---
title: "Seasonal Severity Assessment for Influenza- and Respiratory Illness–Associated Hospitalizations in"
id: "pubmed-42674866"
canonical_url: "https://medichelpline.com/clinical-feed/pubmed-42674866"
content_type: "clinical_feed_article"
specialty: "Pharmacology"
source_name: "PubMed / NCBI"
source_url: "https://pubmed.ncbi.nlm.nih.gov/42674866/"
doi: "10.1111/irv.70314"
published_at: "2026-09-01T00:00:00.000Z"
evidence_level: "Journal Article"
license: "CC-BY-NC-4.0 / Informational Use"
---
# Seasonal Severity Assessment for Influenza- and Respiratory Illness–Associated Hospitalizations in
## Provenance & Clinical Metadata
- **Canonical URL:** https://medichelpline.com/clinical-feed/pubmed-42674866
- **Specialty:** [Pharmacology](https://medichelpline.com/clinical-feed/pharmacology.md)
- **Primary Source:** PubMed / NCBI
- **Source URL:** [Original Journal Publication](https://pubmed.ncbi.nlm.nih.gov/42674866/)
- **DOI:** [10.1111/irv.70314](https://doi.org/10.1111%2Firv.70314)
- **Published At:** 2026-09-01T00:00:00.000Z
- **Evidence Rating:** Journal Article
## Executive GIST (TL;DR)
- Kenya experiences year-round circulation of **influenza** and other respiratory viruses; the Ministry of Health uses sentinel surveillance for severe acute respiratory infections (**SARI**). - Authors developed **intensity thresholds (ITs)** to assess seasonal severity of respiratory illness– and influenza-associated hospitalizations using hospital admission and testing data from sentinel sites. - Nine surveillance sites contributed weekly data on all-cause admissions, respiratory illnesses, and influenza testing in pediatric (0–13 years) and adult (≥14 years) wards from January 2019 through December 2025, with rolling start dates and a mix of retrospective and prospective data collection. - Four sites had sufficient historical data to calculate ITs for the 2024 assessment; eight sites were included in the 2025 assessment. - The moving epidemic method was used to calculate annual and biannual ITs for moderate (IT50), high (IT90), and very high (IT98) severity for the percentage of hospitalizations due to **respiratory illness** and **influenza**, overall and by age group. - In both 2024 and 2025, respiratory illness–associated hospitalizations remained below the IT50 for most weeks, with only 1–2 weeks above IT50 across age groups. - Influenza-associated hospitalizations stayed below the annual IT50 in both years but exceeded the biannual IT50 for several weeks at each wave peak. - Authors conclude that severity was low to moderate in 2024–2025; the approach can support public health activities, inform global influenza surveillance, and provide a framework for countries without clear Northern or Southern Hemisphere seasonality. - Specific numerical values for thresholds, site-level data, and detailed limitations were not reported in the abstract.
