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Estimation of influenza-attributable burden in primary care from season 2014/2015 to 2018/2019, France

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Abstract

Influenza viruses cause seasonal epidemics whose intensity varies according to the circulating virus type and subtype. We aim to estimate influenza-like illness (ILI) incidence attributable to influenza viruses in France from October 2014 to May 2019. Physicians participating in the French Sentinelles network reported the number of patients with ILI seen in consultation and performed nasopharyngeal swabs in a sample of these patients. The swabs were tested by RT-PCR for the presence of influenza viruses. These clinical and virological data were combined to estimate ILI incidence attributable to influenza viruses by subtypes and age groups. Influenza incidence rates over seasons ranged from 1.9 (95% CI, 1.9; 2.0) to 3.4% (95% CI, 3.2; 3.6) of the population. Each season, more than half of ILI cases were attributable to influenza. Children under 15 years were the most affected, with influenza incidence rates ranging from 3.0 (95% CI, 2.8;3.3) to 5.7% (95% CI, 5.3;6.1). Co-circulation of several (sub)types of influenza viruses was observed each year, except in 2016/2017 where A(H3N2) viruses accounted for 98.0% of the influenza cases. Weekly ILI incidences attributable to each influenza virus (sub)type were mostly synchronized with ILI incidence, except in 2014/2015 and 2017/2018, where incidence attributable to type B viruses peaked few weeks later. The burden of medically attended influenza among patients with ILI is significant in France, varying considerably across years and age groups. These results show the importance of influenza surveillance in primary care combining clinical and virological data.

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Data availability

Incidence of influenza-like illness are available in the Sentinelles network website, https://www.sentiweb.fr/france/fr/?page=table. The virological data analyzed during the current study are available from the corresponding author on reasonable request.

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Acknowledgements

We thank all the general practitioners and pediatricians participating in the French Sentinelles network.

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Authors and Affiliations

  1. Sorbonne Université, INSERM, Institut Pierre Louis d’épidémiologie et de Santé publique (IPLESP UMRS 1136), Paris, France

    Morgane Paternoster, Caroline Guerrisi, Thierry Blanchon, Thomas Hanslik, Clément Turbelin & Cécile Souty

  2. EA 7310, Laboratoire de Virologie, Université de Corse, Corte, France

    Shirley Masse, Natacha Villechenaud & Alessandra Falchi

  3. National Reference Center for Respiratory Viruses, Molecular Genetics of RNA Viruses, CNRS—UMR 3569, Univ de Paris, Institut Pasteur, Paris, France

    Sylvie van der Werf & Sylvie Behillil

  4. Laboratoire de Virologie des HCL, Institut des Agents Infectieux, CNR des virus à transmission respiratoire (dont la grippe), Hôpital de la Croix Rousse, Lyon, France

    Bruno Lina & Martine Valette

  5. Santé Publique France, Direction des Maladies Infectieuses, Saint-Maurice, France

    Daniel Levy-Bruhl & Sibylle Bernard-Stoecklin

  6. Faculty of Health Sciences Simone Veil, University of Versailles Saint Quentin - University of Paris Saclay, Versailles, France

    Thomas Hanslik

  7. Service de Médecine Interne, Hôpital Ambroise Paré, Assistance Publique-Hôpitaux de Paris (APHP), Boulogne Billancourt, France

    Thomas Hanslik

Authors
  1. Morgane Paternoster
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  2. Shirley Masse
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  3. Sylvie van der Werf
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  4. Bruno Lina
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  8. Sylvie Behillil
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  10. Caroline Guerrisi
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  13. Thomas Hanslik
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  14. Clément Turbelin
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  15. Cécile Souty
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Contributions

SvDW, BL, DLB, SBS, TB, TH, CT, and CS participated to the conception of the study. CT performed the statistical analysis. MP, CT, and CS contributed to the interpretation of data. SvDW, BL, DLB, SBS, TB, TH, SM, NV, CG, MV, SB, and AF contributed to the data collection. MP and CS drafted and wrote the manuscript. All authors read and approved the final manuscript.

Corresponding author

Correspondence to Cécile Souty.

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Ethics approval

The protocol was conducted in agreement with the Helsinki declaration. We obtained authorization from the French Data Protection Agency (CNIL, registration number #471393) and the French ethical research committee (Comité de protection des personnes).

Conflict of interest

The authors declare no competing interests.

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Paternoster, M., Masse, S., van der Werf, S. et al. Estimation of influenza-attributable burden in primary care from season 2014/2015 to 2018/2019, France. Eur J Clin Microbiol Infect Dis 40, 1263–1269 (2021). https://doi.org/10.1007/s10096-021-04161-1

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  • DOI: https://doi.org/10.1007/s10096-021-04161-1

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