Öz
Aim: Influenza is an acute respiratory infection caused by influenza viruses which circulate in all parts of the world.
Patients infected with influenza can develop complications that result in hospitalization and death. In this study, it has
been aimed to interpret the clinical, virologic findings and risk factors for severe illness of the patients during 2015-
2016 influenza epidemic.
Materials and Methods: The hospitalised 284 patients diagnosed with Influenza like illness during 2015-2016
influenza season, were evaluated retrospectively. Nasopharynegeal swab samples were tested for 21 different virus
by PCR in Public Health Laboratory.
Results: Of the 284 patients hospitalized with the diagnose of Influenza like-illness, 134 (47.2%) were male; 150
(52.8%) were female and the median age was 31.4 (0-91) years. Clinical influenza diagnose was confirmed
virologically in 175 patients. Influenza virus distribution was H1N1 in 136 (78%) patients, H3N2 in 30 patients and
Influenza B in 9 (5%) patients. Clinical and/or radiological findings consistent with pneumonia were present in 97
(71.3%) of H1N1 cases, 15 (50%) of H3N2 cases and 4 (44.4%) of Influenza B cases. Mortality was statistically
significantly higher in elderly (≥65 years) patients (p=0.007).
Conclusion: Beside the sentinel surveillance which is conducted in the first-level health facilities, national hospital
based surveillance practices will contribute both to follow-up the influenza activity and to determine the real disease
burden. Collected data will play an important role in developing both disease control measures and national
vaccination policies
Anahtar Kelimeler
Kaynakça
- Influenza (Seasonal), Fact sheet [homepage on the Internet]. World Health Organization [updated November 2016; cited 20 February 2016]. Available from: http://www.who.int/mediacentre/factsheets/fs211/en/
- Ciblak MA, Tütenyurd MK, Asar S, Tulunoğlu M, Fındıkçı N, Badur S. 2003-2012 Yıllarını Kapsayan Dokuz Sezonda Grip Sürveyansı Bulguları: İstanbul Tıp Fakültesi Ulusal İnfluenza Referans Laboratuvarı Sonuçları. Mikrobiyoloji Bülteni 2012 46(4): 575-593.
- Puig-Barber J, Tormos A, Trushakova S, et al. The Global Influenza Hospital Surveillance Network (GIHSN): A new platform to describe the epidemiology of severe influenza. Influenza Other Respir Viruses 2015; 21. doi: 10.1111/irv.12335.
- İnfluenza Vaka Yönetim Algoritması [homepage on the Internet]. Türkiye Halk Sağlığı Kurumu [cited 21 February 2016]. Available from: http://grip.gov.tr/saglik-personeli-icin-bilgiler/282-influenza-vaka-yonetim-algoritmasi.html
- Ortiz JR, Neuzil KM, Shay DK, et al. The burden of influenza-associated critical illness hospitalizations. Crit Care Med 2014;42(11):2325-32.
- Ortiz JR, Neuzil KM, Cooke CR, Neradilek MB, Goss CH, Shay DK. Influenza pneumonia surveillance among hospitalized adults may underestimate the burden of severe influenza disease. PLoS One 201425;9(11):e113903.
- Zhou H, Thompson WW, Viboud CG, et al. Hospitalizations associated with influenza and respiratory syncytial virus in the United States, 1993-2008. Clin Infect Dis 2012;54(10):1427-36.
- Chaves SS, Aragon D, Bennett N, et al. Patients hospitalized with laboratory-confirmed influenza during the 2010-2011 influenza season: Exploring disease severity by virus type and subtype. J Infect Dis 2013;208(8):1305-14.
- Puig-Barberà J, Tormos A, Sominina A, et al. First-year results of the Global Influenza Hospital Surveillance Network: 2012-2013 Northern hemisphere influenza season. BMC Public Health 2014;5(14):564.
- Puig-Barberà J, Natividad-Sancho A, Trushakova S, et al. Global Influenza Hospital Surveillance Study Group. Epidemiology of hospital admissions with influenza during the 2013/2014 northern hemisphere influenza season: Results from the global influenza hospital surveillance network. PLoS One 2016;19(11):5.
- Puig-Barberà J, Burtseva E, Yu H, et al. Influenza epidemiology and influenza vaccine effectiveness during the 2014–2015 season: Annual report from the Global Influenza Hospital Surveillance Network. BMC Public Health 2016;16(Suppl 1):757.
- Summary of the 2015-2016 Season Results [homepage on the Internet]. Global Influenza Hospital Surveillance Report [cited 21 February 2016]. Available from: http://gihsn.org/?page=result&id=2015-2016.
- Mullooly JP , Bridges CB, Thompson WW, et al. Influenza- and RSV-associated hospitalizations among adults. Vaccine 2007;25(5):846-55.
- Ono S, Ono Y, Matsui H, Yasunaga H. Factors associated with hospitalization for seasonal influenza in a Japanese nonelderly cohort. BMC Public Health 2016; 2(16):922.
