Burden of hospitalizations for pandemic influenza in Slovenia

Aim To analyze the 2009/2010 epidemiological data of patients hospitalized for confirmed pandemic influenza in Slovenia. Methods We conducted a retrospective analysis of health statistical data collected in an electronic data set Diagnosis-related Group system. Data on age, sex, primary and secondary diagnoses, duration of hospital stay, admission to the intensive care unit, disease outcome, and the week of the admission to the hospital were extracted for patients diagnosed with confirmed influenza virus infection. Results A total of 748 (hospitalization rate 37.4/100,000) patients diagnosed with confirmed influenza virus infection were admitted to 19 public hospitals and 7 private acute care providers during the period from September 28, 2009 to April 11, 2010. The highest admission rate was recorded for mid-November 2009. Out of 748 hospitalized patients, 411 (55%) were children younger than 15 years. Influenza was coded as the primary diagnosis in 536 patients. In 35% of the patients, influenza caused viral pneumonia. Fewer than one third of patients (28%) had a preexisting chronic disease and/or condition predisposing them to complicated or adverse outcomes of influenza, most frequently chronic lung diseases, mainly asthma. A median hospital stay was 2 days for children and 5 days for adult patients. Longer hospitalization was required in patients who had a secondary diagnosis of influenza. Older male individuals suffering from pneumonia and chronic diseases were overrepresented among cases admitted to the intensive care units. Conclusions The epidemiological data extracted from the Diagnosis-related Group system in Slovenia were comparable with the data on pandemic patients published elsewhere

Comparing COVID-19 severity in patients hospitalized for community-associated Delta, BA.1 and BA.4/5 variant infection

BackgroundDespite decreasing COVID-19 disease severity during the Omicron waves, a proportion of patients still require hospitalization and intensive care.ObjectiveTo compare demographic characteristics, comorbidities, vaccination status, and previous infections in patients hospitalized for community-associated COVID-19 (CAC) in predominantly Delta, Omicron BA.1 and BA.4/5 SARS-CoV-2 waves.MethodsData were extracted from three national databases—the National COVID-19 Database, National Vaccination Registry and National Registry of Hospitalizations.ResultsAmong the hospitalized CAC patients analyzed in this study, 5,512 were infected with Delta, 1,120 with Omicron BA.1, and 1,143 with the Omicron BA.4/5 variant. The age and sex structure changed from Delta to BA.4/5, with the proportion of women (9.5% increase), children and adolescents (10.4% increase), and octa- and nonagenarians increasing significantly (24.5% increase). Significantly more patients had comorbidities (measured by the Charlson Comorbidity Index), 30.3% in Delta and 43% in BA.4/5 period. The need for non-invasive ventilatory support (NiVS), ICU admission, mechanical ventilation (MV), and in-hospital mortality (IHM) decreased from Delta to Omicron BA.4/5 period for 12.6, 13.5, 11.5, and 6.3%, respectively. Multivariate analysis revealed significantly lower odds for ICU admission (OR 0.68, CI 0.54–0.84, p < 0.001) and IHM (OR 0.74, CI 0.58–0.93, p = 0.011) during the Delta period in patients who had been fully vaccinated or boosted with a COVID-19 vaccine within the previous 6 months. In the BA.1 variant period, patients who had less than 6 months elapsed between the last vaccine dose and SARS-CoV-2 positivity had lower odds for MV (OR 0.38, CI 0.18-0.72, p = 0.005) and IHM (OR 0.56, CI 0.37- 0.83, p = 0.005), but not for NIVS or ICU admission.ConclusionThe likelihood of developing severe CAC in hospitalized patients was higher in those with the Delta and Omicron BA.1 variant compared to BA.4/5

Varicella susceptibility and transmission dynamics in Slovenia

<p>Abstract</p> <p>Background</p> <p>A cross-sectional, age-stratified study was conducted to determine varicella-zoster seroprevalence and force of infection in Slovenia.</p> <p>Methods</p> <p>3689 serum samples were tested for VZV IgG antibodies with an enzyme immunoassay. Semiparametric and parametric modelling were used to estimate the force of infection.</p> <p>Results</p> <p>Overall, 85.6% of serum samples were seropositive. Age-specific prevalence rose rapidly in preschool children and over 90% of 8 years old tested positive for VZV. However, 2.8% of serum samples among women of childbearing age were seronegative. Semiparametric modelling yielded force of infection estimates of 0.182 (95% CI 0.158-0.206), 0.367 (95% CI 0.285-0.448) and 0.008 (95% CI 0.0-0.032) for age groups 0.5- < 6, 6-11 and ≥12 years, respectively, and 0.175 (95% CI 0.147-0.202), 0.391 (95% CI 0.303-0.480) and 0.025 (95% CI 0.003-0.046) for age groups 0.5- < 5, 5-9 and ≥10 years, respectively.</p> <p>Conclusions</p> <p>Regardless of the age grouping used, the highest transmission occurred in children in their first years of school.</p

