An outbreak investigation of paediatric severe acute respiratory infections requiring admission to intensive care units – Fiji, May 2016
DOI:
https://doi.org/10.5365/wpsar.2017.8.4.009Abstract
Introduction: Influenza-associated severe acute respiratory infections (SARI) are a major contributor to global morbidity and mortality. In response to a cluster of SARI cases and deaths in pregnant women, with two deceased cases testing positive for influenza A(H1N1)pdm09, an investigation was initiated to determine whether there was an increase of paediatric SARI cases admitted to divisional hospital intensive care units in Fiji in may 2016 compared to May 2013–2015.
Methods: Retrospective case finding was conducted at the paediatric intensive care units (PICUs) in Fiji’s three divisional hospitals. Data were collected from 1 January 2013 to 26 May 2016. Cases were identified using a list of clinical diagnoses compatible with SARI.
Results: A total of 632 cases of paediatric SARI with complete details were identified. The median age of cases was 6 months (Interquartile range: 2–14 months). Children aged less than 5 years had a higher rate of paediatric SARI requiring admission to a divisional hospital PICU in May 2016 compared to May 2013–2015 (Incidence rate ratio: 1.7 [95% CI: 1.1–2.6]). This increase was not observed in children aged 5–14 years. The case-fatality ratio was not significantly different in 2016 compared to previous years.
Conclusion: The investigation enabled targeted public health response measures, including enhanced SARI surveillance at divisional hospitals and an emergency influenza vaccination campaign in the Northern Division.
References
World Health Organization. Vaccines against influenza: WHO position paper. Weekly Epidemiological Record November 2012;87(47):461-76.
Members of the Western Pacific Region Global Influenza Surveillance and Response System. Epidemiological and Virological Characteristics of Influenza in the Western Pacific Region of the World Health Organization, 2006–2010. PLOS ONE 2012;7(5):e37568.
Members of the Western Pacific Region Global Influenza Surveillance and Response System. Seasonal influenza vaccine policies, recommendations and use in the World Health Organization’s Western Pacific Region. Western Pacific Surveillance and Response Journal 2013;4(3):51-9.
Fiji Bureau of Statistics. Population and Labour Force Estimates of 2014. Statistical News 31 December 2015;Press Release No. 99.
Fiji Centre for Communicable Disease Control, World Health Organisation Western Pacific Region. Fiji National SARI Surveillance Guideline. Suva: Fiji Ministry of Health and Medical Services; 2014.
Fiji Ministry of Health and Medical Services. Fiji National Immunisation Policy and Procedure Manual. Fiji Ministry of Health and Medical Services; 2013-2016.
Fiji Ministry of Health and Medical Services. Fiji National Influenza Pandemic Plan. Fiji Ministry of Health and Medical Services; 2006.
CSL Limited. Seqirus donates vaccines to Fiji to alleviate increase in influenza. 6 June 2016; Available from: http://www.csl.com.au/docs/231/602/2016JUN06%20-%20Fiji%20donation.pdf
Fiji Bureau of Statistics. 2007 Fiji Census of Population and Housing: Analytical Report. Suva: Government of Fiji; 2012.
Nair H, Brooks WA, Katz M, Roca A, Berkley JA, Madhi SA, et al. Global burden of respiratory infections due to seasonal influenza in young children: a systematic review and meta-analysis. Lancet (London, England) 2011;378(9807):1917-30.
Government of Fiji. Fiji Post-Disaster Needs Assessment: Tropical Cyclone Winston, February 20 2016. Suva: Government of Fiji; May 2016.
Bellos A, Mulholland K, O'Brien KL, Qazi SA, Gayer M, Checchi F. The burden of acute respiratory infections in crisis-affected populations: a systematic review. Conflict and Health 2010;4(3).
Influenza Laboratory Surveillance Information: Fiji. Global Influenza Surveillance and Response System. FluNet: World Health Organization; Epidemiological weeks 13-22, 2016.
World Health Organization. Weekly Epidemiological Record 16 December 2016;91(52):601-4.
World Health Organization Regional Office for Europe. Risk assessment of the 2015–2016 influenza season in the WHO European Region, week 40/2015 to week 04/2016. Copenhagen: World Health Organization; 17 February 2016.
