Key result
Tobacco smoking, lung disorders, and A(H1N1)pdm09 infection were associated with severe influenza disease in hospitalized patients.
Observational (n=249)
No
Lung disorder, tobacco smoking, and A(H1N1)pdm09 infection were risk factors for severe influenza disease during the 2014-2015 season in a French region.
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May link divergent A(H3N2) strains to vaccination failure; hypothesis-generating and should not change practice.
Current influenza vaccination strategy is based on limited analyses of circulating strains and has some drawbacks, as illustrated during the 2014-2015 season with the circulation of A(H3N2) viruses belonging to divergent genetic subgroups. We reasoned that these strains, poorly neutralized in vitro, may have been associated with vaccination failure and more severe diseases. We conducted a study on a continuous series of 249 confirmed influenza infections. Incidence was three fold greater than in the previous three years. Most isolates were A(H3N2) viruses (78%) and clustered in subgroups 3C.2a (57%) and 3C.3b (43%). We identified 23 non-synonymous mutations that had already been identified during previous seasons at low frequencies, except mutation Q197H, present in 26% of 3C.3b isolates. We identified lung disorder, tobacco smoking and A(H1N1)pdm09 infection as risk factor of severe influenza disease. In contrast, young age (< 5 years), A(H3N2) infection and initial admission to an emergency department were associated with a better outcome of influenza infection.
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Marlet et al. (2018) conducted an observational in Influenza A infection (n=249). Tobacco smoking vs. Non-smokers was evaluated on Severe influenza disease (complication, ICU admission, or death) (OR 4.88, 95% CI 1.54-15.47). Tobacco smoking, lung disorders, and A(H1N1)pdm09 infection were associated with severe influenza disease in hospitalized patients.
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