{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,14]],"date-time":"2026-10-14T08:50:04Z","timestamp":1791967804362,"version":"4.3.4"},"reference-count":22,"publisher":"Wiley","issue":"9","license":[{"start":{"date-parts":[[2026,8,31]],"date-time":"2026-08-31T00:00:00Z","timestamp":1788134400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"},{"start":{"date-parts":[[2026,8,31]],"date-time":"2026-08-31T00:00:00Z","timestamp":1788134400000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"funder":[{"DOI":"10.13039\/100000030","name":"Centers for Disease Control and Prevention","doi-asserted-by":"publisher","award":["5NU51IP000934"],"award-info":[{"award-number":["5NU51IP000934"]}],"id":[{"id":"10.13039\/100000030","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Influenza Resp Viruses"],"published-print":{"date-parts":[[2026,9]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>In Kenya, influenza and other respiratory viruses circulate year\u2010round. The Ministry of Health monitors severe acute respiratory infections (SARI), including influenza\u2010associated hospitalizations, through a sentinel surveillance network. We developed intensity thresholds (ITs) to assess seasonal severity based on respiratory illness\u2010 and influenza\u2010associated hospitalizations.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      Nine surveillance sites contributed data from January 2019 through December 2025 (with rolling start dates). Weekly all\u2010cause admissions, respiratory illnesses, and influenza testing in pediatric (0\u201313\u2009years) and adult (\u2265\u200914\u2009years) 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; IT\n                      <jats:sub>50<\/jats:sub>\n                      ), high (IT\n                      <jats:sub>90<\/jats:sub>\n                      ), and very high (IT\n                      <jats:sub>98<\/jats:sub>\n                      ) severity for the percentage of hospitalizations for respiratory illness and influenza, overall and by age group.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      During 2024 and 2025, respiratory illness\u2013associated hospitalizations remained below the IT\n                      <jats:sub>50<\/jats:sub>\n                      for most of the year across age groups, with 1\u20132\u2009weeks above the IT\n                      <jats:sub>50<\/jats:sub>\n                      . Influenza\u2010associated hospitalizations also remained below the annual IT\n                      <jats:sub>50<\/jats:sub>\n                      in both years but exceeded the biannual IT\n                      <jats:sub>50<\/jats:sub>\n                      for several weeks at each wave's peak.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>In 2024 and 2025, respiratory illness\u2013associated and influenza\u2010associated 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.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/irv.70314","type":"journal-article","created":{"date-parts":[[2026,9,1]],"date-time":"2026-09-01T01:34:31Z","timestamp":1788226471000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Establishing a Seasonal Severity Assessment for Respiratory Illness\u2010 and Influenza\u2010Associated Hospitalizations in Kenya, 2019\u20132025"],"prefix":"10.1111","volume":"20","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-9242-3507","authenticated-orcid":false,"given":"Elizabeth B.","family":"White","sequence":"first","affiliation":[{"name":"Influenza Division Centers for Disease Control and Prevention  Atlanta Georgia USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jorim O.","family":"Ayugi","sequence":"additional","affiliation":[{"name":"Centre for Global Health Research Kenya Medical Research Institute  Kisumu Kenya"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nzisa","family":"Liku","sequence":"additional","affiliation":[{"name":"Influenza Division Centers for Disease Control and Prevention  Atlanta Georgia USA"},{"name":"Centers for Disease Control and Prevention  Nairobi Kenya"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0069-1473","authenticated-orcid":false,"given":"Bryan O.","family":"Nyawanda","sequence":"additional","affiliation":[{"name":"Centre for Global Health Research Kenya Medical Research Institute  Kisumu Kenya"},{"name":"Swiss Tropical and Public Health Institute  Allschwil Switzerland"},{"name":"University of Basel  Basel Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0009-2414-9460","authenticated-orcid":false,"given":"Victor","family":"Opere","sequence":"additional","affiliation":[{"name":"Centre for Global Health Research Kenya Medical Research Institute  Kisumu Kenya"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2089-887X","authenticated-orcid":false,"given":"Joel","family":"Machuki","sequence":"additional","affiliation":[{"name":"Henry Jackson Foundation Medical Research International  Dar es Salaam