## Clinical Analysis & Structured Key Points
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Establishing a Seasonal Severity Assessment for Respiratory Illness- and Influenza-Associated Hospitalizations in Kenya, 2019-2025 [Elizabeth B White](https://pubmed.ncbi.nlm.nih.gov/?term=White+EB&cauthor_id=42674866)[ 1 ](https://pubmed.ncbi.nlm.nih.gov/42674866/#full-view-affiliation-1 "Influenza Division, Centers for Disease Control and Prevention, Atlanta, Georgia, USA."), [Jorim O Ayugi](https://pubmed.ncbi.nlm.nih.gov/?term=Ayugi+JO&cauthor_id=42674866)[ 2 ](https://pubmed.ncbi.nlm.nih.gov/42674866/#full-view-affiliation-2 "Centre for Global Health Research, Kenya Medical Research Institute, Kisumu, Kenya."), [Nzisa Liku](https://pubmed.ncbi.nlm.nih.gov/?term=Liku+N&cauthor_id=42674866)[ 1 ](https://pubmed.ncbi.nlm.nih.gov/42674866/#full-view-affiliation-1 "Influenza Division, Centers for Disease Control and Prevention, Atlanta, Georgia, USA.")[ 3 ](https://pubmed.ncbi.nlm.nih.gov/42674866/#full-view-affiliation-3 "Centers for Disease Control and Prevention, Nairobi, Kenya."), [Bryan O Nyawanda](https://pubmed.ncbi.nlm.nih.gov/?term=Nyawanda+BO&cauthor_id=42674866)[ 2 ](https://pubmed.ncbi.nlm.nih.gov/42674866/#full-view-affiliation-2 "Centre for Global Health Research, Kenya Medical Research Institute, Kisumu, Kenya.")[ 4 ](https://pubmed.ncbi.nlm.nih.gov/42674866/#full-view-affiliation-4 "Swiss Tropical and Public Health Institute, Allschwil, Switzerland.")[ 5 ](https://pubmed.ncbi.nlm.nih.gov/42674866/#full-view-affiliation-5 "University of Basel, Basel, Switzerland."), [Victor Opere](https://pubmed.ncbi.nlm.nih.gov/?term=Opere+V&cauthor_id=42674866)[ 2 ](https://pubmed.ncbi.nlm.nih.gov/42674866/#full-view-affiliation-2 "Centre for Global Health Research, Kenya Medical Research Institute, Kisumu, Kenya."), [Joel Machuki](https://pubmed.ncbi.nlm.nih.gov/?term=Machuki+J&cauthor_id=42674866)[ 6 ](https://pubmed.ncbi.nlm.nih.gov/42674866/#full-view-affiliation-6 "Henry Jackson Foundation Medical Research International, Dar es Salaam, Tanzania."), [Peter Muturi](https://pubmed.ncbi.nlm.nih.gov/?term=Muturi+P&cauthor_id=42674866)[ 6 ](https://pubmed.ncbi.nlm.nih.gov/42674866/#full-view-affiliation-6 "Henry Jackson Foundation Medical Research International, Dar es Salaam, Tanzania."), [Rosalia Kalani](https://pubmed.ncbi.nlm.nih.gov/?term=Kalani+R&cauthor_id=42674866)[ 7 ](https://pubmed.ncbi.nlm.nih.gov/42674866/#full-view-affiliation-7 "Kenya Ministry of Health, Nairobi, Kenya."), [Nancy A Otieno](https://pubmed.ncbi.nlm.nih.gov/?term=Otieno+NA&cauthor_id=42674866)[ 2 ](https://pubmed.ncbi.nlm.nih.gov/42674866/#full-view-affiliation-2 "Centre for Global Health Research, Kenya Medical Research Institute, Kisumu, Kenya."), [Patrick Dawson](https://pubmed.ncbi.nlm.nih.gov/?term=Dawson+P&cauthor_id=42674866)[ 1 ](https://pubmed.ncbi.nlm.nih.gov/42674866/#full-view-affiliation-1 "Influenza Division, Centers for Disease Control and Prevention, Atlanta, Georgia, USA."), [A Danielle Iuliano](https://pubmed.ncbi.nlm.nih.gov/?term=Iuliano+AD&cauthor_id=42674866)[ 1 ](https://pubmed.ncbi.nlm.nih.gov/42674866/#full-view-affiliation-1 "Influenza Division, Centers for Disease Control and Prevention, Atlanta, Georgia, USA."), [Gideon O Emukule](https://pubmed.ncbi.nlm.nih.gov/?term=Emukule+GO&cauthor_id=42674866)[ 1 ](https://pubmed.ncbi.nlm.nih.gov/42674866/#full-view-affiliation-1 "Influenza Division, Centers for Disease Control and Prevention, Atlanta, Georgia, USA.")