Influenza-like Illness Incidence Is Not Reduced by Influenza Vaccination in a Cohort of Older Adults, Despite Effectively Reducing Laboratory-Confirmed Influenza Virus Infections
Influenza-like Illness Incidence Is Not Reduced by Influenza Vaccination in a Cohort of Older Adults, Despite Effectively Reducing Laboratory-Confirmed Influenza Virus Infections
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DOI：
10.1093/infdis/jix268
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发表时间：
2017-08-15
影响因子：
6.4
通讯作者：
Luytjes, Willem
中科院分区：
文献类型：
--
作者：
van Beek, Josine;Veenhoven, Reinier H.;Luytjes, Willem
背景需要关于流感病毒和其他呼吸道病原体对社区老年人（≥ 60岁）呼吸道感染的相对贡献的数据。在荷兰进行了为期2个冬季的前瞻性观察性队列研究。在流感样疾病（ILI）发作期间和对照组中采集鼻咽和口咽拭子。采用多重连接探针扩增法和常规细菌培养法鉴定病毒和细菌。流感病毒引起的ILI分别占18.9%和34.2%。在80%的ILI事件中检测到潜在病原体，其中流感病毒、冠状病毒、鼻病毒、人偏肺病毒、呼吸道合胞病毒、副流感病毒和流感嗜血杆菌是最常见的。在ILI患者中，流感疫苗接种可使流感病毒感染降低73%（95%置信区间[CI]，26%-90%）和51%（95% CI，7%-74%）。然而，2011-2012年和2012-2013年接种疫苗（7.6%和10.8%）和未接种疫苗（4.2%和11.4%）的参与者之间的ILI发病率相似（P > 0.05）。流感病毒是老年人ILI的常见病原体。疫苗接种减少了流感病毒感染的数量，但没有减少ILI发作的总数：其他病原体填补差距。我们认为存在一个对呼吸道感染高度敏感的个体库。
Background. Data on the relative contribution of influenza virus and other respiratory pathogens to respiratory infections in community-dwelling older adults (>= 60 years) are needed.Methods. A prospective observational cohort study was performed in the Netherlands during 2 winters. Nasopharyngeal and oropharyngeal swabs were collected during influenza-like illness (ILI) episodes and from controls. Viruses and bacteria were identified by multiplex ligation-dependent probe amplification assay and conventional bacterial culture.Results. The ILI incidence in the consecutive seasons was 7.2% and 11.6%, and influenza virus caused 18.9% and 34.2% of ILI episodes. Potential pathogen were detected in 80% of the ILI events with influenza virus, coronaviruses, rhinoviruses, human metapneumovirus, respiratory syncytial virus, parainfluenza viruses, and Haemophilus influenzae being the most common. Influenza vaccination reduced influenza virus infection by 73% (95% confidence interval [CI], 26%-90%) and 51% (95% CI, 7%-74%) in ILI patients. However, ILI incidence was similar between vaccinated (7.6% and 10.8%) and nonvaccinated (4.2% and 11.4%) participants in 2011-2012 and 2012-2013, respectively (P >.05).Conclusions. Influenza virus is a frequent pathogen in older adults with ILI. Vaccination reduces the number of influenza virus infections but not the overall number of ILI episodes: other pathogens fill the gap. We suggest the existence of a pool of individuals with high susceptibility to respiratory infections.