2496. A Comparative Evaluation of the Burden of Disease Caused by Influenza A and Influenza B During the 2011–2012, 2012–2013, and 2013–2014 Influenza Seasons in Canada

Abstract

BackgroundWhen assessing burden of influenza disease, influenza B has typically been associated with infection in children and young adults, and is considered less prevalent and/or severe in older adults. We sought to assess the burden of influenza type A disease compared with influenza type B disease in Canadian adults admitted to hospital with laboratory-confirmed influenza.MethodsThe Serious Outcomes Surveillance (SOS) Network of the Canadian Immunization Research Network (CIRN) conducted active surveillance for laboratory-confirmed influenza in adults (≥16 years) hospitalized across Canada during the 2011–2014 influenza seasons. Eligible patients who were admitted to hospital with any acute respiratory illness or symptom had a nasopharyngeal swab collected and tested for influenza virus using reverse transcriptase polymerase chain reaction (PCR). Demographic/clinical information, as well as in-hospital outcomes were collected. Frailty Index scores were also recorded at baseline and 30-days after discharge, when possible, in patients ≥65 years. Patients with influenza A and B were compared using descriptive statistics; discrete outcomes were compared using Chi-squared (χ2) tests; continuous outcomes were compared using student’s t-tests.ResultsOverall, there were 3484 influenza A cases and 1375 influenza B cases enrolled in the SOS Network from 2011 to 2014. Mean age was significantly different between influenza A and influenza B cases (mean age of influenza A: 65.8, mean age of influenza B: 71.2, P < 0.01). A significantly larger proportion of influenza B patients were admitted from long-term care (A: 5.5%, B: 12.1%, P < 0.01). There was no significant difference with respect to length of hospitalization (influenza A: 11.1 days, influenza B: 10.27 days, P = 0.07) or mortality (A: 9.01%, B: 9.45%, P = 0.63) between influenza A and B. Patients with influenza B were significantly more frail prior to the onset of illness (A: 0.21, B: 0.22, P < 0.01).ConclusionCurrent attitudes consider influenza A to be the more significant virus in terms of morbidity and mortality in adults. However, influenza B is responsible for similar duration of hospitalization and similar mortality rates. In addition, influenza B predominantly affected the frail elderly and thus optimizing influenza B protection is important in this population.Disclosures M. K. Andrew, GSK: Grant Investigator, Research grant. Pfizer: Grant Investigator, Research grant. Sanofi Pasteur: Grant Investigator, Research grant. T. F. Hatchette, GSK: Grant Investigator, Research grant. Pfizer: Grant Investigator, Research grant. Abbvie: Consultant, Speaker honorarium. S. A. McNeil, GSK: Grant Investigator, Research grant. Pfizer: Grant Investigator, Research grant. Merck: Collaborator and Consultant, Contract clinical trials and Speaker honorarium. Novartis: Collaborator, Contract clinical trials. Sanofi Pasteur: Collaborator, Contract clinical trials.