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Abstract

Background

Across the World Health Organization European Region, there are few estimates of the proportion of people seeking medical care for influenza-like illness or acute respiratory infections and who have laboratory-confirmed seasonal influenza infection.

Methods

We conducted a meta-analysis of data extracted from studies published between 2004 and 2017 and from sentinel data from the European surveillance system (TESSy) between 2004 and 2018. We pooled within-season estimates by influenza type/subtype, setting (outpatient (OP)/inpatient (IP)) and age group to estimate the proportion of people tested who have laboratory-confirmed and medically-attended seasonal influenza in Europe.

Results

In the literature review, the pooled proportion for all influenza types was 33% (95% confidence interval (CI): 30–36), higher among OP 36% (95% CI: 33–40) than IP 24% (95% CI: 20–29). Pooled estimates for all influenza types by age group were: 0–17 years, 26% (22–31); 18–64 years, 41% (32–50); ≥ 65 years, 33% (27–40). From TESSy data, 33% (31–34) of OP and 24% (21–27) of IP were positive. The highest proportion of influenza A was in people aged 18–64 years (22%, 16–29). By subtype, A(H1N1)pdm09 was highest in 18–64 year-olds (16%, 11–21%) whereas A(H3N2) was highest in those ≥ 65 years (10%, 2–22). For influenza B, the highest proportion of infections was in those aged 18–64 years (15%, 9–24).

Conclusions

Laboratory-confirmed influenza accounted for approximately one third of all acute respiratory infections for which medical care was sought during the influenza season.

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2021-09-30
2024-11-05
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References

  1. Hayward AC, Fragaszy EB, Bermingham A, Wang L, Copas A, Edmunds WJ, et al. Comparative community burden and severity of seasonal and pandemic influenza: results of the Flu Watch cohort study. Lancet Respir Med. 2014;2(6):445-54.  https://doi.org/10.1016/S2213-2600(14)70034-7  PMID: 24717637 
  2. Nicholson KG, Wood JM, Zambon M. Influenza. Lancet. 2003;362(9397):1733-45.  https://doi.org/10.1016/S0140-6736(03)14854-4  PMID: 14643124 
  3. Ghebrehewet S, MacPherson P, Ho A. Influenza. BMJ. 2016;355:i6258.  https://doi.org/10.1136/bmj.i6258  PMID:27927672
  4. Cox NJ, Subbarao K. Influenza. Lancet. 1999;354(9186):1277-82.  https://doi.org/10.1016/S0140-6736(99)01241-6  PMID: 10520648 
  5. Hannoun C. The evolving history of influenza viruses and influenza vaccines. Expert Rev Vaccines. 2013;12(9):1085-94.  https://doi.org/10.1586/14760584.2013.824709  PMID: 24024871 
  6. Rota PA, Wallis TR, Harmon MW, Rota JS, Kendal AP, Nerome K. Cocirculation of two distinct evolutionary lineages of influenza type B virus since 1983. Virology. 1990;175(1):59-68.  https://doi.org/10.1016/0042-6822(90)90186-U  PMID: 2309452 
  7. Leung NH, Xu C, Ip DK, Cowling BJ. Review article: the fraction of influenza virus infections that are asymptomatic: a systematic review and meta-analysis. Epidemiology. 2015;26(6):862-72.  https://doi.org/10.1097/EDE.0000000000000340  PMID: 26133025 
  8. Cromer D, van Hoek AJ, Jit M, Edmunds WJ, Fleming D, Miller E. The burden of influenza in England by age and clinical risk group: a statistical analysis to inform vaccine policy. J Infect. 2014;68(4):363-71.  https://doi.org/10.1016/j.jinf.2013.11.013  PMID: 24291062 
  9. Rondy M, Launay O, Puig-Barberà J, Gefenaite G, Castilla J, de Gaetano Donati K, et al. 2012/13 influenza vaccine effectiveness against hospitalised influenza A(H1N1)pdm09, A(H3N2) and B: estimates from a European network of hospitals. Euro Surveill. 2015;20(2):21011.  https://doi.org/10.2807/1560-7917.ES2015.20.2.21011  PMID: 25613779 
  10. WHO Regional Office for Europe (WHO/Europe). Surveillance and lab network 2018. Copenhagen: WHO/Europe. [Accessed: 20 Feb 2020]. Available from: http://www.euro.who.int/en/health-topics/communicable-diseases/influenza/surveillance-and-lab-network
