-2009 influenza virus, as well as the H3N2 are co-circulating as seasonal influenza in the human society. If you need to go back and make any changes, you can always do so by going to our Privacy Policy page. Influenza sentinel surveillance in low- and lower-middle-income countries during the first year of the 2009 H1N1 influenza pandemic - "Global burden of influenza as a cause of cardiopulmonary morbidity and mortality." The first pandemic was described in 1580. Methods and findings: Conclusions: In this meta-analysis, we estimated that influenza viruses are associated with over 5 million hospitalizations worldwide per year. Error bars indicate interquartile range for each estimate. K W A R T E N G worked as editorial assistant to the volume editor. 2003;289(2):17986. However, despite an increase in the number of countries producing estimates to inform influenza prevention measures, gaps still remain such as a lack of high quality and up-to-date estimates of severe influenza burden at global and regional levels; relatively few low and middle-income countries (LMICs) that have developed reliable national estimates of influenza burden of disease (BoD); and a lack of reliable BoD data and on the possible impact of vaccination among specific high-risk groups. [view We calculated rates by dividing the above estimates by the 2016 global population [16]. Harish Nair, A full list of eligible published articles with key abstracted data, and a PRISMA checklist for systematic reviews [15], are provided in S2 Table and S1 PRISMA Checklist. 1) The potential risks of the flu during COVID-19. PLOS Medicine. Titles and abstracts of all articles identified were screened for inclusion in the analysis by a member of the review team (KEL, RMP, MJW, EAB, MAW, J. Kile) with support from native language speakers as needed. GBD, Influenza Division, US Centers for Disease Control and Prevention, Atlanta, Georgia, United States of America, Lancet. Initiatives are underway to develop better global estimates for influenza-associated hospitalizations and deaths. Nicholson, Influenza, Lancet, 362, . doi: 10.1016/S2214-109X(20)30393-4. SARS-CoV-2 and influenza are lipid-enveloped viruses with differential morbidity and mortality but shared modes of transmission. Knowledge gaps remain regarding the role of influenza viruses in severe respiratory disease and hospitalizations among adults, particularly in lower . I have read the journals policy and the authors of this manuscript have the following competing interests: H.N. Calabr GE, Icardi G, Bonanni P, Gabutti G, Vitale F, Rizzo C, Cicchetti A, Staiano A, Ansaldi F, Orsi A, DE Waure C, Panatto D, Amicizia D, Bert F, Villani A, Ieraci R, Conversano M, Russo C, Rumi F, Scotti S, Maio T, Russo R, Vaccaro CM, Siliquini R, Ricciardi W. J Prev Med Hyg. Changes in the US burden of chronic kidney disease from 2002 to 2016: An analysis of the global burden of disease study. 1733 https://doi.org/10.1016/S0140-6736(03)14854-4 Ministry of Health of Chile, National Inmunization Programme Circular . Assuming the majority of these deaths occur among adults, and using the upper bound of this estimate, this would translate to 11% of influenza-associated hospitalizations and 2% of influenza-associated LRI episodes, which are consistent with US Centers for Disease Control and Prevention estimates of the burden of disease for influenza [21]. The limited range of currently licensed IV antiviral drugs is susceptible to the rapid rise of resistant viruses. In Australia, cases peaked 6-8 weeks earlier than normal, and monthly cases hit an all-time high in May 2022, more than double the previous record for May set in 2019. MRCUniversity of Glasgow Centre for Virus Research, Glasgow, United Kingdom, Incidence of hospitalisation for severe complications of influenza virus infection in Japanese patients between 2012 and 2016: a cross-sectional study using routinely collected administrative data. Epub 2018 Oct 23. The global burden of illness due to influenza virus infection among children is substantial. Mandeep Chadha, Moreover, previous global analyses [10] indicate that non-severe LRI is often more likely to be influenza-positive than severe LRI, and thus applying the hospitalized percent positive to potentially milder non-hospitalized LRI cases suggests that we may have underestimated the true burden of total influenza-associated LRI episodes worldwide. We used a p-value of <0.05 as our threshold for significance. 2016; 387:251-272. doi: 10.1016/S0140-6736(15)00551-6. Most comprehensive global studyanalysing 286 causes of death, 369 diseases and injuries, and 87 risk factors in 204 countries and territoriesreveals how well the world's population were . [Flu vaccination and value-based health care: operational solutions to safeguard public health]. The incremental reduction in the burden of influenza B disease associated with switching from TIV to QIV was initially modeled by the US Centers for Disease Control and Prevention . Ministry of Health, Amman, Jordan, Affiliation: 39:A6A14. Competing interests: I have read the journals policy and the authors of this manuscript have the following competing interests: H.N. (2021) Global burden of influenza-associated lower respiratory tract infections and hospitalizations among adults: A systematic review and meta-analysis. Welcome, Dr. Bresee. Treasure Island (FL): StatPearls Publishing; 2022 Jan. Approximately 57% of published articles presented <2 years of data, versus 8% of surveillance datasets (p < 0.001). Stefano Tempia, LinkedIn and 3rd parties use essential and non-essential cookies to provide, secure, analyze and improve our Services, and to show you relevant ads (including professional and job ads) on and off LinkedIn. date according to global circumstances [10]. A forest plot of findings by dataset is presented in S1 Fig. We did not preregister the protocol for this systematic review. PLoS One. Epub 2017 Aug 23. The global influenza diagnostics market size is estimated to be USD 843.5 million in 2021 and is expected to witness a CAGR of 7.89% during the forecast period. GRIPP, Global Respiratory HospitalizationsInfluenza Proportion Positive. 