Risk factors for death from invasive pneumococcal disease, europe, 2010

We studied the possible association between patient age and sex, clinical presentation, Streptococcus pneumoniae serotype, antimicrobial resistance, and death in invasive pneumococcal disease cases reported by 17 European countries during 2010. The study sample comprised 2,921 patients, of whom 56.8% were men and 38.2% were >65 years of age. Meningitis occurred in 18.5% of cases. Death was reported in 264 (9.0%) cases. Older age, meningitis, and nonsusceptibility to penicillin were signifcantly asso ciated with death. Non-pneumococcal conjugate vaccine (PCV) serotypes among children 65 years of age, risk did not differ by serotype. These fndings highlight differences in case-fatality rates between sero types and age; thus, continued epidemiologic surveillance across all ages is crucial to monitor the long-term effects of PCVs

Referenčne ambulante: izkušnje diplomiranih medicinskih sester

Uvod: Referenčna ambulanta je ambulanta z razširjenim timom, katere članica je diplomirana medicinska sestra, ki je opolnomočena s podiplomskim znanjem. Raziskava prikazuje izkušnje diplomiranih medicinskih sester z referenčnimi ambulantami, dosedanje izobraževanje, zadovoljstvo z delom v referenčni ambulanti ter potrebe po dodatnih veščinah, znanju, dopolnitvah in spremembah. Metode: V raziskavi so sodelovale diplomirane medicinske sestre (n = 88) v referenčnih ambulantah iz 18 zdravstvenih domov. Strukturiran vprašalnik je vključeval demografska vprašanja in vprašanja, ki so se nanašala na zadovoljstvo diplomiranih medicinskih sester z delom in potrebo po izobraževanju. Zanesljivost instrumenta (Cronbach alfa) je bila 0,734. Uporabljeni so bili opisna statistika, hi-kvadrat test (χ2) in Fisherjev test. Rezultati: Anketiranci so se strinjali, da z izobraževanjem pridobijo dodatna znanja (81,8 %), ki so koristna (73,9 %) in uporabna pri delu v referenčni ambulanti (72,7 %). Najbolj so se strinjali, da si izkušnje izmenjujejo s sodelavci (x̄ = 4,2) in da so bolniki zadovoljni z njihovim delom (x̄ = 4,2). Pri znanju anketirancev (χ2 = 20,734, p = 0,016) in predlogih izboljšav delovnega procesa (χ2 = 9,905, p = 0,007) so statistično pomembne razlike v povezavi s starostjo. Diskusija in zaključek: Raziskava pokaže, da so anketiranci delno zadovoljni na delovnem mestu. Treba bi bilo omogočiti napredovanje na delovnem mestu, dodatna izobraževanja, izboljšati informacijsko podporo in spodbujati podiplomsko izobraževanje

Epidemiološki i virološki nadzor influence i influenci slične bolesti u Sloveniji