  11. Beauté J, Zucs P, Korsun N, Bragstad K, Enouf V, Kossyvakis A, et al. Age-specific differences in influenza virus type and subtype distribution in the 2012/2013 season in 12 European countries. Epidemiol Infect. 2015;143(14):2950-8.  https://doi.org/10.1017/S0950268814003422  PMID: 25648399 
  12. Meerhoff TJ, Simaku A, Ulqinaku D, Torosyan L, Gribkova N, Shimanovich V, et al. Surveillance for severe acute respiratory infections (SARI) in hospitals in the WHO European region - an exploratory analysis of risk factors for a severe outcome in influenza-positive SARI cases. BMC Infect Dis. 2015;15(1):1.  https://doi.org/10.1186/s12879-014-0722-x  PMID: 25567701 
  13. Moher D, Liberati A, Tetzlaff J, Altman DG. PRISMA Group. Preferred reporting items for systematic reviews and meta-analyses: the PRISMA statement. BMJ. 2009;339(jul21 1):b2535.  https://doi.org/10.1136/bmj.b2535  PMID:19622551
  14. WHO Regional Office for Europe (WHO/Europe). Countries. Copenhagen: WHO/Europe. [Accessed: 14 Sep 2021]. Available from: http://www.euro.who.int/en/countries
  15. Buchan SA, Hottes TS, Rosella LC, Crowcroft NS, Tran D, Kwong JC. Contribution of influenza viruses to medically attended acute respiratory illnesses in children in high-income countries: a meta-analysis. Influenza Other Respir Viruses. 2016;10(6):444-54.  https://doi.org/10.1111/irv.12400  PMID: 27311404 
  16. Fell DB, Johnson J, Mor Z, Katz MA, Skidmore B, Neuzil KM, et al. Incidence of laboratory-confirmed influenza disease among infants under 6 months of age: a systematic review. BMJ Open. 2017;7(9):e016526.  https://doi.org/10.1136/bmjopen-2017-016526  PMID: 28882916 
  17. Katz MA, Gessner BD, Johnson J, Skidmore B, Knight M, Bhat N, et al. Incidence of influenza virus infection among pregnant women: a systematic review. BMC Pregnancy Childbirth. 2017;17(1):155.  https://doi.org/10.1186/s12884-017-1333-5  PMID: 28558777 
  18. Tafalla M, Buijssen M, Geets R, Vonk Noordegraaf-Schouten M. A comprehensive review of the epidemiology and disease burden of Influenza B in 9 European countries. Hum Vaccin Immunother. 2016;12(4):993-1002.  https://doi.org/10.1080/21645515.2015.1111494  PMID: 26890005 
  19. Nair H, Brooks WA, Katz M, Roca A, Berkley JA, Madhi SA, et al. Global burden of respiratory infections due to seasonal influenza in young children: a systematic review and meta-analysis. Lancet. 2011;378(9807):1917-30.  https://doi.org/10.1016/S0140-6736(11)61051-9  PMID: 22078723 
  20. Wells G, Shea B, O’Connell D, Peterson J, Welch V, Losos M, et al. The Newcastle-Ottawa Scale (NOS) for assessing the quality of nonrandomised studies in meta-analyses 2018. Ottawa: The Ottawa Hospital Research Institute. [Accessed: 14 Sep 2018]. Available from: http://www.ohri.ca/programs/clinical_epidemiology/oxford.asp
  21. DerSimonian R, Laird N. Meta-analysis in clinical trials. Control Clin Trials. 1986;7(3):177-88.  https://doi.org/10.1016/0197-2456(86)90046-2  PMID: 3802833 
  22. Freeman M, Tukey J. Transformations related to the angular and the square root. Ann Math Stat. 1950;21(4):607-11.  https://doi.org/10.1214/aoms/1177729756 
  23. European Centre for Disease Prevention and Control and World Health Organization Regional Office for Europe (ECDC and WHO/Europe). System. Description of regional surveillance and national surveillance systems contributing to Flu News Europe. ECDC and WHO/Europe. [Accessed: 20 Nov 2019]. Available from: https://flunewseurope.org/System
  24. European Commission. Decision No 1082/2013/EU of the European Parliament and of the Council of 22 October 2013 on serious cross-border threats to health and repealing Decision No 2119/98/EC. Official Journal of the European Union. Luxembourg: Publications Office of the European Union. 5 Nov 2013:L 293/1. Available from: https://eur-lex.europa.eu/legal-content/EN/TXT/?uri=CELEX%3A32013D1082