11 min read. eCollection 2022. 2017 Nov;17(11):1133-1161. doi: 10.1016/S1473-3099(17)30396-1. 2022 Sep 15;12:998584. doi: 10.3389/fcimb.2022.998584. We applied meta-analytic proportions to global estimates of lower respiratory infections (LRIs) and hospitalizations from the Global Burden of Disease study in adults 20 years and by age groups (20-64 years and 65 years) to obtain the number of influenza-associated LRI episodes and hospitalizations for 2016. Visit Flu Burden Averted by Vaccination for CDC estimates of flu-related illness and hospitalization averted by vaccination. Ethical approval was not required for this study. During a global pandemic, it can be easy to forget about something like the seasonal flu. National Institute of Virology, Pune, India, Affiliation: The attributable fraction used in the GBD analysis also included data derived from less-sensitive diagnostic assays (i.e., ELISA) in addition to RT-PCRdiagnosed influenza [20]. Any discrepant decisions on full-text articles were first discussed between the 2 reviewers; those that could not be resolved (n = 2) were adjudicated by a third reviewer (MAW). 20 , 21 Briefly, the primary aim of the NPICS study is to assess the burden, incidence, and seasonality of influenza in Nicaragua. Inclusion of both published and unpublished findings allowed for increased power to generate stratified estimates, and improved representation from lower-income countries. -, Feng L, Shay DK, Jiang Y, Zhou H, Chen X, Zheng Y, et al.. Influenza-associated mortality in temperate and subtropical Chinese cities, 20032008. Quality of evidence for each published paper was evaluated on a simplified NewcastleOttawa scale, as described previously [8,14]. For titles and abstracts meeting the inclusion criteria, full-text articles were assessed independently by 2 members of the review team. The proportion of patients with respiratory disease who are hospitalized is also affected by many factors, such as access to care and health-seeking behavior; diagnostic, admission, and referral practices; age; and underlying health status, which likely differ by study site. Post hoc sensitivity analyses were conducted to explore patterns in heterogeneity (I2) of the pooled proportion positive and percent change in the estimated number of hospitalizations by stratifying for key covariates. Duc Anh Dang, People at Higher Risk of Flu Complications. 2019;9(1):e024687. Health Sciences Unit, Faculty of Social Sciences, Tampere University, Tampere, Finland, Affiliation: Cookies used to make website functionality more relevant to you. Key variables (number tested and positive, laboratory method used, and quality score) were abstracted by 2 independent reviewers. We conducted a systematic review to identify published articles on influenza-associated respiratory disease in hospitalized adults. Chinese-language articles were screened by native Mandarin speakers (ZS and ZR). Lack of robust influenza epidemiology in the world's most populous and under-resourced regions heralds a major deficiency in our understanding of the true burden of influenza. 18(3): e1003550. Flow diagram for the systematic review process. Through this approach, we estimated that influenza was associated with 14% of acute respiratory hospitalizations among adults worldwide. Institut National de Recherches Biomdicales, Kinshasa, Rpublique Dmocratique du Congo, Affiliation: You can update your choices at any time in your settings. Idris Al-Abaidani, This equates to over 5 million influenza-associated hospitalizations per year, with the highest rates among those 65 years and older. Linking to a non-federal website does not constitute an endorsement by CDC or any of its employees of the sponsors or the information and products presented on the website. Influenza has long been a global public health priority because of the threat of another global pandemic. Ministry of Health, Dar es Salaam, Tanzania, Affiliation: 1980-2017: a systematic analysis for the Global Burden of Disease Study 2017. Seminars in Pediatric Infectious Diseases. This is an open access article, free of all copyright, and may be freely reproduced, distributed, transmitted, modified, built upon, or otherwise used by anyone for any lawful purpose. In this module, we will explore the relationship between universal health coverage, disasters and pandemics. Strategic Advisory Group of Experts on Immunization;SARI, We collected the following data in a standardized form: the number of persons tested and positive for influenza by calendar year and age group (1864 years and 65 years), the total number of inpatient sites, case definition used, and any participant selection procedures. We searched 9 online databases (Medline, Embase, CINAHL, Cochrane Library, Scopus, Global Health, LILACS, WHOLIS, and CNKI; 1 January 1996-31 December 2016) to identify observational studies of influenza-associated hospitalizations in adults, and assessed eligible papers for bias using a simplified Newcastle-Ottawa scale for observational data. Additionally, one-off proactive vaccination might be able to prevent the excess infection burden of