title: Oculo-respiratory syndrome after influenza vaccination: trends over four influenza seasons.
abstract: BACKGROUND
  Oculo-respiratory syndrome (ORS) following influenza vaccination was identified in Canada in 2000. This report describes trends of ORS reported during four consecutive seasons 2000, 2001, 2002 and 2003 in the province of Quebec, Canada.
  
  
  METHODS
  Data come from the vaccine-associated adverse event (VAAE) passive reporting system of the Province of Quebec.
  
  
  RESULTS
  The rate of ORS reported per 100000 doses distributed declined from 46.6 in 2000 to 34.2, 20.6 and 9 in 2001, 2002 and 2003, respectively. There was no significant difference in rates for ORS between the two vaccines in use in Canada (Fluviral and Vaxigrip) both in 2001 and 2002. During the 4 years, incidence was highest in people aged 40-59 years and declined in older age groups. The clinical profile of ORS has remained remarkably stable over years. Overall, ocular, respiratory symptoms or facial edema were reported by 58%, 84% and 31% of patients, respectively, and 15% had symptoms including all three symptom categories. ORS lasted more than a week in 8-13% of the cases.
  
  
  CONCLUSIONS
  ORS is an adverse event that occurred with both influenza vaccines used in Canada. Its frequency has declined substantially but is still present after 4 years. It constitutes a clinical entity distinct from anaphylactic allergy. Unlike anaphylaxis, ORS does not constitute an absolute contraindication to further doses.
authors.affiliation: Institut National de Santé Publique du Québec, Canada. gaston.deserres@ssss.gouv.qc.ca
authors.forename: Gaston
authors.initials: G
authors.lastname: De Serres
authors.forename: Eveline
authors.initials: E
authors.lastname: Toth
authors.forename: Suzanne
authors.initials: S
authors.lastname: Ménard
authors.forename: Jean Luc
authors.initials: JL
authors.lastname: Grenier
authors.forename: Renée
authors.initials: R
authors.lastname: Roussel
authors.forename: Michèle
authors.initials: M
authors.lastname: Tremblay
authors.forename: Monique
authors.initials: M
authors.lastname: Landry
authors.forename: Yves
authors.initials: Y
authors.lastname: Robert
authors.forename: Louis
authors.initials: L
authors.lastname: Rochette
authors.forename: Danuta M
authors.initials: DM
authors.lastname: Skowronski
mesh_terms: D000293:Adolescent; D000328:Adult; D000367:Age Factors; D002170:Canada / Q000453:epidemiology; D002648:Child; D002675:Child, Preschool; D005128:Eye Diseases / Q000453:epidemiology / Q000209:etiology*; D005260:Female; D006801:Humans; D015994:Incidence; D007223:Infant; D007231:Infant, Newborn; D007252:Influenza Vaccines / Q000008:administration & dosage / Q000009:adverse effects*; D008297:Male; D008875:Middle Aged; D012140:Respiratory Tract Diseases / Q000453:epidemiology / Q000209:etiology*
chemical_list: D007252:Influenza Vaccines