Burden of paediatric influenza in Western Europe: a systematic review

BMC Public Health

Nicola Principi⁴  Terho Heikkinen¹  Christopher S Ambrose²  Catherine E Rycroft³  Evgeniya N Antonova² 

[1] Department of Paediatrics, University of Turku and Turku University Hospital, FI-20520, Turku, Finland;MedImmune, LLC, 1 MedImmune Way, Gaithersburg, Maryland 20878, USA;RTI Health Solutions, 2nd Floor, The Pavilion, Towers Business Park, Wilmslow Road Didsbury, Manchester, M20 2LS, United Kingdom;Department of Physiopathology and Transplantation, University of Milan, Fondazione IRCCS Ca' Granda, Ospedale Maggiore Policlinico, I-20122, Milan, Italy

关键词: Burden;    Europe;    Vaccination;    Children;    Influenza;   

Others  :  1162858
DOI  :  10.1186/1471-2458-12-968

 received in 2012-03-02, accepted in 2012-10-17,  发布年份 2012

【 摘 要 】

Background

Influenza illness in children causes significant clinical and economic burden. Although some European countries have adopted influenza immunisation policies for healthy children, the debate about paediatric influenza vaccination in most countries of the European Union is ongoing. Our aim was to summarise influenza burden (in terms of health outcomes and economic burden) in children in Western Europe via a systematic literature review.

Methods

We conducted a systematic literature search of PubMed, EMBASE, and the Cochrane Library (1970-April 2011) and extracted data on influenza burden in children (defined as aged ≤ 18 years) from 50 publications (13 reporting laboratory-confirmed influenza; 37 reporting influenza-like illness).

Results

Children with laboratory-confirmed influenza experienced hospitalisations (0.3%-20%), medical visits (1.7-2.8 visits per case), antibiotic prescriptions (7%-55%), and antipyretic or other medications for symptomatic relief (76%-99%); young children and those with severe illness had the highest rates of health care use. Influenza in children also led to absenteeism from day care, school, or work for the children, their siblings, and their parents. Average (mean or median) length of absence from school or day care associated with confirmed influenza ranged from 2.8 to 12.0 days for the children, from 1.3 to 6.0 days for their siblings, and from 1.3 to 6.3 days for their parents. Influenza negatively affected health-related quality of life in children with asthma, including symptoms and activities; this negative effect was smaller in vaccinated children than in non-vaccinated children.

Conclusions

Influenza burden in children is substantial and has a significant direct impact on the ill children and an indirect impact on their siblings and parents. The identified evidence regarding the burden of influenza may help inform both influenza antiviral use in children and paediatric immunisation policies in European countries.

【 授权许可】

   
2012 Antonova et al.; licensee BioMed Central Ltd.

【 图 表 】

Figure 1.

Figure 2.

Figure 3.

Figure 4.

Figure 5.