  25. Fajfr M, Stěpánová V, Plíšková L. Influenza in seasons 2009-2013 in the faculty hospital Hradec kralove, East Bohemia. Epidemiol Mikrobiol Imunol. 2014;63(1):10-6. PMID: 24730989 
  26. Pierangeli A, Gentile M, Di Marco P, Pagnotti P, Scagnolari C, Trombetti S, et al. Detection and typing by molecular techniques of respiratory viruses in children hospitalized for acute respiratory infection in Rome, Italy. J Med Virol. 2007;79(4):463-8.  https://doi.org/10.1002/jmv.20832  PMID: 17311326 
  27. Puig-Barberà J, Tormos A, Sominina A, Burtseva E, Launay O, Ciblak MA, et al. First-year results of the Global Influenza Hospital Surveillance Network: 2012-2013 Northern hemisphere influenza season. BMC Public Health. 2014;14(1):564.  https://doi.org/10.1186/1471-2458-14-564  PMID: 24903737 
  28. Redlberger-Fritz M, Aberle JH, Popow-Kraupp T, Kundi M. Attributable deaths due to influenza: a comparative study of seasonal and pandemic influenza. Eur J Epidemiol. 2012;27(7):567-75.  https://doi.org/10.1007/s10654-012-9701-y  PMID: 22678614 
  29. Rezza G, Valdarchi C, Puzelli S, Ciotti M, Farchi F, Fabiani C, et al. Respiratory viruses and influenza-like illness: a survey in the area of Rome, winter 2004-2005. Euro Surveill. 2006;11(10):9-10.  https://doi.org/10.2807/esm.11.10.00652-en  PMID: 29208116 
  30. Harvala H, Smith D, Salvatierra K, Gunson R, von Wissmann B, Reynolds A, et al. Burden of influenza B virus infections in Scotland in 2012/13 and epidemiological investigations between 2000 and 2012. Euro Surveill. 2014;19(37):20903.  https://doi.org/10.2807/1560-7917.ES2014.19.37.20903  PMID: 25259532 
  31. Pebody RG, Warburton F, Ellis J, Andrews N, Thompson C, von Wissmann B, et al. Low effectiveness of seasonal influenza vaccine in preventing laboratory-confirmed influenza in primary care in the United Kingdom: 2014/15 mid-season results. Euro Surveill. 2015;20(5):21025.  https://doi.org/10.2807/1560-7917.ES2015.20.5.21025  PMID: 25677050 
  32. Puig-Barberà J, Natividad-Sancho A, Trushakova S, Sominina A, Pisareva M, Ciblak MA, et al. 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;11(5):e0154970.  https://doi.org/10.1371/journal.pone.0154970  PMID: 27196667 
  33. Puig-Barberà J, Burtseva E, Yu H, Cowling BJ, Badur S, Kyncl J, 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(S1) Suppl 1;757.  https://doi.org/10.1186/s12889-016-3378-1  PMID: 27556802 
  34. Redlberger-Fritz M, Kundi M, Popow-Kraupp T. Detailed Report on 2014/15 Influenza Virus Characteristics, and Estimates on Influenza Virus Vaccine Effectiveness from Austria’s Sentinel Physician Surveillance Network. PLoS One. 2016;11(3):e0149916.  https://doi.org/10.1371/journal.pone.0149916  PMID: 26975056 
  35. Plymoth A, Rotzen-Ostlund M, Zweygberg-Wirgart B, Sundin CG, Ploner A, Nyren O, et al. Self-sampling for analysis of respiratory viruses in a large-scale epidemiological study in Sweden. Euro Surveill. 2015;20(11):19.  https://doi.org/10.2807/1560-7917.ES2015.20.11.21063  PMID: 25811646 
  36. An der Heiden M, Buchholz U. Estimation of influenza-attributable medically attended acute respiratory illness by influenza type/subtype and age, Germany, 2001/02-2014/15. Influenza Other Respir Viruses. 2017;11(2):110-21.  https://doi.org/10.1111/irv.12434  PMID: 27754611 
  37. Mosnier A, Caini S, Daviaud I, Bensoussan JL, Stoll-Keller F, Bui TT, et al. Ten influenza seasons in France: distribution and timing of influenza A and B circulation, 2003-2013. BMC Infect Dis. 2015;15(1):357.  https://doi.org/10.1186/s12879-015-1056-z  PMID: 26289794 
  38. Boddington NL, Verlander NQ, Pebody RG. Developing a system to estimate the severity of influenza infection in England: findings from a hospital-based surveillance system between 2010/2011 and 2014/2015. Epidemiol Infect. 2017;145(7):1461-70.  https://doi.org/10.1017/S095026881700005X  PMID: 28166855 
