496. Risk factors & vaccine failure associated with influenza related death in severe cases in Greece during the 2014-15 season
Session: Poster Abstract Session: Respiratory Infections: Influenza
Thursday, October 8, 2015
Room: Poster Hall
Posters
  • IDSA2015flu1Tsiodras.pdf (2.4 MB)
  • Background: We examined risk factors for influenza related death in all severe cases in Greece during the 2014-15 influenza season

    Methods: A national severe influenza surveillance network includes reporting to HCDCP of all laboratory-confirmed influenza cases admitted to ICU &/or in-hospital deaths of influenza patients. Each case is followed up daily, with a structured questionnaire until discharged. We evaluated risk factors for death using univariate & multivariate analyses

    Results: 248 cases were recorded (median age 67 yrs, 54.7% male, 87.1% high risk pts with comorbidities). Influenza A was noted in 56.5%. 111 deaths were recorded (median age 57 yrs, 55% male). In 64 (57.7%) deaths, influenza A was diagnosed [A(H1N1): 36%, A(H3N2): 64%]. 99/111 (89.2%) deaths occurred in pts with immunization indications; 15 were immunized. ARDS (OR 3.43 (95%CI 1.27 - 9.3) p=0.006), renal insufficiency (OR 3.9;  95% CI 1.4-11.3, p = 0.01), occurrence of secondary bacterial infection & septic shock  (OR 4.4;  95% CI 1.2-16.4, p=0.015) were risk factors for death. Influenza  A cases did not differ from B regarding age, comorbidities, rates of intubation or death. Within 31 vaccinated cases influenza A was more prevalent to B (77.4% vs. 22.6%, p=0.06)

    Conclusion: ARDS, renal insufficiency & the presence of secondary infections or septic shock were risk factors for death in a mixed A & B season. Influenza B did not differ from A in the risk for complications & death. Vaccine failures were noted especially among serious influenza A cases, consistent with the reported drift of A(H3N2)

    Anastasia Andreopoulou, MSc1, Elisavet Mouratidou, RN, MSc2, Georgia Spala, MD3, Ourania Kalkouni, MD1, Theodore Lytras, MD, MPH4, Agoritsa Baka, MD5, Stavroula Koukouli, BSc4, Eirini Velioti, BSc4, Theano Georgakopoulou, MD, MPH, PhD4, Christos Hadjichristodoulou, MD, MPH, PhD6 and Sotirios Tsiodras, MD, PhD, Assoc Professor7, (1)Epidemiology and Intervention, Hellenic Centre for Disease Control and Prevention, Marousi, Greece, (2)Hellenic Centre for Disease Control and Prevention (HCDCP), Marousi, Greece, (3)Epidemiology and Intervention, Hellenic Center for Disease Control and Prevention, Marousi, Greece, (4)Epidemiology Surveillance and Response, Hellenic Centre for Disease Control and Prevention (HCDCP), Marousi, Greece, (5)Hellenic Ctr for Disease Control & Prevention (HCDCP), Marousi, Greece, (6)Dept of Hygiene and Epidemiology, University of Thessaly, Larissa, Greece, (7)4th Department of Internal Medicine, University of Athens Medical School, Athens, Greece

    Disclosures:

    A. Andreopoulou, None

    E. Mouratidou, None

    G. Spala, None

    O. Kalkouni, None

    T. Lytras, None

    A. Baka, None

    S. Koukouli, None

    E. Velioti, None

    T. Georgakopoulou, None

    C. Hadjichristodoulou, None

    S. Tsiodras, None

    Findings in the abstracts are embargoed until 12:01 a.m. PDT, Wednesday Oct. 7th with the exception of research findings presented at the IDWeek press conferences.