【 参考文献 】

• [1]World Health Organization: [http://www.who.int/mediacentre/factsheets/fs211/en/index.html] webciteInfluenza (Seasonal). 2009.
• [2]Heikkinen T, Booy R, Campins M, Finn A, Olcén P, Peltola H, Rodrigo C, Schmitt HJ, Schumacher F, Teo S, Weil-Olivier C: Should healthy children be vaccinated against influenza? A consensus report of the Summits of Independent European Vaccination Experts. Eur J Pediatr 2006, 165:223-228.
• [3]Usonis V, Anca I, André F, Chlibek R, Ivaskeviciene I, Mangarov A, Mészner Z, Prymula R, Simurka P, Tamm E, Tesović G, Central European Vaccination Advisory Group: Central European Vaccination Advisory Group (CEVAG) guidance statement on recommendations for influenza vaccination in children. BMC Infect Dis 2010, 10:168. BioMed Central Full Text
• [4]Molinari NA, Ortega-Sanchez IR, Messonnier ML, Thompson WW, Wortley PM, Weintraub E, Bridges CB: The annual impact of seasonal influenza in the US: measuring disease burden and costs. Vaccine 2007, 25:5086-5096.
• [5]Neuzil KM, Mellen BG, Wright PF, Mitchel EF Jr, Griffin MR: The effect of influenza on hospitalizations, outpatient visits, and courses of antibiotics in children. N Engl J Med 2000, 342:225-231.
• [6]Neuzil KM, Hohlbein C, Zhu Y: Illness among schoolchildren during influenza season: effect on school absenteeism, parental absenteeism from work, and secondary illness in families. Arch Pediatr Adolesc Med 2002, 156:986-991.
• [7]Thompson WW, Shay DK, Weintraub E, Brammer L, Bridges CB, Cox NJ, Fukuda K: Influenza-associated hospitalizations in the United States. JAMA 2004, 292:1333-1340.
• [8]Tamma PD, Turnbull AE, Milstone AM, Cosgrove SE, Valsamakis A, Budd A, Perl TM: Clinical outcomes of seasonal influenza and pandemic influenza A (H1N1) in pediatric inpatients. BMC Pediatr 2010, 10:72. BioMed Central Full Text
• [9]Fiore AE, Shay DK, Broder K, Iskander JK, Uyeki TM, Mootrey G, Bresee JS, Cox NS, Centers for Disease Control and Prevention (CDC); Advisory Committee on Immunization Practices (ACIP): Prevention and control of influenza: recommendations of the Advisory Committee on Immunization Practices (ACIP) 2008. MMWR Recomm Rep 2008, 57:1-60.
• [10]Thompson WW, Shay DK, Weintraub E, Brammer L, Cox N, Anderson LJ, Fukuda K: Mortality associated with influenza and respiratory syncytial virus in the United States. JAMA 2003, 289:179-186.
• [11]Fairbrother G, Cassedy A, Ortega-Sanchez IR, Szilagyi PG, Edwards KM, Molinari NA, Donauer S, Henderson D, Ambrose S, Kent D, Poehling K, Weinberg GA, Griffin MR, Hall CB, Finelli L, Bridges C, Staat MA, New Vaccine Surveillance Network (NVSN): High costs of influenza: direct medical costs of influenza disease in young children. Vaccine 2010, 28:4913-4919.
• [12]Savidan E, Chevat C, Marsh G: Economic evidence of influenza vaccination in children. Health Pol 2008, 86:142-152.
• [13]Lopalco PL, Giesecke J: [http:/ / www.ecdc.europa.eu/ en/ publications/ Publications/ 0701_TER_Scientific_Panel_on_Vaccin es_and_Immunisation.pdf] webciteTechnical Report of the Scientific Panel on Vaccines and Immunisation: infant and children seasonal immunisation against influenza on a routine basis during inter-pandemic period.
• [14]Salo H, Kilpi T, Sintonen H, Linna M, Peltola V, Heikkinen T: Cost-effectiveness of influenza vaccination of healthy children. Vaccine 2006, 24(23):4934-4941.
• [15]Loeb M, Russell ML, Moss L, Fonseca K, Fox J, Earn DJ, Aoki F, Horsman G, Van Caeseele P, Chokani K, Vooght M, Babiuk L, Webby R, Walter SD: Effect of influenza vaccination of children on infection rates in Hutterite communities: a randomized trial. JAMA 2010, 303:943-950.
• [16]Frank AL, Taber LH, Wells CR, Wells JM, Glezen WP, Paredes A: Patterns of shedding of myxoviruses and paramyxoviruses in children. J Infect Dis 1981, 144:433-441.
• [17]Glezen WP: Herd protection against influenza. J Clin Virol 2006, 37:237-243.
• [18]Vynnycky E, Pitman R, Siddiqui R, Gay N, Edmunds WJ: Estimating the impact of childhood influenza vaccination programmes in England and Wales. Vaccine 2008, 26:5321-5330.
• [19]Basta NE, Chao DL, Halloran ME, Matrajt L, Longini IM Jr: Strategies for pandemic and seasonal influenza vaccination of school children in the United States. Am J Epidemiol 2009, 170:679-686.
• [20]Pitman RJ, White LJ, Sculpher M: Estimating the clinical impact of introducing paediatric influenza vaccination in England and Wales. Vaccine 2011.