  39. Gasparini R, Durando P, Ansaldi F, Sticchi L, Banfi F, Amicizia D, et al. Influenza and respiratory syncytial virus in infants and children: relationship with attendance at a paediatric emergency unit and characteristics of the circulating strains. Eur J Clin Microbiol Infect Dis. 2007;26(9):619-28.  https://doi.org/10.1007/s10096-007-0351-z  PMID: 17610094 
  40. Gooskens J, van der Ploeg V, Sukhai RN, Vossen AC, Claas EC, Kroes AC. Clinical evaluation of viral acute respiratory tract infections in children presenting to the emergency department of a tertiary referral hospital in the Netherlands. BMC Pediatr. 2014;14(1):297.  https://doi.org/10.1186/s12887-014-0297-0  PMID: 25491885 
  41. Esposito S, Cantarutti L, Molteni CG, Daleno C, Scala A, Tagliabue C, et al. Clinical manifestations and socio-economic impact of influenza among healthy children in the community. J Infect. 2011;62(5):379-87.  https://doi.org/10.1016/j.jinf.2011.02.015  PMID: 21414357 
  42. Esposito S, Molteni CG, Daleno C, Valzano A, Fossali E, Da Dalt L, et al. Clinical and socioeconomic impact of different types and subtypes of seasonal influenza viruses in children during influenza seasons 2007/2008 and 2008/2009. BMC Infect Dis. 2011;11(1):271.  https://doi.org/10.1186/1471-2334-11-271  PMID: 21992699 
  43. Esposito S, Gasparini R, Bosis S, Marchisio P, Tagliabue C, Tosi S, et al. Clinical and socio-economic impact of influenza and respiratory syncytial virus infection on healthy children and their households. Clin Microbiol Infect. 2005;11(11):933-6.  https://doi.org/10.1111/j.1469-0691.2005.01270.x  PMID: 16216113 
  44. Ajayi-Obe EK, Coen PG, Handa R, Hawrami K, Aitken C, McIntosh ED, et al. Influenza A and respiratory syncytial virus hospital burden in young children in East London. Epidemiol Infect. 2008;136(8):1046-58.  https://doi.org/10.1017/S0950268807009557  PMID: 17903316 
  45. Paixão P, Piedade C, Papoila A, Caires I, Pedro C, Santos M, et al. Improving influenza surveillance in Portuguese preschool children by parents’ report. Eur J Pediatr. 2014;173(8):1059-65.  https://doi.org/10.1007/s00431-014-2285-7  PMID: 24599798 
  46. Tsolia MN, Logotheti I, Papadopoulos NG, Mavrikou M, Spyridis NP, Drossatou P, et al. Impact of influenza infection in healthy children examined as outpatients and their families. Vaccine. 2006;24(33-34):5970-6.  https://doi.org/10.1016/j.vaccine.2006.05.006  PMID: 16759761 
  47. Kouni S, Karakitsos P, Chranioti A, Theodoridou M, Chrousos G, Michos A. Evaluation of viral co-infections in hospitalized and non-hospitalized children with respiratory infections using microarrays. Clin Microbiol Infect. 2013;19(8):772-7.  https://doi.org/10.1111/1469-0691.12015  PMID: 23020634 
  48. Pebody R, Andrews N, McMenamin J, Durnall H, Ellis J, Thompson CI, et al. Vaccine effectiveness of 2011/12 trivalent seasonal influenza vaccine in preventing laboratory-confirmed influenza in primary care in the United Kingdom: evidence of waning intra-seasonal protection. Euro Surveill. 2013;18(5):20389.  https://doi.org/10.2807/ese.18.05.20389-en  PMID: 23399424 
  49. Karadag-Oncel E, Ciblak MA, Ozsurekci Y, Badur S, Ceyhan M. Viral etiology of influenza-like illnesses during the influenza season between December 2011 and April 2012. J Med Virol. 2014;86(5):865-71.  https://doi.org/10.1002/jmv.23747  PMID: 24105787 
  50. Castilla J, Guevara M, Martínez-Baz I, Ezpeleta C, Delfrade J, Irisarri F, et al. Enhanced Estimates of the Influenza Vaccination Effect in Preventing Mortality: A Prospective Cohort Study. Medicine (Baltimore). 2015;94(30):e1240.  https://doi.org/10.1097/MD.0000000000001240  PMID: 26222861 
  51. Chatzopoulou E, Melidou A, Gioula G, Exindari M, Chatzidimitriou D, Chatzopoulou F, et al. Contribution of influenza viruses, human metapneumovirus and respiratory syncytial virus to acute respiratory infections in children in northern Greece, 2008 – 2010. East J Med. 2012;17(1):24-9.
