ABSTRACT
BACKGROUND: In France, 2-15% of the population is affected annually by influenza, which causes significant socioeconomic disruption. Nevertheless, despite its importance for policy makers, few published studies have evaluated the impact of influenza B. Therefore, we assessed the costs associated with influenza B during 2010-2011 in France. METHODS: Cases of lab-confirmed influenza B were analyzed as part of the Influenza B in General Practice Study. Cost calculations were based on micro-costing methods according to the French Health Insurance (FHI) perspective (in Euros, 2011). Costs were compared between age groups using the Kruskal-Wallis test, and when significant, by multiple comparisons based on rank. Moreover, uncertainties were assessed using one-way sensitivity and probabilistic analyses. Overall economic burden was estimated by multiplying cost per patient, flu attack rate, and the French population. RESULTS: A total of 201 patients were included in the study. We found that the mean cost associated with Influenza B was 72 (SD: 205) per patient: 70 (SD: 262) for younger children, 50 (SD: 195) for older children, 126 (SD: 180) for adults, and 42 (SD: 18) for elderly. Thus, we observed significantly different costs between the distinct age groups (p<0.0001). Finally, the economic burden of influenza B for the FHI was estimated to be 145 million Euros (95% CI: 88-201). CONCLUSIONS: Our findings highlight the important impact of influenza B and encourage further investigation on policy regarding vaccination strategies in France.
Subject(s)
Cost of Illness , Influenza B virus , Influenza, Human/economics , Adolescent , Adult , Age Factors , Aged , Child , Child, Preschool , Female , France/epidemiology , Health Care Costs/statistics & numerical data , Humans , Infant , Infant, Newborn , Influenza, Human/epidemiology , Male , Middle Aged , Seasons , Statistics, Nonparametric , Young AdultABSTRACT
BACKGROUND: Multiplex assays are a new strategy for diagnosing respiratory infections. These assays are better than those based on cultures or antigen detection, but few data are available for comparing them to monoplex polymerase chain reactions (PCRs). This study evaluated the performance of the Luminex xTAG Respiratory Viral Panel (RVP) Fast assay with reference to 2 real-time PCR assays for detecting type A influenza H1 viruses and human enteroviruses and rhinoviruses. METHODS: This was an analysis of nasal swab specimens obtained from 590 outpatients suffering from acute respiratory tract disease between September 2009 and February 2010. RESULTS: The RVP Fast assay performed well in less than 4 h for detecting type A influenza H1 viruses, particularly (H1N1)pdm09, and human entero/rhinoviruses, with 95.2% and 90.05% agreement, respectively, when compared to monoplex real-time PCR assays. This multiplex assay also detected at least 1 virus in 69.3% of the specimens and detected multiple infections in 40 samples. CONCLUSIONS: The multiplex assay detected clinically important viruses in a single genomic test. It will thus be useful for detecting several viruses causing respiratory tract disorders.
Subject(s)
Influenza A virus/isolation & purification , Influenza, Human/diagnosis , Molecular Diagnostic Techniques/methods , Multiplex Polymerase Chain Reaction/methods , Picornaviridae Infections/diagnosis , Respiratory Tract Infections/virology , Rhinovirus/isolation & purification , Adolescent , Adult , Aged , Aged, 80 and over , Child , Child, Preschool , Female , Humans , Infant , Influenza A virus/genetics , Influenza, Human/virology , Male , Middle Aged , Nasal Mucosa/virology , Picornaviridae Infections/virology , Rhinovirus/genetics , Young AdultABSTRACT
BACKGROUND: Neuraminidase inhibitors (NAIs) have been used since 2005 in France. OBJECTIVE: Influenza viruses isolated in hospital and community cases in winter 2005-2006 were evaluated for their sensitivity to NAIs. STUDY DESIGN: Isolates were tested in duplicate with a fluorescence-based neuraminidase assay. The IC50 for oseltamivir or zanamivir was calculated for each strain. Mean IC50 (+/-S.D.) are expressed in nM. Viruses with IC50 superior or very superior to the upper limit (mean IC50+2.5 S.D.) were considered as outliers or resistant viruses, respectively. HA and NA genes for outliers, resistant strains and for a few sensitive strains were sequenced. RESULTS: Out of 225 B isolates, one was found resistant to both oseltamivir and zanamivir with a D197Y mutation in NA and eight isolates were outliers for oseltamivir and/or zanamivir. Out of 151 A (H1N1) isolates, one was found resistant to oseltamivir but sensitive to zanamivir with a H275Y mutation in NA, two isolates were resistant to zanamivir and three isolates were outliers for oseltamivir and/or zanamivir. New mutations were detected in outliers compared to sensitive viruses. CONCLUSION: Resistant influenza strains to NAIs are circulating at a stable and low level of 1% since the introduction of NAIs in clinical practice.