Tanzania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Peter","family":"Muturi","sequence":"additional","affiliation":[{"name":"Henry Jackson Foundation Medical Research International  Dar es Salaam Tanzania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rosalia","family":"Kalani","sequence":"additional","affiliation":[{"name":"Kenya Ministry of Health  Nairobi Kenya"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7083-4735","authenticated-orcid":false,"given":"Nancy A.","family":"Otieno","sequence":"additional","affiliation":[{"name":"Centre for Global Health Research Kenya Medical Research Institute  Kisumu Kenya"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1324-9994","authenticated-orcid":false,"given":"Patrick","family":"Dawson","sequence":"additional","affiliation":[{"name":"Influenza Division Centers for Disease Control and Prevention  Atlanta Georgia USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8742-3687","authenticated-orcid":false,"given":"A. Danielle","family":"Iuliano","sequence":"additional","affiliation":[{"name":"Influenza Division Centers for Disease Control and Prevention  Atlanta Georgia USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gideon O.","family":"Emukule","sequence":"additional","affiliation":[{"name":"Influenza Division Centers for Disease Control and Prevention  Atlanta Georgia USA"},{"name":"Centers for Disease Control and Prevention  Nairobi Kenya"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,8,31]]},"reference":[{"key":"e_1_2_14_2_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(17)33293-2"},{"key":"e_1_2_14_3_1","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0153003"},{"key":"e_1_2_14_4_1","doi-asserted-by":"publisher","DOI":"10.1111\/irv.12393"},{"key":"e_1_2_14_5_1","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0098615"},{"key":"e_1_2_14_6_1","doi-asserted-by":"publisher","DOI":"10.1016\/S2214-109X(23)00109-2"},{"key":"e_1_2_14_7_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1750-2659.2012.00422.x"},{"key":"e_1_2_14_8_1","unstructured":"WHO \u201cPandemic Influenza Severity Assessment (PISA): A WHO Guide to Assess the Severity of Influenza in Seasonal Epidemics and Pandemics Second Edition \u201d Geneva (2024)."},{"key":"e_1_2_14_9_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jiph.2019.05.005"},{"key":"e_1_2_14_10_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12879-020-4827-0"},{"key":"e_1_2_14_11_1","doi-asserted-by":"publisher","DOI":"10.2471\/BLT.18.211508"},{"key":"e_1_2_14_12_1","doi-asserted-by":"publisher","DOI":"10.1017\/S0950268819000542"},{"key":"e_1_2_14_13_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12889-020-09145-y"},{"key":"e_1_2_14_14_1","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0255646"},{"key":"e_1_2_14_15_1","doi-asserted-by":"publisher","DOI":"10.2807\/1560\u20107917.ES.2019.24.12.1800042"},{"key":"e_1_2_14_16_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijid.2021.01.058"},{"key":"e_1_2_14_17_1","doi-asserted-by":"publisher","DOI":"10.1111\/irv.12748"},{"key":"e_1_2_14_18_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijregi.2023.12.005"},{"key":"e_1_2_14_19_1","doi-asserted-by":"publisher","DOI":"10.1111\/irv.12979"},{"key":"e_1_2_14_20_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.vaccine.2018.11.062"},{"key":"e_1_2_14_21_1","unstructured":"World Health Organization \u201cUsing a Hospital Admission Survey to Determine Rates of Influenza\u2010Associated Severe Acute Respiratory Infections \u201d (2019)."},{"key":"e_1_2_14_22_1","unstructured":"G.McBride \u201cA Proposal for Strength\u2010of\u2010Agreement Criteria for Lin's Concordance Correlation Coefficient \u201d NIWA client report: HAM2005\u2013062.45 (2005):307\u2013310."},{"key":"e_1_2_14_23_1","unstructured":"Diseases NIfC \u201cInfluenza Surveillance in South Africa: 2025 \u201d (2025)."}],"container-title":["Influenza and Other Respiratory Viruses"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/irv.70314","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1111\/irv.70314","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/irv.70314","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,10,14]],"date-time":"2026-10-14T08:16:47Z","timestamp":1791965807000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/irv.70314"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,8,31]]},"references-count":22,"journal-issue":{"issue":"9","published-print":{"date-parts":[[2026,9]]}},"alternative-id":["10.1111\/irv.70314"],"URL":"https:\/\/doi.org\/10.1111\/irv.70314","archive":["Portico"],"relation":{},"ISSN":["1750-2640","1750-2659"],"issn-type":[{"value":"1750-2640","type":"print"},{"value":"1750-2659","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,8,31]]},"assertion":[{"value":"2026-04-13","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-08-22","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-08-31","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}],"article-number":"e70314"}}