Influenza-associated respiratory illness among five cohorts of pregnant women and their young infants (0-6 months), Bangladesh, 2013-2017

Influenza Other Respir Viruses. 2023 Aug 13;17(8):e13175. doi: 10.1111/irv.13175. eCollection 2023 Aug.

Abstract

Background: Pregnant women with their infants are considered at higher risk for influenza-associated complications, and the World Health Organization (WHO) recommends influenza vaccination during pregnancy to protect them, including their infants (0-6 months). There are limited data on the influenza burden among pregnant women and their infants (0-6 months), and there are no routine influenza vaccinations in Bangladesh.

Methods: Five annual cohorts (2013-2017) of pregnant women were enrolled from the eight sub-districts of Bangladesh before the influenza season (May-September); they were contacted weekly to identify new onset of influenza-like illness (ILI) (subjective or measured fever and cough) and acute respiratory illness (ARI) (at least two of these symptoms: cough, rhinorrhea, or difficulty in breathing) among their infants from birth to 6 months of age. We collected nasopharyngeal swabs from ILI and ARI cases, tested by real-time reverse transcription polymerase chain reaction (rRT-PCR) for influenza virus (including types and subtypes) and estimated influenza incidence (95% CI)/10000 pregnant women-months or infant-months, respectively.

Results: We enrolled 9020 pregnant women, followed for 26,709 pregnancy-months, and detected 1241 ILI episodes. We also followed 8963 infants for 51,518 infant-months and identified 5116 ARI episodes. Influenza positivity was 23% for ILI and 3% for ARI cases. The overall incidence (2013-2017) of influenza among pregnant women was 158.5/10000 pregnant women-months (95% CI: 141.4-177.6) and that among infants was 21.9/10000 infant-months (95% CI: 18.2-26.5).

Conclusions: Although the data was collected more than 5 years ago, as the only baseline data, our findings illustrate evidence of influenza burden among pregnant women and infants (0-6 months), which may support preventive policy decisions in Bangladesh.

Keywords: 0–6 months infant influenza; LMP; maternal influenza; portable ultrasound; pregnancy.

Publication types

  • Research Support, U.S. Gov't, P.H.S.
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Bangladesh / epidemiology
  • Cough
  • Female
  • Humans
  • Infant
  • Influenza Vaccines*
  • Influenza, Human* / complications
  • Influenza, Human* / epidemiology
  • Influenza, Human* / prevention & control
  • Pregnancy
  • Pregnancy Complications, Infectious* / epidemiology
  • Pregnancy Complications, Infectious* / prevention & control
  • Pregnant Women
  • Real-Time Polymerase Chain Reaction
  • Virus Diseases*

Substances

  • Influenza Vaccines