  52. 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(10) Suppl;S207-10.  https://doi.org/10.1097/01.inf.0000092188.48726.e4  PMID: 14551476 
  53. Meury S, Zeller S, Heininger U. Comparison of clinical characteristics of influenza and respiratory syncytial virus infection in hospitalised children and adolescents. Eur J Pediatr. 2004;163(7):359-63.  https://doi.org/10.1007/s00431-004-1445-6  PMID: 15106003 
  54. Heikkinen T, Silvennoinen H, Peltola V, Ziegler T, Vainionpaa R, Vuorinen T, et al. Burden of influenza in children in the community. J Infect Dis. 2004;190(8):1369-73.  https://doi.org/10.1086/424527  PMID: 15378427 
  55. Bennet R, Hamrin J, Wirgart BZ, Östlund MR, Örtqvist Å, Eriksson M. Influenza epidemiology among hospitalized children in Stockholm, Sweden 1998-2014. Vaccine. 2016;34(28):3298-302.  https://doi.org/10.1016/j.vaccine.2016.04.082  PMID: 27155498 
  56. Tsolia MN, Psarras S, Bossios A, Audi H, Paldanius M, Gourgiotis D, et al. Etiology of community-acquired pneumonia in hospitalized school-age children: evidence for high prevalence of viral infections. Clin Infect Dis. 2004;39(5):681-6.  https://doi.org/10.1086/422996  PMID: 15356783 
  57. Heikkinen T, Ziegler T, Peltola V, Lehtinen P, Toikka P, Lintu M, et al. Incidence of influenza in Finnish children. Pediatr Infect Dis J. 2003;22(10) Suppl;S204-6.  https://doi.org/10.1097/01.inf.0000092187.17911.2e  PMID: 14551475 
  58. Silvennoinen H, Peltola V, Lehtinen P, Vainionpää R, Heikkinen T. Clinical presentation of influenza in unselected children treated as outpatients. Pediatr Infect Dis J. 2009;28(5):372-5.  https://doi.org/10.1097/INF.0b013e318191eef7  PMID: 19295464 
  59. Zambon MC, Stockton JD, Clewley JP, Fleming DM. Contribution of influenza and respiratory syncytial virus to community cases of influenza-like illness: an observational study. Lancet. 2001;358(9291):1410-6.  https://doi.org/10.1016/S0140-6736(01)06528-X  PMID: 11705487 
  60. Zieliński A, Czarkowski MP, Sadkowska-Todys M. Infectious diseases in Poland in 2011. Przegl Epidemiol. 2013;67(2):171-9, 301-5. PMID: 24040711 
  61. Barakat A, Ihazmad H, Benkaroum S, Cherkaoui I, Benmamoun A, Youbi M, et al. Influenza surveillance among outpatients and inpatients in Morocco, 1996-2009. PLoS One. 2011;6(9):e24579.  https://doi.org/10.1371/journal.pone.0024579  PMID: 21931764 
  62. Emukule GO, Khagayi S, McMorrow ML, Ochola R, Otieno N, Widdowson MA, et al. The burden of influenza and RSV among inpatients and outpatients in rural western Kenya, 2009-2012. PLoS One. 2014;9(8):e105543.  https://doi.org/10.1371/journal.pone.0105543  PMID: 25133576 
  63. Tallo VL, Kamigaki T, Tan AG, Pamaran RR, Alday PP, Mercado ES, et al. Estimating influenza outpatients’ and inpatients’ incidences from 2009 to 2011 in a tropical urban setting in the Philippines. Influenza Other Respir Viruses. 2014;8(2):159-68.  https://doi.org/10.1111/irv.12223  PMID: 24393336 
  64. Yang J, Jit M, Leung KS, Zheng YM, Feng LZ, Wang LP, et al. The economic burden of influenza-associated outpatient visits and hospitalizations in China: a retrospective survey. Infect Dis Poverty. 2015;4(1):44.  https://doi.org/10.1186/s40249-015-0077-6  PMID: 26445412 
  65. Fiore AE, Fry A, Shay D, Gubareva L, Bresee JS, Uyeki TM, Centers for Disease Control and Prevention (CDC). Antiviral agents for the treatment and chemoprophylaxis of influenza --- recommendations of the Advisory Committee on Immunization Practices (ACIP). MMWR Recomm Rep. 2011;60(1):1-24. PMID: 21248682 
