title: Epidemiology, Seasonality and Treatment of Hospitalized Adults and Adolescents with Influenza in Jingzhou, China, 2010-2012.
abstract: BACKGROUND
  After the 2009 influenza A (H1N1) pandemic, we conducted hospital-based severe acute respiratory infection (SARI) surveillance in one central Chinese city to assess disease burden attributable to influenza among adults and adolescents.
  
  
  METHODS
  We defined an adult SARI case as a hospitalized patient aged ≥ 15 years with temperature ≥38.0°C and at least one of the following: cough, sore throat, tachypnea, difficulty breathing, abnormal breath sounds on auscultation, sputum production, hemoptysis, chest pain, or chest radiograph consistent with pneumonia. For each enrolled SARI case-patient, we completed a standardized case report form, and collected a nasopharyngeal swab within 24 hours of admission. Specimens were tested for influenza viruses by real-time reverse transcription polymerase chain reaction (rRT-PCR). We analyzed data from adult SARI cases in four hospitals in Jingzhou, China from April 2010 to April 2012.
  
  
  RESULTS
  Of 1,790 adult SARI patients enrolled, 40% were aged ≥ 65 years old. The median duration of hospitalization was 9 days. Nearly all were prescribed antibiotics during their hospitalization, less than 1% were prescribed oseltamivir, and 28% were prescribed corticosteroids. Only 0.1% reported receiving influenza vaccination in the past year. Of 1,704 samples tested, 16% were positive for influenza. Influenza activity in all age groups showed winter-spring and summer peaks. Influenza-positive patients had a longer duration from illness onset to hospitalization and a shorter duration from hospital admission to discharge or death compared to influenza negative SARI patients.
  