• [21]Glezen WP, Gaglani MJ, Kozinetz CA, Piedra PA: Direct and indirect effectiveness of influenza vaccination delivered to children at school preceding an epidemic caused by 3 new influenza virus variants. J Infect Dis 2010, 202(11):1626-1633.
• [22]Reichert TA, Sugaya N, Fedson DS, Glezen WP, Simonsen L, Tashiro M: The Japanese experience with vaccinating schoolchildren against influenza. N Engl J Med 2001, 344(12):889-896.
• [23]King JC Jr, Stoddard JJ, Gaglani MJ, Moore KA, Magder L, McClure E, Rubin JD, Englund JA, Neuzil K: Effectiveness of school-based influenza vaccination. N Engl J Med 2006, 355(24):2523-2532.
• [24]United Nations Children’s Fund and the World Health Organization: [http://www.childinfo.org/files/Immunization_Summary_2008_r6.pdf] webciteImmunization Summary: a Statistical Reference Containing Data Through 2008.
• [25]Ramet J, Weil-Olivier C, Sedlak W: Influenza vaccination: the paediatric perspective. Vaccine 2007, 25:780-787.
• [26]Ropero-Álvarez AM, Kurtis HJ, Danovaro-Holliday MC, Ruiz-Matus C, Andrus JK: Expansion of seasonal influenza vaccination in the Americas. BMC Publ Health 2009, 9:361. BioMed Central Full Text
• [27]Ng S, Wu P, Nishiura H, Ip DK, Lee ES, Cowling BJ: An analysis of national target groups for monovalent 2009 pandemic influenza vaccine and trivalent seasonal influenza vaccines in 2009-10 and 2010-11. BMC Infect Dis 2011, 11:230. BioMed Central Full Text
• [28]Centre for Health Protection, Scientific Committee on Vaccine Preventable Diseases: [http://www.chp.gov.hk/files/pdf/SCVPD_09_flu_vaccine_recommendation.pdf] webciteRecommendations on Seasonal Influenza Vaccination for the 2009/10 Season.
• [29]Korea Centers for Disease Control and Prevention: [http:/ / www.cdc.go.kr/ kcdchome/ jsp/ home/ health/ vac/ HEALVAC0001Detail.jsp?menuid=100182 &contentid=4020&boardid=null&appid= kcdchome&pageNum=3&sub=4&tabinx=2&q _had01=A&q_had02=2010&loadType=null &boardseq=null&q_s_1=&q_s_2=&q_s_3] webciteVaccination schedule 2009.
• [30]Center for Disease Control, Taiwan (CDC Taiwan): [http://www.cdc.gov.tw/public/Data/911241112671.pdf] webciteCurrent Immunization Schedule in Taiwan.
• [31]de Lataillade C, Auvergne S, Delannoy I: 2005 and 2006 seasonal influenza vaccination coverage rates in 10 countries in Africa, Asia Pacific, Europe, Latin America and the Middle East. J Public Health Policy 2009, 30:83-101.
• [32]Mereckiene J, Cotter S, Nicoll A, Levy-Bruhl D, Ferro A, Tridente G, Zanoni G, Berra P, Salmaso S, O’Flanagan DO, Flanagan D, for the VENICE Project Gatekeepers Group: National seasonal influenza vaccination survey in Europe, 2008. Eur Surveill 2008, 13:pii, 19017.
• [33][http://www.lua.sachsen.de/hm/impf/Docs/Synopsis_2011.pdf] webciteImmunisation Calendar for Children, Adolescents and Adults in the Free State of Saxony.
• [34]Joint Commission on Vaccination and Immunization: [https:/ / www.wp.dh.gov.uk/ transparency/ files/ 2012/ 07/ JCVI-statement-on-the-annual-influe nza-vaccination-programme-25-July-2 012.pd] webciteJCVI statement on the annual influenza vaccination programme—extension of the programme to children.
• [35]Heikkinen T, Silvennoinen H, Peltola V, Ziegler T, Vainionpää R, Vuorinen T, Kainulainen L, Puhakka T, Jartti T, Toikka P, Lehtinen P, Routi T, Juven T: Burden of influenza in children in the community. J Infect Dis 2004, 190:1369-1373.
• [36]Ploin D, Gillet Y, Morfin F, Fouilhoux A, Billaud G, Liberas S, Denis A, Thouvenot D, Fritzell B, Lina B, Floret D: Influenza burden in febrile infants and young children in a pediatric emergency department. Pediatr Infect Dis J 2007, 26:142-147.
• [37]Esposito S, Cantarutti L, Molteni CG, Daleno C, Scala A, Tagliabue C, Pelucchi C, Giaquinto C, Principi N: Clinical manifestations and socio-economic impact of influenza among healthy children in the community. J Infect 2011, 62:379-387.
• [38]Principi N, Esposito S, Gasparini R, Marchisio P, Crovari P: Burden of influenza in healthy children and their households. Arch Dis Child 2004, 89:1002-1007.
• [39]Liberati A, Altman DG, Tetzlaff J, Mulrow C, Gøtzsche PC, Ioannidis JP, Clarke M, Devereaux PJ, Kleijnen J, Moher D: The PRISMA statement for reporting systematic reviews and meta-analyses of studies that evaluate healthcare interventions: explanation and elaboration. BMJ 2009, 339:b2700.
• [40]Moher D, Liberati A, Tetzlaff J, Altman DG, The PRISMA Group: Preferred reporting items for systematic reviews and meta-analyses: the PRISMA Statement. PLoS Med 2009, 6(6):e1000097.
