Headlines - Brief Regional Summary of Surveillance of Severe Influenza Cases Admitted to Intensive Care, 2013–14

Surveillance of severe influenza cases admitted to intensive care was conducted again between weeks 45/2013 (November 4–10) and 15/2014 (April 7–13), for the fifth consecutive year, with regional coordination by the InVS Regional Units (Cire). During this period, 32 severe influenza cases were reported: 23 in Burgundy and 9 in Franche-Comté (representing nearly 5% of cases reported in France). Patients were admitted between December 13, 2013, and April 13, 2014. The peak in admissions occurred between March 3 and 9, with a total of 5 patients (Figure). No cases were reported in Jura, Territoire-de-Belfort, or by one of the three departments in Doubs. Men were in the majority (male-to-female ratio of 1.1 in Burgundy and 2.0 in Franche-Comté). Ages ranged from 12 days to 80 years. Except for the infant, there were no cases under the age of 14. The average age of cases in Burgundy was 55 years, and that in Franche-Comté was 65 years. In total, 27 cases were infected with an influenza A virus (11 A(H1N1)pdm09, 3 A(H3N2), 13 un-subtyped A viruses), 1 with a type B virus, and 4 were unconfirmed. Among the 22 cases with known vaccination status, 4 had received an influenza vaccine (18.2%). The majority of cases (n=27) had at least one risk factor targeted by vaccination (number of factors ranging from 1 to 3 in Burgundy; from 1 to 6 in Franche-Comté). The most common risk factors were: being 65 years of age or older (n=12), having a pulmonary condition (n=10), having a cardiac condition (n=9), and being obese (n=8). The mean Body Mass Index (BMI) of patients with obesity was 34 kg/m² (min-max: 30.4–38.5 kg/m²; 1 missing BMI but estimated to be greater than 35 kg/m²).Nearly three-quarters of the cases (71.9%) presented with acute respiratory distress syndrome. All cases received ventilation, including 3 cases of extracorporeal membrane oxygenation. In total, 6 patients died (including 4 in Burgundy), representing a case fatality rate of 18.8%.