upcoming influenza seasons in temperate locations, but might not be sufficient for subtropical locations such as southern mainland China, Hong Kong, Taiwan, and Singapore, where some effective PHSMs could be considered to mitigate the excess burden. https://www1.health.gov.au/internet/main/publishing.nsf/Content/cda-surveil-ozflu-flucurr.htm/$File/flu-10-2022.pdf Accessed September 2022. Rachael M. Porter, The. We excluded studies that described nosocomial influenza infections or included data from calendar year 2009 (the initial wave of influenza A(H1N1)pdm09 virus circulation) in a manner that could not be separated from data from other years, since both influenza epidemiology and testing practices were atypical during this period. To receive weekly email updates about Seasonal Flu, enter your email address: We take your privacy seriously. Influenza vaccination can prevent infections and severe disease, but decisions on how to prioritize risk groups, particularly in limited-resource settings, require a robust evidence base, including global, regional, and local data. [8] CDC. Fig 1. Objective With a descriptive epidemiological framing, we assessed whether recent historical patterns of regional influenza burden are reflected in the observed heterogeneity in COVID-19 cases across regions of the world. The work is made available under the Creative Commons CC0 public domain dedication. Influenza viruses contribute substantially to respiratory disease worldwide, including severe lower respiratory tract illnesses, hospitalizations, and deaths. WHO continues to support countries in generating national estimates. And that could worsen this year as it's possible to have both COVID . Clipboard, Search History, and several other advanced features are temporarily unavailable. From each eligible article, we abstracted the following data elements: (1) the total number of inpatients tested and total positive for influenza by age group and influenza type and subtype where available, (2) location and timeframe of data collection, (3) the case definition and diagnostic tests used, (4) the proportion of the study population with any underlying conditions (as defined by the paper), and (5) influenza vaccination coverage in the study population. Thank you for taking the time to confirm your preferences. Preliminary In-Season Disease Burden Estimates, Centers for Disease Control and Prevention. Centre for Global Health, Usher Institute, University of Edinburgh, Edinburgh, United Kingdom, Affiliations: 10.1001/jama.289.2.179 Accessed September 2022. Influenza A virus NS1 protein represses antiviral immune response by hijacking NF-B to mediate transcription of type III IFN. The proportion associated with influenza may be similar between those who are and are not hospitalized in these settings. It's been dubbed the "tripledemic," the threat of three viral infections influenza, RSV (respiratory syncytial virus) and coronavirus . The inclusion criteria were (1) an original study on human participants; (2) laboratory testing for both influenza A and B viruses, with description of diagnostic methods used; (3) a minimum of 12 months continuous data; (4) a specified case definition or other clear criteria for systematic specimen collection and testing; (5) inclusion of hospitalized patients; (6) inclusion of the number of cases from whom clinical specimens were collected and the number found positive; and (7) a minimum of 50 adults 18 years of age (or an adult population, as described by authors) tested for influenza across the duration of the study. The health burden of influenza is compounded with non-medical consequences, including children missing school, worker absenteeism, and declines in daily productivity. TABLE 1. But the risk of dying from influenza has declined substantially over time from improvements in sanitation, healthcare, and vaccination. National Center for Laboratory and Epidemiology, Vientiane, Lao Peoples Democratic Republic, Affiliation: Virology Department, Institut National dHygine, Rabat, Morocco, 10.1542/peds.2012-1255 Kedar Prasad Baral, Data from 63 sources showed that influenza was associated with 14.1% (95% CI 12.1%16.5%) of acute respiratory hospitalizations among all adults, with no significant differences by age group. Mariana Casal, : Grants from the Foundation for Influenza Epidemiology, grants from Innovative Medicines Initiative, grants from the WHO, personal fees from Bill and Melinda Gates Foundation, grants and personal fees from Sanofi, grants from National Institute of Health Research, personal fees from Janssen and personal fees from AbbVie, outside the submitted work. doi: 10.1128/jvi.00871-22. Influenza Laboratory Surveillance information. Patient comorbid conditions and influenza vaccination status were not frequently reported in partner surveillance platforms, and were not collected on the standardized form. October 20, 2022 Globally, hundreds of thousands of people die from seasonal influenza every year. A Serious Respiratory Disease with a Considerable Burden, While influenza is often just seen as a respiratory disease that resolves on its own, it can come with broader health consequences, such as cardiovascular events, exacerbations of underlying conditions, susceptibility to secondary infections, and moreall of which may lead to an increased risk for hospitalization and death. Median number of specimens tested and percent positive for influenza, by age group, study design, and population, among studies included in the meta-analysis. And make any changes, you can always do so by going to our policy! 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