Germs
September 2024
High quality research is critical for evidence-based decision making in public health and fundamental to maintain progress and trust in immunization programs in Europe. In 2024 the European Centre for Disease Prevention and Control (ECDC) conducted an update of the 2020 systematic review to capture more recent evidence on of the efficacy, effectiveness of influenza vaccines in individuals aged 18 years and older in the prevention of laboratory-confirmed influenza. While this report was highly anticipated due to the strength of the protocol and processes put in place, during our assessment, we expressed two chief concerns.
View Article and Find Full Text PDFBackground: Pertussis is a highly contagious respiratory tract infection that affects all ages, though it is most severe in young infants. Adults, especially those with respiratory conditions or other chronic illnesses can also suffer serious consequences of pertussis. Pertussis vaccination is the best method of disease prevention in a lifetime.
View Article and Find Full Text PDFObjectives: High-dose quadrivalent influenza vaccine (HD-QIV) was introduced during the 2021/2022 influenza season in France for adults aged ≥65 years as an alternative to standard-dose quadrivalent influenza vaccine (SD-QIV). The aim of this study is to estimate the relative vaccine effectiveness of HD-QIV vs. SD-QIV against influenza-related hospitalizations in France.
View Article and Find Full Text PDFThe lifting of non-pharmaceutical measures preventing transmission of SARS-CoV-2 (and other viruses, including influenza viruses) raises concerns about healthcare resources and fears of an increased number of cases of influenza and COVID-19. For the 2021-2022 influenza season, the WHO and >20 European countries promoted coadministration of influenza and COVID-19 vaccines. Recently, the French Health Authority recommended coupling the COVID-19 vaccination with the 2022-2023 influenza vaccination campaign for healthcare professionals and people at risk of severe COVID-19.
View Article and Find Full Text PDFBackground: Influenza surveillance systems vary widely between countries and there is no framework to evaluate national surveillance systems in terms of data generation and dissemination. This study aimed to develop and test a comparative framework for European influenza surveillance.
Methods: Surveillance systems were evaluated qualitatively in five European countries (France, Germany, Italy, Spain, and the United Kingdom) by a panel of influenza experts and researchers from each country.
Background: Fibrosis-4 test (FIB-4) is one of the simplest, free of charge, noninvasive scoring tests. We aimed to prospectively measure the prevalence of liver fibrosis in adults with no previously known liver disease and who consulted a general practitioner by FIB-4 score; compare this test to an NAFLD Fibrosis Score (NFS) and Fibrometer (FM); explore the prevalence of risk factors (obesity, diabetes, alcohol, and hypertension) and reconsider a possible cause of liver disease in patients recognized as FIB-4-positive.
Methods: Over a 6-month period, 40 general practitioners (GPs) offered all their consecutive adult primary care patients with no previously known liver pathology and a liver fibrosis screening via a blood test of three scores.
Influenza Other Respir Viruses
May 2022
Background: In response to the coronavirus disease (COVID-19) outbreak that unfolded across Europe in 2020, the World Health Organisation (WHO) called for repurposing existing influenza surveillance systems to monitor COVID-19. This analysis aimed to compare descriptively the extent to which influenza surveillance systems were adapted and enhanced and how COVID-19 surveillance could ultimately benefit or disrupt routine influenza surveillance.
Methods: We used a previously developed framework in France, Germany, Italy, Spain and the United Kingdom to describe COVID-19 surveillance and its impact on influenza surveillance.
Background: Influenza vaccines are the main tool to prevent morbidity and mortality of the disease; however, egg adaptations associated with the choice of the manufacturing process may reduce their effectiveness. This study aimed to estimate the impact of egg adaptations and antigenic drift on the effectiveness of trivalent (TIV) and quadrivalent (QIV) influenza vaccines.
Methods: Nine experts in influenza virology were recruited into a Delphi-style exercise.
Covigie is a free online platform set up in response to the COVID-19 global pandemic. It has enabled all caregivers and coordinators of primary care teams to report in real time the initiatives, observations, questions and problems encountered in the fight against the new coronavirus. The Covigie team summarised the information from the various contributions received, individual or collective, sent them to the health authorities and shared them with the caregivers.
View Article and Find Full Text PDFBackground: Gastroenteritis (GE) and respiratory tract infection (RTI) outbreaks are a significant issue in nursing homes. This study aimed to describe GE and RTI outbreaks with infection and all-cause lethality rates according to the individual characteristics of nursing home residents.
Methods: Clinical and virological surveillance were conducted (2007 to 2018).
Currently, circulating viruses responsible for annual seasonal influenza epidemics belong to two influenza A subtypes, A(H1N1) and A(H3N2), and to two antigenically distinct type B lineages, B/Yamagata and B/Victoria lineages. Like diseases due to influenza A virus, influenza B virus diseases may have severe consequences and should be prevented. Until now, in France, the vaccines used to prevent seasonal influenza were trivalent, systematically targeting viruses belonging to both A subtypes and to one or other of the B lineages.