- Loubet P, Samih-Lenzi N, Galtier F, et al. Factors associated with poor outcomes among adults hospitalized for influenza in France: A three-year prospective multicenter study. J Clin Virol 2016;79(1):68-73.
- Ciblak MA, Grip Platformu. Influenza vaccination in Turkey: Prevalence of risk groups, current vaccination status, factors influencing vaccine uptake and steps taken to increase vaccination rate. Vaccine. 2013;31(3):518-23.
- Beauté J, Zucs P, Korsun N, et al. European Influenza Surveillance Network. Age-specific differences in influenza virus type and subtype distribution in the 2012/2013 season in 12 European countries. Epidemiol Infect 2015t;143(14):2950-8.
- Gözalan A, Altaş AB, Sevencan F, et al. Seroprevalence following the first wave of pandemic influenza A (H1N1) in Turkey, 2009. Jpn J Infect Dis 2012;65(1):13-8.
- Çifci A, Erol Ö, Cesur S, Aksoy N, Kisa Ü. The comparison of pandemic HIN1 IgG levels between HIN1 influenza-vaccinated healthcare workers and unvaccinated healthcare workers. Turk J Med Sci 2014;44(6):1047-50.
- Choi HS, Kim MN, Sung H, et al. Laboratory-based surveillance of hospital-acquired respiratory virus infection in a tertiary care hospital. Am J Infect Control 2017;45(5):e45-e4.
- Haftalık İnfluenza Sürveyans Raporu 2015-2016 [homepage on the Internet]. Türkiye Halk Sağlığı Kurumu [cited 21 February 2016]. Available from: http://www.grip.gov.tr/saglik-personeli-icin-bilgiler/283-haftalik-influenza-surveyans-raporu-2.
- Eser FC, Solay AH, Altın N, et al. Ciddi alt solunum yolu enfeksiyonu tanısı ile yatarak takip edilen hastalarda etken virüslerin belirlenmesi. Mediterr J Infect Microb Antimicrob 2016;6(Supplement 1).
Öz
Amaç: Grip, dünyanın bütün bölgelerinde görülebilen, influenza virüsünün neden olduğu bir akut solunum yolu enfeksiyonudur. İnfluenza ile enfekte olan hastalarda, hastaneye yatışı gerektiren ve ölüme yol açabilen komplikasyonlar gelişebilmektedir. Bu çalışmada 2015-2016 sezonundaki influenza epidemisi sırasında hastaların klinik ve virolojik bulgularının ve ağır hastalık açısından risk faktörlerinin değerlendirilmesi amaçlanmıştır.
Gereç ve Yöntem: İnfluenza benzeri hastalık tanısıyla, 2015-2016 influenza sezonunda hastanemizde yatırılarak takip edilen 284 hasta retrospektif olarak değerlendirildi. Nazofarengeal sürüntü örnekleri, Halk Sağlığı Laboratuvarında 21 farklı virüs açısından PCR ile test edildi.
Bulgular: İnfluenza benzeri hastalık tanısı ile yatırılarak takip edilen 284 hastanın 134’ü (%47.2) erkek, 150’si (%52.8) kadın ve yaş ortalaması 31.4 yıl (0-91) idi. İnfluenza tanısı 175 (%62) hastada virolojik olarak doğrulandı. İnfluenza virüslerinin 136’sı (%78) H1N1; 30’u (%17) H3N2; dokuzu (%5) ise influenza B virüsü idi. H1N1 saptanan olguların 97’sinde (%71.3); H3N2 saptanan olguların 15’inde (%50); İnfluenza B saptananların dördünde (%44.4) pnömoni ile uyumlu klinik ve/veya radyolojik bulgular mevcuttu. İleri yaştaki (≥65 yaş) hastalarda mortalite istatistiksel olarak anlamlı derecede yüksekti (p=0.007).
Sonuç: Birinci basamak sağlık kurumları ile yürütülen sentinel sürveyansın yanında ulusal hastane bazlı sürveyansın yapılıyor olması hem influenza aktivitesinin izlenmesine hem de gerçek hastalık yükünün belirlenmesine katkı sağlayacaktır. Toplanan veriler hastalık kontrol önlemlerinin ve ulusal aşı politikalarının şekillenmesinde önemli rol oynayacaktır.
Anahtar Kelimeler
Kaynakça
- Influenza (Seasonal), Fact sheet [homepage on the Internet]. World Health Organization [updated November 2016; cited 20 February 2016]. Available from: http://www.who.int/mediacentre/factsheets/fs211/en/
- Ciblak MA, Tütenyurd MK, Asar S, Tulunoğlu M, Fındıkçı N, Badur S. 2003-2012 Yıllarını Kapsayan Dokuz Sezonda Grip Sürveyansı Bulguları: İstanbul Tıp Fakültesi Ulusal İnfluenza Referans Laboratuvarı Sonuçları. Mikrobiyoloji Bülteni 2012 46(4): 575-593.
- Puig-Barber J, Tormos A, Trushakova S, et al. The Global Influenza Hospital Surveillance Network (GIHSN): A new platform to describe the epidemiology of severe influenza. Influenza Other Respir Viruses 2015; 21. doi: 10.1111/irv.12335.