[ 3 ](https://pubmed.ncbi.nlm.nih.gov/42674866/#full-view-affiliation-3 "Centers for Disease Control and Prevention, Nairobi, Kenya.") Affiliations Expand ### Affiliations * 1 Influenza Division, Centers for Disease Control and Prevention, Atlanta, Georgia, USA. * 2 Centre for Global Health Research, Kenya Medical Research Institute, Kisumu, Kenya. * 3 Centers for Disease Control and Prevention, Nairobi, Kenya. * 4 Swiss Tropical and Public Health Institute, Allschwil, Switzerland. * 5 University of Basel, Basel, Switzerland. * 6 Henry Jackson Foundation Medical Research International, Dar es Salaam, Tanzania. * 7 Kenya Ministry of Health, Nairobi, Kenya. * PMID: **42674866** * DOI: [ 10.1111/irv.70314 ](https://doi.org/10.1111/irv.70314) Item in Clipboard # Establishing a Seasonal Severity Assessment for Respiratory Illness- and Influenza-Associated Hospitalizations in Kenya, 2019-2025 Elizabeth B White et al. Influenza Other Respir Viruses. 2026 Sep. Show details Display options Display options Format Abstract PubMed PMID Influenza Other Respir Viruses Actions * [ Search in PubMed ](https://pubmed.ncbi.nlm.nih.gov/?term=%22Influenza+Other+Respir+Viruses%22%5Bjour%5D&sort=date&sort_order=desc) * [ Search in NLM Catalog ](https://www.ncbi.nlm.nih.gov/nlmcatalog?term=%22Influenza+Other+Respir+Viruses%22%5BTitle+Abbreviation%5D) * [ Add to Search ](https://pubmed.ncbi.nlm.nih.gov/42674866/) . 2026 Sep;20(9):e70314. doi: 10.1111/irv.70314. ### Authors [Elizabeth B White](https://pubmed.ncbi.nlm.nih.gov/?term=White+EB&cauthor_id=42674866)[ 1 ](https://pubmed.ncbi.nlm.nih.gov/42674866/#short-view-affiliation-1 "Influenza Division, Centers for Disease Control and Prevention, Atlanta, Georgia, USA."), [Jorim O Ayugi](https://pubmed.ncbi.nlm.nih.gov/?term=Ayugi+JO&cauthor_id=42674866)[ 2 ](https://pubmed.ncbi.nlm.nih.gov/42674866/#short-view-affiliation-2 "Centre for Global Health Research, Kenya Medical Research Institute, Kisumu, Kenya."), [Nzisa Liku](https://pubmed.ncbi.nlm.nih.gov/?term=Liku+N&cauthor_id=42674866)[ 1 ](https://pubmed.ncbi.nlm.nih.gov/42674866/#short-view-affiliation-1 "Influenza Division, Centers for Disease Control and Prevention, Atlanta, Georgia, USA.")[ 3 ](https://pubmed.ncbi.nlm.nih.gov/42674866/#short-view-affiliation-3 "Centers for Disease Control and Prevention, Nairobi, Kenya."), [Bryan O Nyawanda](https://pubmed.ncbi.nlm.nih.gov/?term=Nyawanda+BO&cauthor_id=42674866)[ 2 ](https://pubmed.ncbi.nlm.nih.gov/42674866/#short-view-affiliation-2 "Centre for Global Health Research, Kenya Medical Research Institute, Kisumu, Kenya.")[ 4 ](https://pubmed.ncbi.nlm.nih.gov/42674866/#short-view-affiliation-4 "Swiss Tropical and Public Health Institute, Allschwil, Switzerland.")[ 5 ](https://pubmed.ncbi.nlm.nih.gov/42674866/#short-view-affiliation-5 "University of Basel, Basel, Switzerland."), [Victor Opere](https://pubmed.ncbi.nlm.nih.gov/?term=Opere+V&cauthor_id=42674866)[ 2 ](https://pubmed.ncbi.nlm.nih.gov/42674866/#short-view-affiliation-2 "Centre for Global Health Research, Kenya Medical Research Institute, Kisumu, Kenya."), [Joel Machuki](https://pubmed.ncbi.nlm.nih.gov/?term=Machuki+J&cauthor_id=42674866)[ 6 ](https://pubmed.ncbi.nlm.nih.gov/42674866/#short-view-affiliation-6 "Henry Jackson Foundation Medical Research International, Dar es Salaam, Tanzania."), [Peter Muturi](https://pubmed.ncbi.nlm.nih.gov/?term=Muturi+P&cauthor_id=42674866)[ 6 ](https://pubmed.ncbi.nlm.nih.gov/42674866/#short-view-affiliation-6 "Henry Jackson Foundation Medical Research International, Dar es Salaam, Tanzania."), [Rosalia Kalani](https://pubmed.ncbi.nlm.nih.gov/?term=Kalani+R&cauthor_id=42674866)[ 7 ](https://pubmed.ncbi.nlm.nih.gov/42674866/#short-view-affiliation-7 "Kenya Ministry of Health, Nairobi, Kenya."), [Nancy A Otieno](https://pubmed.ncbi.nlm.nih.gov/?term=Otieno+NA&cauthor_id=42674866)[ 2 ](https://pubmed.ncbi.nlm.nih.gov/42674866/#short-view-affiliation-2 "Centre for Global Health Research, Kenya Medical Research Institute, Kisumu, Kenya."), [Patrick Dawson](https://pubmed.ncbi.nlm.nih.gov/?term=Dawson+P&cauthor_id=42674866)[ 1 ](https://pubmed.ncbi.nlm.nih.gov/42674866/#short-view-affiliation-1 "Influenza Division, Centers for Disease Control and Prevention, Atlanta, Georgia, USA."), [A Danielle Iuliano](https://pubmed.ncbi.nlm.nih.gov/?term=Iuliano+AD&cauthor_id=42674866)[ 1 ](https://pubmed.ncbi.nlm.nih.gov/42674866/#short-view-affiliation-1 "Influenza Division, Centers for Disease Control and Prevention, Atlanta, Georgia, USA."), [Gideon O Emukule](https://pubmed.ncbi.nlm.nih.gov/?term=Emukule+GO&cauthor_id=42674866)[ 1 ](https://pubmed.ncbi.nlm.nih.gov/42674866/#short-view-affiliation-1 "Influenza Division, Centers for Disease Control and Prevention, Atlanta, Georgia, USA.")[ 3 ](https://pubmed.ncbi.nlm.nih.gov/42674866/#short-view-affiliation-3 "Centers for Disease Control and Prevention, Nairobi, Kenya.") ### Affiliations * 1 Influenza Division, Centers for Disease Control and Prevention, Atlanta, Georgia, USA. * 2 Centre for Global Health Research, Kenya Medical Research Institute, Kisumu, Kenya. * 3 Centers for Disease Control and Prevention, Nairobi, Kenya. * 4 Swiss Tropical and Public Health Institute, Allschwil, Switzerland. * 5 University of Basel, Basel, Switzerland. * 6 Henry Jackson Foundation Medical Research International, Dar es Salaam, Tanzania. * 7 Kenya Ministry of Health, Nairobi, Kenya. * PMID: **42674866** * DOI: [ 10.1111/irv.70314 ](https://doi.org/10.1111/irv.70314) Item in Clipboard Cite Display options Display options Format Abstract PubMed PMID ## Abstract **Background:** In Kenya, influenza and other respiratory viruses circulate year-round. The Ministry of Health monitors severe acute respiratory infections (SARI), including influenza-associated hospitalizations, through a sentinel surveillance network. We developed intensity thresholds (ITs) to assess seasonal severity based on respiratory illness- and influenza-associated hospitalizations. **Methods:** Nine surveillance sites contributed data from January 2019 through December 2025 (with rolling start dates). Weekly all-cause admissions, respiratory illnesses, and influenza testing in pediatric (0-13 years) and adult (≥ 14 years) medical wards were collected using retrospective record review (prior to June 2023) and SARI surveillance platform reporting (June 2023 onwards). Four sites had sufficient historical data to calculate ITs for the 2024 assessment; eight sites were included for 2025. We used the moving epidemic method to calculate annual and biannual ITs for moderate (50th percentile; IT50), high (IT90), and very high (IT98) severity for the percentage of hospitalizations for respiratory illness and influenza, overall and by age group. **Results:** During 2024 and 2025, respiratory illness-associated hospitalizations remained below the IT50 for most of the year across age groups, with 1-2 weeks above the IT50. Influenza-associated hospitalizations also remained below the annual IT50 in both years but exceeded the biannual IT50 for several weeks at each wave's peak. **Conclusions:** In 