  
  CONCLUSIONS
  There is substantial burden of influenza-associated SARI hospitalizations in Jingzhou, China, especially among older adults. More effective promotion of annual seasonal influenza vaccination and timely oseltamivir treatment among high risk groups may improve influenza prevention and control in China.
authors.affiliation: Division of Infectious Disease, Key Laboratory of Surveillance and Early-warning on Infectious Disease, Chinese Center for Disease Control and Prevention, Beijing, China.
authors.forename: Jiandong
authors.initials: J
authors.lastname: Zheng
authors.affiliation: Hubei Provincial Centre for Disease Control and Prevention, Wuhan, China.
authors.forename: Xixiang
authors.initials: X
authors.lastname: Huo
authors.affiliation: China-US Collaborative Program on Emerging and Re-emerging Infection Disease, Center for Global Health, Centers for Disease Control and Prevention, Beijing, China.
authors.forename: Yang
authors.initials: Y
authors.lastname: Huai
authors.affiliation: Jingzhou Center for Disease Control and Prevention, Jingzhou, China.
authors.forename: Lin
authors.initials: L
authors.lastname: Xiao
authors.affiliation: Division of Infectious Disease, Key Laboratory of Surveillance and Early-warning on Infectious Disease, Chinese Center for Disease Control and Prevention, Beijing, China.
authors.forename: Hui
authors.initials: H
authors.lastname: Jiang
authors.affiliation: China-US Collaborative Program on Emerging and Re-emerging Infection Disease, Center for Global Health, Centers for Disease Control and Prevention, Beijing, China.|Global Disease Detection Branch, Division of Global Health Protection, Center for Global Health, Centers for Disease Control and Prevention, Atlanta, United States of America.
authors.forename: John
authors.initials: J
authors.lastname: Klena
authors.affiliation: China-US Collaborative Program on Emerging and Re-emerging Infection Disease, Center for Global Health, Centers for Disease Control and Prevention, Beijing, China.|Influenza Division, U.S. Centers for Disease Control and Prevention, Atlanta, United States of America.
authors.forename: Carolyn M
authors.initials: CM
authors.lastname: Greene
authors.affiliation: Hubei Provincial Centre for Disease Control and Prevention, Wuhan, China.
authors.forename: Xuesen
authors.initials: X
authors.lastname: Xing
authors.affiliation: Jingzhou Center for Disease Control and Prevention, Jingzhou, China.
authors.forename: Jigui
authors.initials: J
authors.lastname: Huang
authors.affiliation: Jingzhou Central Hospital, Jingzhou, China.
authors.forename: Shali
authors.initials: S
authors.lastname: Liu
authors.affiliation: Jingzhou First People's Hospital, Jingzhou, China.
authors.forename: Youxing
authors.initials: Y
authors.lastname: Peng
authors.affiliation: Jingzhou Second People's Hospital, Jingzhou, China.
authors.forename: Hui
authors.initials: H
authors.lastname: Yang
authors.affiliation: Jingzhou Maternal and Children's Hospital, Jingzhou, China.
authors.forename: Jun
authors.initials: J
authors.lastname: Luo
authors.affiliation: Division of Infectious Disease, Key Laboratory of Surveillance and Early-warning on Infectious Disease, Chinese Center for Disease Control and Prevention, Beijing, China.
authors.forename: Zhibin
authors.initials: Z
authors.lastname: Peng
authors.affiliation: Hubei Provincial Centre for Disease Control and Prevention, Wuhan, China.
authors.forename: Linlin
authors.initials: L
authors.lastname: Liu
authors.affiliation: Jingzhou Center for Disease Control and Prevention, Jingzhou, China.
authors.forename: Maoyi
authors.initials: M
authors.lastname: Chen
authors.affiliation: Hubei Provincial Centre for Disease Control and Prevention, Wuhan, China.
authors.forename: Hui
authors.initials: H
authors.lastname: Chen
authors.affiliation: China-US Collaborative Program on Emerging and Re-emerging Infection Disease, Center for Global Health, Centers for Disease Control and Prevention, Beijing, China.
authors.forename: Yuzhi
authors.initials: Y
authors.lastname: Zhang
authors.affiliation: Hubei Provincial Centre for Disease Control and Prevention, Wuhan, China.
authors.forename: Danqin
authors.initials: D
authors.lastname: Huang
authors.affiliation: Hubei Provincial Centre for Disease Control and Prevention, Wuhan, China.
authors.forename: Xuhua
authors.initials: X
authors.lastname: Guan
authors.affiliation: Division of Infectious Disease, Key Laboratory of Surveillance and Early-warning on Infectious Disease, Chinese Center for Disease Control and Prevention, Beijing, China.
authors.forename: Luzhao
authors.initials: L
authors.lastname: Feng
authors.affiliation: Hubei Provincial Centre for Disease Control and Prevention, Wuhan, China.
authors.forename: Faxian
authors.initials: F
authors.lastname: Zhan
authors.affiliation: China-US Collaborative Program on Emerging and Re-emerging Infection Disease, Center for Global Health, Centers for Disease Control and Prevention, Beijing, China.|Global Disease Detection Branch, Division of Global Health Protection, Center for Global Health, Centers for Disease Control and Prevention, Atlanta, United States of America.|Vaccine Research Program, Division of AIDS, NIAID/NIH, Bethesda, United States of America.
authors.forename: Dale J
authors.initials: DJ
authors.lastname: Hu
authors.affiliation: China-US Collaborative Program on Emerging and Re-emerging Infection Disease, Center for Global Health, Centers for Disease Control and Prevention, Beijing, China.|Global Disease Detection Branch, Division of Global Health Protection, Center for Global Health, Centers for Disease Control and Prevention, Atlanta, United States of America.
authors.forename: Jay K
authors.initials: JK
authors.lastname: Varma
authors.affiliation: Division of Infectious Disease, Key Laboratory of Surveillance and Early-warning on Infectious Disease, Chinese Center for Disease Control and Prevention, Beijing, China.
authors.forename: Hongjie
authors.initials: H
authors.lastname: Yu
mesh_terms: D000208:Acute Disease; D000293:Adolescent; D000328:Adult; D000368:Aged; D002681:China / Q000453:epidemiology; D005260:Female; D006760:Hospitalization; D006801:Humans; D007251:Influenza, Human / Q000453:epidemiology*; D008297:Male; D008875:Middle Aged; D012621:Seasons; D055815:Young Adult