• [41]Oxford Centre for Evidence-based Medicine: [http://www.cebm.net/index.aspx?o=1025] webciteLevels of Evidence.
• [42]Heinonen S, Silvennoinen H, Lehtinen P, Vainionpää R, Vahlberg T, Ziegler T, Ikonen N, Puhakka T, Heikkinen T: Early oseltamivir treatment of influenza in children 1-3 years of age: a randomized controlled trial. Clin Infect Dis 2010, 51:887-894.
• [43]Ploin D, Liberas S, Thouvenot D, Fouilhoux A, Gillet Y, Denis A, Chapuis F, Lina B, Floret D: Influenza burden in children newborn to eleven months of age in a pediatric emergency department during the peak of an influenza epidemic. Pediatr Infect Dis J 2003, 22(Suppl 10):S218-S222.
• [44]Sanni E, Mazaud S, Odievre MH, Weill C, Laurent C, Olivier C: Influenzae infection in hospitalized children. J Pédiatr Puér 2004, 17:331-337.
• [45]Ehlken B, Ihorst G, Lippert B, Rohwedder A, Petersen G, Schumacher M, Forster J, PRIDE Study Group: Economic impact of community-acquired and nosocomial lower respiratory tract infections in young children in Germany. Eur J Pediatr 2005, 164:607-615.
• [46]Bosis S, Esposito S, Niesters HG, Crovari P, Osterhaus AD, Principi N: Impact of human metapneumovirus in childhood: comparison with respiratory syncytial virus and influenza viruses. J Med Virol 2005, 75:101-104.
• [47]Esposito S, Gasparini R, Bosis S, Marchisio P, Tagliabue C, Tosi S, Bianchi C, Crovari P, Principi N: Clinical and socio-economic impact of influenza and respiratory syncytial virus infection on healthy children and their households. Clin Microbiol Infect 2005, 11:933-936.
• [48]Principi N, Esposito S, Marchisio P, Gasparini R, Crovari P: Socioeconomic impact of influenza on healthy children and their families. Pediatr Infect Dis J 2003, 22(Suppl 10):S207-S210.
• [49]Bueving HJ, van der Wouden JC, Raat H, Bernsen RM, de Jongste JC, van Suijlekom-Smit LW, Osterhaus AD, Rimmelzwaan GF, Mölken MR, Thomas S: Influenza vaccination in asthmatic children: effects on quality of life and symptoms. Eur Respir J 2004, 24:925-931.
• [50]Van Der Zalm MM: Respiratory pathogens in respiratory tract illnesses during the first year of life: a birth cohort study. Pediatr Infect Dis J 2009, 28:472-476.
• [51]Glezen WP, Paredes A, Taber LH: Influenza in children. Relationship to other respiratory agents. JAMA 1980, 243(13):1345-1349.
• [52]Neuzil KM, Zhu Y, Griffin MR, Edwards KM, Thompson JM, Tollefson SJ, Wright PF: Burden of interpandemic influenza in children younger than 5 years: a 25-year prospective study. J Infect Dis 2002, 185(2):147-152.
• [53]Lum LC, Borja-Tabora CF, Breiman RF, Vesikari T, Sablan BP, Chay OM, Tantracheewathorn T, Schmitt HJ, Lau YL, Bowonkiratikachorn P, Tam JS, Lee BW, Tan KK, Pejcz J, Cha S, Gutierrez-Brito M, Kaltenis P, Vertruyen A, Czajka H, Bojarskas J, Brooks WA, Cheng SM, Rappaport R, Baker S, Gruber WC, Forrest BD: Influenza vaccine concurrently administered with a combination measles, mumps, and rubella vaccine to young children. Vaccine 2010, 28(6):1566-1574.
• [54]Keech M, Beardsworth P: The impact of influenza on working days lost: a review of the literature. Pharmacoeconomics 2008, 26:911-924.
• [55]Katz M, Rubino A, Collier J, Rosen J, Ehrich JH: Demography of pediatric primary care in Europe: delivery of care and training. Pediatrics 2002, 109:788-796.
• [56]Paget WJ, Balderston C, Casas I, Donker G, Edelman L, Fleming D, Larrauri A, Meijer A, Puzelli S, Rizzo C, Simonsen L, EPIA Collaborators: Assessing the burden of paediatric influenza in Europe: the European Paediatric Influenza Analysis (EPIA) project. Eur J Pediatr 2010, 169:997-1008.
• [57]European Center for Disease Prevention and Control: [http:/ / www.ecdc.europa.eu/ en/ healthtopics/ H1N1/ Documents/ 1003_RA_forward_look_influenza.pdf] webciteECDC Forward Look Risk Assessment. Likely Scenarios for Influenza in 2010 and the 2010/2011 Influenza Season In Europe and the Consequent Work Priorities.
• [58]World Health Organization: [http://whqlibdoc.who.int/hq/2005/WHO_IVB_05.18.pdf] webciteVaccine Introduction Guidelines. Adding a Vaccine to a National Immunization Programme: Decision and Implementation.
• [59]Lopalco PL: Improving vaccination programmes in the European Union. J Public Health 2008, 16:281-285.
• [60]Freed GL: The structure and function of immunization advisory committees in Western Europe. Hum Vaccin 2008, 4:292-297.