Influenza- and respiratory syncytial virus-associated mortality and hospitalisations

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Abstract
The aim of the current study was to estimate influenza- and respiratory syncytial virus (RSV)-associated mortality and hospitalisations, especially the influenza-associated burden among low-risk individuals ≤65 yrs old, not yet recommended for influenza vaccination in many European countries.Retrospectively during 1997–2003, Dutch national all-cause mortality and hospital discharge figures and virus surveillance data were used to estimate annual average influenza- and RSV-associated excess mortality and hospitalisation using rate difference methods.Influenza virus active periods were significantly associated with excess mortality among 50–64-yr-olds and the elderly, but not in younger age categories. Influenza-associated hospitalisation was highest and about equal for 0–1-yr-olds and the elderly, and also significant for low-risk adults. Hospitalisation among children was mostly due to respiratory conditions, and among adults cardiovascular complications were frequent. RSV-active periods were associated with excess mortality and hospitalisation among the elderly. The highest RSV-related excess hospitalisation was found in 0–1-yr-olds.Influenza-associated mortality was demonstrated in 50–64-yr-olds. Among low-risk individuals ≤65 yrs of age, influenza-associated hospitalisation rates were highest for 0–4-yr-olds, but also significant for 5–64-yr-olds. These data may further support extension of recommendations for influenza vaccination to include younger low-risk persons. The respiratory syncytial virus-associated burden was highest for young children but also substantial for the elderly.