Seasonal influenza is a cause of hospitalization, especially in people with underlying disease or extreme age, and its severity may differ depending on the types and subtypes of circulating viruses. We investigated the factors associated with ICU admission or death in hospitalized patients with severe laboratory-confirmed influenza according to the viral type and subtype. An observational epidemiological study was carried out in patients aged ≥18 years from 12 Catalan hospitals between 2010 and 2016. For each reported case we collected demographic, virological and clinical characteristics. A mixed-effects logistic regression model was used to estimate crude and adjusted ORs. 1726 hospitalized patients were included: 595 (34.5%) were admitted to the ICU and 224 (13.0%) died. Lower ICU admission was associated with age ≥75 years in all influenza types and subtypes and with age 65-74 years for type A. In contrast, the 65-74 and ≥75 years age groups were associated with an increased risk of death in all types and subtypes, especially for type B (aOR 27.42, 95% CI: 4.95-151.93 and 15.96; 95% CI: 3.01-84.68). The comorbidity most closely associated with severe outcomes was immune deficiency, which was associated with death for type B (aOR 9.02, 95% CI: 3.05-26.69) and subtype A(H1N1)pdm09 (aOR 3.16, 95% CI: 1.77-5.66). Older age was a differential factor for ICU admission and death: it was associated with lower ICU admission but a risk factor for death. The comorbidity with the closest association with death was immune deficiency, mainly in influenza type B patients.
In 2000, the circulation of indigenous measles was interrupted in Catalonia as a result of the activities of the elimination programme introduced in 1991. However, various transmission chains occurred in the indigenous population after the introduction of an imported case, and this caused a total change in the existing situation of elimination. The objective of this study was to analyze the epidemiological and clinical characteristics of the measles outbreak in Catalonia in 2006. Cases reported between August 28 2006 and July 8 2007 were collected. Cases were microbiologically confirmed by determination of measles-specific IgM and/or detection of the viral genome in urine samples. A total of 381 cases of measles were confirmed, representing an incidence of 6.6 per 100,000 inhabitants. Laboratory confirmation was made in 87.1% of the cases and all specimens sequenced belonged to the D4 genotype. A total of 89.5% of the cases occurred in non-vaccinated people, above all in infants aged <16 months.
From 1 October 2006 to 31 January 2007, 213 confirmed cases of measles occurred in the Barcelona Region, resulting from the importation of one case.