  66. Tokars JI, Olsen SJ, Reed C. Seasonal incidence of symptomatic influenza in the United States. Clin Infect Dis. 2018;66(10):1511-8.  https://doi.org/10.1093/cid/cix1060  PMID: 29206909 
  67. European Centre for Disease Prevention and Control (ECDC). Seasonal influenza vaccination and antiviral use in Europe – Overview of vaccination recommendations and coverage rates in the EU Member States for the 2013-14 and 2014-15 influenza seasons. Stockholm: ECDC; 2016. https://www.ecdc.europa.eu/en/publications-data/seasonal-influenza-vaccination-europe-vaccination-recommendations-and-coverage-0
  68. Grohskopf LA, Alyanak E, Broder KR, Walter EB, Fry AM, Jernigan DB. Prevention and control of seasonal influenza with vaccines: recommendations of the advisory committee on immunization practices - United States, 2019-20 Influenza Season. MMWR Recomm Rep. 2019;68(3):1-21.  https://doi.org/10.15585/mmwr.rr6803a1  PMID: 31441906 
  69. van Noort SP, Codeço CT, Koppeschaar CE, van Ranst M, Paolotti D, Gomes MG. Ten-year performance of Influenzanet: ILI time series, risks, vaccine effects, and care-seeking behaviour. Epidemics. 2015;13:28-36.  https://doi.org/10.1016/j.epidem.2015.05.001  PMID: 26616039 
  70. Mook P, Meerhoff T, Olsen SJ, Snacken R, Adlhoch C, Pereyaslov D, et al. Alternating patterns of seasonal influenza activity in the WHO European Region following the 2009 pandemic, 2010-2018. Influenza Other Respir Viruses. 2020;14(2):150-61.  https://doi.org/10.1111/irv.12703  PMID: 31944604 
  71. European Centre for Disease Prevention and Control (ECDC). Annual epidemiological report on communicable diseases in Europe 2009. Stockholm: ECDC; 2009. Available from: https://www.ecdc.europa.eu/sites/default/files/media/en/publications/Publications/0910_SUR_Annual_Epidemiological_Report_on_Communicable_Diseases_in_Europe.pdf
  72. European Centre for Disease Prevention and Control (ECDC). Annual epidemiological report on communicable diseases in Europe 2010. Stockholm: ECDC; 2010. Available from: https://www.ecdc.europa.eu/sites/portal/files/media/en/publications/Publications/1011_SUR_Annual_Epidemiological_Report_on_Communicable_Diseases_in_Europe.pdf
  73. Paget J, Marquet R, Meijer A, van der Velden K. Influenza activity in Europe during eight seasons (1999-2007): an evaluation of the indicators used to measure activity and an assessment of the timing, length and course of peak activity (spread) across Europe. BMC Infect Dis. 2007;7(1):141.  https://doi.org/10.1186/1471-2334-7-141  PMID: 18047685 
  74. European Centre for Disease Prevention and Control (ECDC). Annual epidemiological report on communicable diseases in Europe. Report on the status of communicable diseases in the EU and EEA/EFTA countries. Stockholm: ECDC; 2007. Available from: https://www.ecdc.europa.eu/sites/portal/files/media/en/publications/Publications/0706_SUR_Annual_Epidemiological_Report_2007.pdf
  75. Peppa M, John Edmunds W, Funk S. Disease severity determines health-seeking behaviour amongst individuals with influenza-like illness in an internet-based cohort. BMC Infect Dis. 2017;17(1):238.  https://doi.org/10.1186/s12879-017-2337-5  PMID: 28359335 
  76. Monto AS, Sullivan KM. Acute respiratory illness in the community. Frequency of illness and the agents involved. Epidemiol Infect. 1993;110(1):145-60.  https://doi.org/10.1017/S0950268800050779  PMID: 8432318 
