Australia’s active hospital-based surveillance for severe childhood disease

 

Principal investigator 

Associate Professor Christopher Blyth 

Influenza is the most common vaccine preventable disease and a common cause of hospitalisation for children. PAEDS has been conducting surveillance for hospitalised influenza, in collaboration with the inFluenza Complications Alert Network (FluCAN), led by Professor Allen Cheng. Two sites (The Children’s Hospital at Westmead and Perth Children’s Hospital) joined FluCAN in 2014 and additional PAEDS sites joined the network in 2017, with the assistance of NHMRC partnership grant.

This research has demonstrated the previously unrecognised burden of influenza in paediatric hospitals, explored risk factors for severe disease, evaluated antiviral and vaccine use and estimated vaccine effectiveness on an annual basis (Blyth et al, Eurosurveillance 2016; Blyth et al, Clinical Infectious Diseases 2019). Young children (<5 years), Aboriginal and Torres Strait Islander children and children with underlying medical conditions remain at significantly increased risk of hospitalised influenza. One in ten children admitted to hospital with influenza are admitted to the intensive care unit. Although most hospitalisations are short (less than 3 days), many children have prolonged hospitalisation. Although uncommon, influenza-associated deaths continue to occur.

Despite significant variation between years, vaccination is the most effective prevention strategy we have. PAEDS-FluCAN has demonstrated vaccine effectiveness in young children and children with comorbidities. In addition, the effectiveness of vaccinating pregnant women to prevent infant disease has been demonstrated. Vaccine effectiveness estimates are provided to the national influenza committee to inform strain choice for future annual vaccines. PAEDS-FluCAN has led an advocacy campaign to highlight the need for vaccination in children. Vaccine coverage has increased significantly in recent years, in both children and pregnant women, with the Commonwealth and state governments now providing free influenza vaccination for all children 6 months to 5 years; all children 6 months and older with underlying medical conditions; all Aboriginal and Torres Strait Islander children from 6 months of age; and pregnant women.