Registry-based surveillance of influenza-associated hospitalisations during the 2009 influenza pandemic in Denmark: the hidden burden on the young

PLoS One. 2010 Nov 11;5(11):e13939. doi: 10.1371/journal.pone.0013939.

Abstract

Background: To follow the impact of the 2009 influenza pandemic in Denmark, influenza surveillance was extended with a system monitoring potentially influenza-associated hospitalisations.

Methodology/principal findings: National administrative data from 2004-2010 from the automatic reporting of all hospital visits and admissions in Denmark (population 5.5 million) were used. In-patient hospitalisations linked to ICD-10 codes for potentially influenza-associated conditions (influenza, viral and bacterial pneumonia, respiratory distress, and febrile convulsion) were aggregated by week and age groups; <5 years, 5-24 years, 25-64 years and ≥65 years. Weekly numbers of influenza-associated hospitalisations were plotted to follow the course of the pandemic. We calculated the total numbers of influenza-associated hospitalisations in each influenza season (week 30 to week 15, the following year). Risk ratios of being admitted with an influenza-associated condition in this season (2009/2010) compared to the previous five seasons (2004/2005-2008/2009) were calculated using binary regression. During the pandemic season, influenza-associated hospitalisations peaked in week 47, 2009. The total number of influenza-associated hospitalisations was 38,273 compared to the median of previous seasons of 35,662 (p = 0.28). The risk ratio of influenza-associated hospitalisations during the pandemic season compared to previous seasons was 1.63 (95%CI 1.49-1.78) for 5-24 year-olds and ranged between 0.98 and 1.08 for the other three age groups.

Conclusions: The 2009 pandemic influenza did not lead to an overall increase in the number of influenza-associated hospitalisations in Denmark in the 2009/2010 season and could be managed within existing hospital capacity. However, there was a disproportionally large impact on the age group 5-24 years. The influenza-associated hospitalisations during the 2009/2010 pandemic influenza season bore the signature features of historical pandemics: A skewed age-pattern and early out of season transmission.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adolescent
  • Adult
  • Age Factors
  • Aged
  • Child
  • Child, Preschool
  • Denmark / epidemiology
  • Hospitalization / statistics & numerical data*
  • Humans
  • Incidence
  • Influenza, Human / epidemiology
  • Influenza, Human / therapy*
  • International Classification of Diseases / statistics & numerical data
  • Middle Aged
  • Pandemics
  • Population Surveillance / methods*
  • Registries / statistics & numerical data*
  • Risk Factors
  • Seasons
  • Young Adult