2024 and 2025, respiratory illness-associated and influenza-associated hospitalization severity was low to moderate. This approach can guide public health activities in Kenya, contribute to global influenza surveillance, and provide a framework to assess influenza severity in countries without clear Northern or Southern Hemisphere seasonality. **Keywords:** epidemiology; global health; influenza; respiratory viruses; surveillance. Published 2026. This article is a U.S. Government work and is in the public domain in the United States. Influenza and Other Respiratory Viruses published by John Wiley & Sons Ltd. [PubMed Disclaimer](https://pubmed.ncbi.nlm.nih.gov/disclaimer/) ## References 1. 1. A. D. Iuliano, K. M. Roguski, H. H. Chang, et al., “Estimates of Global Seasonal Influenza‐Associated Respiratory Mortality: A Modelling Study,” Lancet 391, no. 10127 (2018): 1285–1300. 2. 1. S. Hirve, L. P. Newman, J. Paget, et al., “Influenza Seasonality in the Tropics and Subtropics—When to Vaccinate?,” PLoS ONE 11, no. 4 (2016): e0153003. 3. 1. G. O. Emukule, J. A. Mott, P. Spreeuwenberg, et al., “Influenza Activity in Kenya, 2007‐2013: Timing, Association With Climatic Factors, and Implications for Vaccination Campaigns,” Influenza and Other Respiratory Viruses 10, no. 5 (2016): 375–385. 4. 1. M. A. Katz, P. Muthoka, G. O. Emukule, et al., “Results From the First Six Years of National Sentinel Surveillance for Influenza in Kenya, July 2007–June 2013,” PLoS ONE 9, no. 6 (2014): e98615. 5. 1. L. S. Igboh, K. Roguski, P. Marcenac, et al., “Timing of Seasonal Influenza Epidemics for 25 Countries in Africa During 2010–19: A Retrospective Analysis,” Lancet Global Health 11, no. 5 (2010): e729–e739. Show all 22 references ## MeSH terms * Adolescent Actions * [ Search in PubMed ](https://pubmed.ncbi.nlm.nih.gov/?term=%22Adolescent%22%5BMeSH%5D&sort=date&sort_order=desc) * [ Search in MeSH ](https://www.ncbi.nlm.nih.gov/mesh?term=Adolescent) * [ Add to Search ](https://pubmed.ncbi.nlm.nih.gov/42674866/) * Adult Actions * [ Search in PubMed ](https://pubmed.ncbi.nlm.nih.gov/?term=%22Adult%22%5BMeSH%5D&sort=date&sort_order=desc) * [ Search in MeSH ](https://www.ncbi.nlm.nih.gov/mesh?term=Adult) * [ Add to Search ](https://pubmed.ncbi.nlm.nih.gov/42674866/) * Child Actions * [ Search in PubMed ](https://pubmed.ncbi.nlm.nih.gov/?term=%22Child%22%5BMeSH%5D&sort=date&sort_order=desc) * [ Search in MeSH ](https://www.ncbi.nlm.nih.gov/mesh?term=Child) * [ Add to Search ](https://pubmed.ncbi.nlm.nih.gov/42674866/) * Child, Preschool Actions * [ Search in PubMed ](https://pubmed.ncbi.nlm.nih.gov/?term=%22Child%2C+Preschool%22%5BMeSH%5D&sort=date&sort_order=desc) * [ Search in MeSH ](https://www.ncbi.nlm.nih.gov/mesh?term=Child%2C+Preschool) * [ Add to Search ](https://pubmed.ncbi.nlm.nih.gov/42674866/) * Female Actions * [ Search in PubMed ](https://pubmed.ncbi.nlm.nih.gov/?term=%22Female%22%5BMeSH%5D&sort=date&sort_order=desc) * [ Search in MeSH ](https://www.ncbi.nlm.nih.gov/mesh?term=Female) * [ Add to Search ](https://pubmed.ncbi.nlm.nih.gov/42674866/) * Hospitalization* / statistics & numerical data Actions * [ Search in PubMed ](https://pubmed.ncbi.nlm.nih.gov/?term=%22Hospitalization%2Fstatistics+and+numerical+data%22%5BMAJR%5D&sort=date&sort_order=desc) * [ Search in MeSH ](https
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