  77. Troeger CE, Blacker BF, Khalil IA, Zimsen SRM, Albertson SB, Abate D, et al. Mortality, morbidity, and hospitalisations due to influenza lower respiratory tract infections, 2017: an analysis for the Global Burden of Disease Study 2017. Lancet Respir Med. 2019;7(1):69-89.  https://doi.org/10.1016/S2213-2600(18)30496-X  PMID: 30553848 
  78. Reed C, Chaves SS, Daily Kirley P, Emerson R, Aragon D, Hancock EB, et al. Estimating influenza disease burden from population-based surveillance data in the United States. PLoS One. 2015;10(3):e0118369.  https://doi.org/10.1371/journal.pone.0118369  PMID: 25738736 
  79. Schmid CH, Lau J, McIntosh MW, Cappelleri JC. An empirical study of the effect of the control rate as a predictor of treatment efficacy in meta-analysis of clinical trials. Stat Med. 1998;17(17):1923-42.  https://doi.org/10.1002/(SICI)1097-0258(19980915)17:17<1923::AID-SIM874>3.0.CO;2-6  PMID: 9777687 
  80. Maltezou HC, Katerelos P, Mavrouli M, Lourida A, Routsias JG, Spanakis N, et al. Seroepidemiological study of pandemic influenza H1N1 following the 2009-2010 wave in Greece. Vaccine. 2011;29(38):6664-9.  https://doi.org/10.1016/j.vaccine.2011.06.098  PMID: 21762749 
  81. World Health Organization (WHO). WHO global epidemiological surveillance standards for influenza. Geneva: WHO; 2013. Available from: https://www.who.int/influenza/resources/documents/WHO_Epidemiological_Influenza_Surveillance_Standards_2014.pdf?ua=1
  82. Merckx J, Wali R, Schiller I, Caya C, Gore GC, Chartrand C, et al. Diagnostic accuracy of novel and traditional rapid tests for influenza infection compared with reverse transcriptase polymerase chain reaction: a systematic review and meta-analysis. Ann Intern Med. 2017;167(6):394-409.  https://doi.org/10.7326/M17-0848  PMID: 28869986 
Spotlight influenza: Laboratory-confirmed seasonal influenza in people with acute respiratory illness: a literature review and meta-analysis, WHO European Region, 2004 to 2017
<p class="citation"> <span>Citation style for this article:</span> <span class="meta-value authors"> <a href="/search?value1=Sara+Belazi&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Belazi Sara</a>, <a href="/search?value1=Sonja+J+Olsen&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Olsen Sonja J</a>, <a href="/search?value1=Caroline+Brown&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Brown Caroline</a>, <a href="/search?value1=Helen+K+Green&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Green Helen K</a>, <a href="/search?value1=Piers+Mook&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Mook Piers</a>, <a href="/search?value1=Jonathan+Nguyen-Van-Tam&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Nguyen-Van-Tam Jonathan</a>, <a href="/search?value1=Pasi+Penttinen&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Penttinen Pasi</a>, <a href="/search?value1=Louise+Lansbury&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Lansbury Louise</a></span>. Spotlight influenza: Laboratory-confirmed seasonal influenza in people with acute respiratory illness: a literature review and meta-analysis, WHO European Region, 2004 to 2017. <a href="/content/ecdc">Euro Surveill.</a> 2021;26(39):pii=2000343. <a href="https://doi.org/10.2807/1560-7917.ES.2021.26.39.2000343" title="doi link" target="_blank">https://doi.org/10.2807/1560-7917.ES.2021.26.39.2000343</a> <span class="ES_Article_citation"> <span class="generated">Received</span>: 13 Mar 2020;&nbsp;&nbsp; <span class="generated">Accepted</span>: 08 Dec 2020 </span> </p>
/content/10.2807/1560-7917.ES.2021.26.39.2000343
/content/10.2807/1560-7917.ES.2021.26.39.2000343
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