- İnfluenza Vaka Yönetim Algoritması [homepage on the Internet]. Türkiye Halk Sağlığı Kurumu [cited 21 February 2016]. Available from: http://grip.gov.tr/saglik-personeli-icin-bilgiler/282-influenza-vaka-yonetim-algoritmasi.html
- Ortiz JR, Neuzil KM, Shay DK, et al. The burden of influenza-associated critical illness hospitalizations. Crit Care Med 2014;42(11):2325-32.
- Ortiz JR, Neuzil KM, Cooke CR, Neradilek MB, Goss CH, Shay DK. Influenza pneumonia surveillance among hospitalized adults may underestimate the burden of severe influenza disease. PLoS One 201425;9(11):e113903.
- Zhou H, Thompson WW, Viboud CG, et al. Hospitalizations associated with influenza and respiratory syncytial virus in the United States, 1993-2008. Clin Infect Dis 2012;54(10):1427-36.
- Chaves SS, Aragon D, Bennett N, et al. Patients hospitalized with laboratory-confirmed influenza during the 2010-2011 influenza season: Exploring disease severity by virus type and subtype. J Infect Dis 2013;208(8):1305-14.
- Puig-Barberà J, Tormos A, Sominina A, et al. First-year results of the Global Influenza Hospital Surveillance Network: 2012-2013 Northern hemisphere influenza season. BMC Public Health 2014;5(14):564.
- Puig-Barberà J, Natividad-Sancho A, Trushakova S, et al. Global Influenza Hospital Surveillance Study Group. Epidemiology of hospital admissions with influenza during the 2013/2014 northern hemisphere influenza season: Results from the global influenza hospital surveillance network. PLoS One 2016;19(11):5.
- Puig-Barberà J, Burtseva E, Yu H, et al. Influenza epidemiology and influenza vaccine effectiveness during the 2014–2015 season: Annual report from the Global Influenza Hospital Surveillance Network. BMC Public Health 2016;16(Suppl 1):757.
- Summary of the 2015-2016 Season Results [homepage on the Internet]. Global Influenza Hospital Surveillance Report [cited 21 February 2016]. Available from: http://gihsn.org/?page=result&id=2015-2016.
- Mullooly JP , Bridges CB, Thompson WW, et al. Influenza- and RSV-associated hospitalizations among adults. Vaccine 2007;25(5):846-55.
- Ono S, Ono Y, Matsui H, Yasunaga H. Factors associated with hospitalization for seasonal influenza in a Japanese nonelderly cohort. BMC Public Health 2016; 2(16):922.
- Loubet P, Samih-Lenzi N, Galtier F, et al. Factors associated with poor outcomes among adults hospitalized for influenza in France: A three-year prospective multicenter study. J Clin Virol 2016;79(1):68-73.
- Ciblak MA, Grip Platformu. Influenza vaccination in Turkey: Prevalence of risk groups, current vaccination status, factors influencing vaccine uptake and steps taken to increase vaccination rate. Vaccine. 2013;31(3):518-23.
- Beauté J, Zucs P, Korsun N, et al. European Influenza Surveillance Network. Age-specific differences in influenza virus type and subtype distribution in the 2012/2013 season in 12 European countries. Epidemiol Infect 2015t;143(14):2950-8.
- Gözalan A, Altaş AB, Sevencan F, et al. Seroprevalence following the first wave of pandemic influenza A (H1N1) in Turkey, 2009. Jpn J Infect Dis 2012;65(1):13-8.
- Çifci A, Erol Ö, Cesur S, Aksoy N, Kisa Ü. The comparison of pandemic HIN1 IgG levels between HIN1 influenza-vaccinated healthcare workers and unvaccinated healthcare workers. Turk J Med Sci 2014;44(6):1047-50.
- Choi HS, Kim MN, Sung H, et al. Laboratory-based surveillance of hospital-acquired respiratory virus infection in a tertiary care hospital. Am J Infect Control 2017;45(5):e45-e4.
- Haftalık İnfluenza Sürveyans Raporu 2015-2016 [homepage on the Internet]. Türkiye Halk Sağlığı Kurumu [cited 21 February 2016]. Available from: http://www.grip.gov.tr/saglik-personeli-icin-bilgiler/283-haftalik-influenza-surveyans-raporu-2.
- Eser FC, Solay AH, Altın N, et al. Ciddi alt solunum yolu enfeksiyonu tanısı ile yatarak takip edilen hastalarda etken virüslerin belirlenmesi. Mediterr J Infect Microb Antimicrob 2016;6(Supplement 1).
Ayrıntılar
| Birincil Dil | Türkçe |
|---|---|
| Bölüm | Araştırma Makaleleri |
| Yazarlar | |
| Yayımlanma Tarihi | 1 Mart 2018 |
| Gönderilme Tarihi | 25 Şubat 2017 |
| Yayımlandığı Sayı | Yıl 2018Cilt: 57 Sayı: 1 |
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