View Article and Find Full Text PDFObjectives: We aimed to evaluate and compare non-adherence to oral and inhaled antiviral therapies prescribed of a randomised clinical trial in outpatients with influenza A infection.
Design: A parallel, three-arm, double-blinded trial randomly allocated antiviral therapies twice daily for 5 days: (1) oral oseltamivir plus inhaled zanamivir (arm OZ); (2) oseltamivir plus inhaled placebo (arm Opz); or (3) oral placebo plus inhaled zanamivir (arm poZ). Analysis of non-adherence was a secondary objective of the trial.
International case definitions recommended by the Centers for Disease Control and Prevention (CDC), the European Centre for Disease Prevention and Control (ECDC), and the World Health Organization (WHO) are commonly used for influenza surveillance. We evaluated clinical factors associated with the laboratory-confirmed diagnosis of influenza and the performance of these influenza case definitions by using a complete dataset of 14,994 patients with acute respiratory infection (ARI) from whom a specimen was collected between August 2009 and April 2014 by the Groupes Régionaux d'Observation de la Grippe (GROG), a French national influenza surveillance network. Cough and fever ≥ 39 °C most accurately predicted an influenza infection in all age groups.
View Article and Find Full Text PDFVaccine-induced protection against influenza is not optimal, however it has been suggested that the vaccine may reduce the severity of symptoms among those who develop illness despite being vaccinated. We tested this hypothesis within a countrywide, sentinel general practitioners-based surveillance system in France. We included 2277 individuals aged 65years or older (of whom 1293 had been vaccinated against influenza, 56.
View Article and Find Full Text PDFBackground: The study objectives were to describe the incidence and the nature of patient safety incidents (PSIs) in primary care general practice settings, and to explore the association between these incidents and practice or organizational characteristics.
Methods: GPs, randomly selected from a national influenza surveillance network (n = 800) across France, prospectively reported any incidents observed each day over a one-week period between May and July 2013. An incident was an event or circumstance that could have resulted, or did result, in harm to a patient, which the GP would not wish to recur.
Background: Target groups for seasonal influenza vaccination are defined at the country level and are based on several factors. However, little is known about the national decision-making procedures.
Objective: The purpose of this study was to compare the evidence used for the development of recommendations and its impact on the choice of target groups in France and the Netherlands.
Carried out in France in 2013, the national primary care study on adverse events enabled the average frequency of such events in outpatient care to be estimated. General practitioners identified an occurrence of an adverse event every two days, without consequence for the patients in three quarters of the cases.
View Article and Find Full Text PDFObjectives: Target groups for seasonal influenza vaccination are nationally defined based on several factors. However, few studies have explored the policy-making processes at the country-level. We investigated key differences in the policy-making process for the development of vaccination recommendations between France (FR) and The Netherlands (NL).
View Article and Find Full Text PDFObjective: This work evaluated seasonal variations and spatio-temporal pattern of respiratory tract infections (RTI) in geriatric nursing homes in order to improve effective surveillance, prevention, control and management of RTI.
Methods: Prospective surveillance of RTI (Low Respiratory Tract infections and Influenza Like Illnesses) was conducted in 11 sites in Alsace over a 10-year period with clinical case definitions and rapid tests (Immunoassay) to identify influenza virus.
Results: Influenza national epidemic was a period at high risk of RTI in nursing homes with variable impacts depending on the seasonal period.
Influenza B represents a high proportion of influenza cases in some seasons (even over 50%). The Influenza B study in General Practice (IBGP) is a multicenter study providing information about the clinical, demographic and socio-economic characteristics of patients affected by lab-confirmed influenza A or B. Influenza B patients and age-matched influenza A patients were recruited within the sentinel surveillance networks of France and Turkey in 2010-11 and 2011-12 seasons.
View Article and Find Full Text PDFBackground: Studies that aimed at comparing the clinical presentation of influenza patients across virus types and subtypes/lineages found divergent results, but this was never investigated using data collected over several years in a countrywide, primary care practitioners-based influenza surveillance system.
Methods: The IBVD (Influenza B in Vircases Database) study collected information on signs and symptoms at disease onset from laboratory-confirmed influenza patients of any age who consulted a sentinel practitioner in France. We compared the clinical presentation of influenza patients across age groups (0-4, 5-14, 15-64 and 65+ years), virus types (A, B) and subtypes/lineages (A(H3N2), pandemic A(H1N1), B Victoria, B Yamagata).
Background: Describing the circulation of influenza viruses and the characteristics of seasonal epidemics remains an essential tool to optimize the strategies of influenza prevention and control. Special attention has been recently paid to influenza B in the context of the availability of a quadrivalent vaccine, containing two influenza B strains.
Methods: We used data from a practitioners-based influenza surveillance network to describe the circulation of influenza viruses in France from 2003-2004 to 2012-2013.
Objectives: To conduct a literature review of influenza vaccination policy, describing roles and interactions between stakeholders and the factors influencing policy-making.
Methods: Major databases were searched using keywords related to influenza vaccination, decision-making and health policy. Titles and abstracts were screened according to defined criteria using independent reviewers.