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Influenza- and respiratory syncytial virus-associated mortality and hospitalisations

¹ Julius Center for Health Sciences and Primary Care, ² Dept of Paediatric Immunology, Wilhelmina Children's Hospital, and ³ Dept of Virology, University Medical Center Utrecht, Utrecht, The Netherlands.

CORRESPONDENCE: E. Hak, Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, PO Box 85500, 3508 GA Utrecht, The Netherlands. Fax: 31 302539028. E-mail: E.Hak{at}umcutrecht.nl

Keywords: Hospitalisations, influenza viruses, mortality, respiratory syncytial viruses

Received: March 22, 2007
Accepted August 1, 2007

The aim of the current study was to estimate influenza- and respiratory syncytial virus (RSV)-associated mortality and hospitalisations, especially the influenza-associated burden among low-risk individuals 65 yrs old, not yet recommended for influenza vaccination in many European countries.

Retrospectively during 1997–2003, Dutch national all-cause mortality and hospital discharge figures and virus surveillance data were used to estimate annual average influenza- and RSV-associated excess mortality and hospitalisation using rate difference methods.

Influenza virus active periods were significantly associated with excess mortality among 50–64-yr-olds and the elderly, but not in younger age categories. Influenza-associated hospitalisation was highest and about equal for 0–1-yr-olds and the elderly, and also significant for low-risk adults. Hospitalisation among children was mostly due to respiratory conditions, and among adults cardiovascular complications were frequent. RSV-active periods were associated with excess mortality and hospitalisation among the elderly. The highest RSV-related excess hospitalisation was found in 0–1-yr-olds.

Influenza-associated mortality was demonstrated in 50–64-yr-olds. Among low-risk individuals 65 yrs of age, influenza-associated hospitalisation rates were highest for 0–4-yr-olds, but also significant for 5–64-yr-olds. These data may further support extension of recommendations for influenza vaccination to include younger low-risk persons. The respiratory syncytial virus-associated burden was highest for young children but also substantial for the elderly.