The number of patients with acute respiratory infections rises sharply shortly after the influenza virus appears in population. Consequently, the hospitalization and mortality rates increase. Several indicators may be used to measure the burden-of-illness caused by the influenza virus: incidence rate of influenza-like illness (ILI) or acute respiratory illness (ARI), crude or cause-specific mortality rate, sick-live or monitoring the over the counter (OTC) medication sales. Two indicators have been measured in Slovenia since 1999: the ILI and ARI incidence rates in approximately 4% of the population. Multiplex Reverse Transcription-Polymerase Chain Reaction (RT-PCR) was used as a screening method for the detection of influenza viruses, respiratory syncytial virus (RSV), adenoviruses and enteroviruses in nasal and/or throat swabs. All positive samples were further propagated in the corresponding cell culture line. RT-PCR was used for fast determination of hemaglutinins (H1, H3) and neuraminidases (N1, N2) of influenza A viruses. The antigenic subtype of the samples isolated on the cell culture was determined by means of a hemaglutination inhibition assay and confirmed in the WHO European Reference Centre for Influenza. In the 2004/2005 season, the ILI incidence rate was at highest in weeks 5, 6 and 7 of the year 2005, when it reached its peak value (392/100,000). The highest ARI incidence rate was recorded in the period from 31st January to 6th February, and remained elevated for the following two weeks. Samples were taken from 793 patients with clinical signs of ILI. The influenza A or B virus was detected in 15.2% of patients. One third of the influenza A cases were of the H1N1 subtype, while the others were H3N2. Enteroviral infection was relatively common in the past season (15.8% of patients). The influenza isolates in Slovenia were similar to those in other European countries and belonged to: A/H3N2/California/7/2004 (A/H3N2/Fujian/441/2002-like viruses), A/H1N1/New Caledonia/20/99 and B/Jiangsu/10/03 (B/Shaghai/361/2002-like viruses). The dominant influenza virus in Europe and the USA was influenza A H3N2. The ARI and/or ILI incidence rates were higher in most European countries (including Slovenia) compared to previous seasons.Broj pacijenata s akutnom dišnom zarazom naglo se povećava nakon što se u populaciji počinje javljati virus influence. Kao posljedica toga javlja se povećana stopa hospitalizacije i mortaliteta. Nekoliko pokazatelja može se rabiti za mjerenje pojave popratnih bolesti vezanih uz influencu: stopa pojavnosti influenci slične bolesti ili akutne dišne bolesti, stopa nespecifičnog i specifičnog mortaliteta, bolovanje ili promatranje povećane potrošnje lijekova. Dva su pokazate-lja mjerena u Sloveniji od 1999.: pojava bolesti slične influenci i stopa pojave akutne dišne bolesti na oko 4% populacije. Lančana reakcija polimerazom uz prethodnu reverznu transkripciju (RT-PCR) bila je rabljena kao pregledna metoda za dokaz virusa influence, respiratornog sincicijskog virusa, adenovirusa i enterovirusa u obriscima nosa i/ili žrijela. Svi pozitivni uzorci bili su zatim nacijepljeni na odgovarajuće stanične linije. RT-PCR je bio upotrijebljen za brzo određivanje hemaglutinina (H1, H3) i neuraminidaze (N1, N2) virusa influence A. Antigenski podtipovi izdvojenih virusa na staničnim kulturama određeni su pomoću testa inhibicije hemaglutinacije te potvrđeni u Europskom referentnom centru za influencu Svjetske zdravstvene organizacije. U sezoni 2004./2005. stopa pojavnosti bolesti slične influenci bila je najveća u 5., 6. i 7. tjednu 2005., kada je dostigla svoj vrhunac (392/100000). Najviša incidencija akutne dišne bolesti ustanovljena je u razdoblju od 31. siječnja do 6. veljače i na toj je razini ostala sljedeća dva tjedna. Uzorci su bili uzeti od 793 bolesnika s kliničkim znakovima bolesti slične influenci. Virus influence A i B bio je dokazan u 15,2% pacijenata. Trećina slučajeva influence bila je uzrokovana podtipom H1N1 dok su ostali bili uzrokovani podtipom H3N2. Enterovirusne infekcije bile su relativno česte u prošloj sezoni (u 15,8% pacijenata). Izolati virusa influence bili su slični onima izdvojenima u drugim europskim zemljama i pripadali su serotipovima A/H3N2/California/7/2004 (A/H3N2/Fujian/441/2002-slični virusi), A/H1N1/New Caledonia/20/99 and B/Jiangsu/10/03 (B/Shanghai/361/2002-slični virusi). Dominantni virus influence u Europi i SAD-u bio je podtip A H3N2. Pojavnost akutne dišne bolesti i/ili influenci slične bolesti bila je veća u usporedbi s prethodnom sezonom u većini europskih zemalja (uključujući i Sloveniju)

The Impact of Socio-Economic Determinants on the Vaccination Rates with Rotavirus and Human Papiloma Virus Vaccine

Socio-economic inequalities may have an impact on the uptake of selfpaid vaccines. The aim of the study was to identify the effect of some socio economic determinants on vaccination rates with self-paid human papilloma virus (HPV) and rotavirus (RV) vaccines