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Published on 29.03.18 in Vol 4, No 1 (2018): EMPHNET Sixth Regional Conference

Preprints (earlier versions) of this paper are available at, first published Mar 29, 2018.

This paper is in the following e-collection/theme issue:


    Epidemiological Characteristics of Severe Acute Respiratory Illness Cases in Sentinel sites - Egypt, 2009-2017

    Corresponding Author:

    Basma AbdElGawad


    Background: Severe acute respiratory illness (SARI) is recognized as a leading cause of morbidity and mortality. SARI tends to be rapidly progressive illness caused by pathogens like influenza, which have pandemic potential. Egypt established SARI sentinel surveillance sites since 2007 in eight representative sites.

    Objective: Describe epidemiology of SARI, identify influenza positivity and circulating influenza subtypes among SARI patients.

    Methods: Patients who met standard WHO- SARI case definition (fever =38c + cough without any other cause in the last 10 days in a hospitalized patient) from 2009 to mid-2017, were enrolled. Epidemiological data were collected using standardized investigation form. Nasopharyngeal/ oropharyngeal swabs, for all patients, were tested for influenza viruses by reverse transcription polymerase chain reaction (RT-PCR). Data were extracted and analyzed by MS excel 2013.

    Results: From January 2009 to July2017, 22419 SARI patients were enrolled. The most affected age group was below five years with “5490(24.5%) of 22419”. Median hospital stay was 5 days (IQR=3-7). During hospitalization, “159(0.7%) of 22419” were ICU admitted, out of them “65 (41%) of159” were ventilated. Of all SARI admissions, 18.3% (CI: 17.8-18.8) were positive for influenza viruses, 37.9% (CI: 36.4-39.4) were FluA/H1N1 Pdm09, 30.3% (CI: 28.9-31.7) were Flu B, 23.8% (CI: 22.5-25.1) were FluA/H3N2 and 7%(CI:6.3-7.8) were mixed influenza infections. Out of influenza-positive patients, fatalities were significantly higher (P<0.001) in pregnant women and those with preexisting chronic diseases, “41(5%) of 890” and “7(4.4%) of 158” respectively. Vaccination coverage was “13 (0.3%) of 4056” among influenza patients with zero fatality.

    Conclusions: Influenza viruses are frequent cause of SARI admissions, so developing strategies to control Influenza is a key stone to reduce SARI. Improving influenza vaccination coverage for risk groups will prevent some SARI cases who are associated with fatal outcome.

    iproc 2018;4(1):e10598


    Edited by Y Khader; This is a non–peer-reviewed article. submitted 29.03.18; accepted 29.03.18; published 29.03.18

    ©Basma AbdElGawad, M Fahim, A Naguib, S El Shourbagy, H Abu El Sood, S Refaey. Originally published in Iproceedings (, 29.03.2018.

    This is an open-access article distributed under the terms of the Creative Commons Attribution License (, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work, first published in Iproceedings, is properly cited. The complete bibliographic information, a link to the original publication on, as well as this copyright and license information must be included.