Marit de Lange

• MSc
• Infectious disease epidemiologist at National Institute for Public Health and the Environment

Importance In the context of emerging SARS-CoV-2 variants or lineages and new vaccines, it is key to accurately monitor COVID-19 vaccine effectiveness (CVE) to inform vaccination campaigns. Objective To estimate the effectiveness of COVID-19 vaccines administered in autumn and winter 2022 to 2023 against symptomatic SARS-CoV-2 infection (with all...

Background Scarce European data in early 2021 suggested lower vaccine effectiveness (VE) against SARS-CoV-2 Omicron lineages than previous variants. Aim We aimed to estimate primary series (PS) and first booster VE against symptomatic BA.1/BA.2 infection and investigate potential biases. Methods This European test-negative multicentre study teste...

Background: Despite the known relatively high disease burden of influenza, data are lacking regarding a critical epidemiological indicator, the case-fatality ratio. Our objective was to infer age-group and influenza (sub)type specific values by combining modelled estimates of symptomatic incidence and influenza-attributable mortality. Methods: T...

Background: Children play a key role in the transmission of many infectious diseases. They have many of their close social encounters at home or at school. We hypothesized that most of the transmission of respiratory infections among children occur in these two settings and that transmission patterns can be predicted by a bipartite network of scho...

Background. Despite the known relatively high disease burden of influenza, data are lacking regarding a critical epidemiological indicator, the case-fatality ratio. Our objective was to infer age-group and influenza (sub)type specific values by combining modelled estimates of symptomatic incidence and influenza-attributable mortality. Methods. The...

The impact of COVID-19 on population health is recognised as being substantial, yet few studies have attempted to quantify to what extent infection causes mild or moderate symptoms only, requires hospital and/or ICU admission, results in prolonged and chronic illness, or leads to premature death. We aimed to quantify the total disease burden of acu...

IntroductionIn July and August 2021, the SARS-CoV-2 Delta variant dominated in Europe.AimUsing a multicentre test-negative study, we measured COVID-19 vaccine effectiveness (VE) against symptomatic infection.Methods Individuals with COVID-19 or acute respiratory symptoms at primary care/community level in 10 European countries were tested for SARS-...

Influenza-like illness (ILI) can be caused by a range of respiratory viruses. The present study investigates the contribution of influenza and other respiratory viruses, the occurrence of viral co-infections, and the persistence of the viruses after ILI onset in older adults. During the influenza season 2014–2015, 2366 generally healthy community-d...

IntroductionIn July and August 2021, the SARS-CoV-2 Delta variant dominated in Europe. We measured COVID-19 vaccine effectiveness (VE) against symptomatic infection, using a multicentre test-negative study at primary care/community level in Europe.Methods Patients presenting with COVID-19/ARI symptoms at primary care/community level in 10 countries...

We measured COVID-19 vaccine effectiveness (VE) against symptomatic SARS-CoV-2 infection at primary care/outpatient level among adults ≥ 65 years old using a multicentre test-negative design in eight European countries. We included 592 SARS-CoV-2 cases and 4,372 test-negative controls in the main analysis. The VE was 62% (95% CI: 45–74) for one dos...

Background Claims of influenza vaccination increasing COVID‐19 risk are circulating. Within the I‐MOVE‐COVID‐19 primary care multicentre study, we measured the association between 2019‐20 influenza vaccination and COVID‐19. Methods We conducted a multicentre test‐negative case‐control study at primary care level, in study sites in five European co...

Since the 2009 influenza pandemic, the Netherlands has used a weekly death monitoring system to estimate deaths in excess of expectations. We present estimates of excess deaths during the ongoing coronavirus disease (COVID-19) epidemic and 10 previous influenza epidemics. Excess deaths per influenza epidemic averaged 4,000. The estimated 9,554 exce...

Background Claims of influenza vaccination increasing COVID-19 risk are circulating. Within the I-MOVE-COVID-19 primary care multicentre study, we measured the association between 2019–20 influenza vaccination and COVID-19. Methods We conducted a multicentre test-negative case-control study at primary care level, in study sites in five European cou...

Background From 2007 through 2010, a large epidemic of acute Q fever occurred in the Netherlands. Patients with cardiac valvulopathy are at high risk to develop chronic Q fever after an acute infection. This patient group was not routinely screened, so it is unknown whether all their chronic infections were diagnosed. This study aims to investigate...

From 2007 to 2010, the largest reported Q-fever epidemic occurred in the Netherlands with 4026 notified laboratory-confirmed cases. During the course of the epidemic, health-seeking behaviour changed and awareness among health professionals increased. Changes in laboratory workflows were implemented. The aim of this study was to analyse how these c...

The influenza epidemic of 2017/2018 started in week 50 of 2017 and lasted 18 weeks. The epidemic had a peak incidence in week 10 of 2018 of 17 persons with influenza-like illness (ILI) per 10.000 inhabitants and ILI incidence near this maximum from weak 4 until week 9. Influenza B-viruses of the Yamagata lineage were responsible for most influenza...

Objectives: The weekly monitoring of European all-cause excess mortality, the EuroMOMO network, observed a high excess mortality in participating countries during the 2017/18 winter season, especially among elderly; elevated levels of hospitalisations were also observed. This was unexpected as the dominating influenza virus was type B, commonly con...

Due to differences in the circulation of influenza viruses, distribution and antigenic drift of A subtypes and B lineages, and susceptibility to infection in the population, the incidence of symptomatic influenza infection can vary widely between seasons and age-groups. Our goal was to estimate the symptomatic infection incidence in the Netherlands...

Objective Weekly numbers of deaths are monitored to increase the capacity to deal with both expected and unusual (disease) events such as pandemic influenza, other infections and non-infectious incidents. The monitoring information can potentially be used to detect, track and estimate the impact of an outbreak or incident on all-cause mortality.Int...

Background: An association between Coxiella burnetii and non-Hodgkin lymphoma has been suggested. After a large Q fever epidemic in the Netherlands (2007-10), we postulated that the incidence of non-Hodgkin lymphoma would be increased during and after the epidemic in areas with a high endemicity of Q fever compared with those with low endemicity....

Background Results of previous influenza vaccination effects on current season influenza vaccine effectiveness (VE) are inconsistent. Objectives To explore previous influenza vaccination effects on current season VE among population targeted for vaccination. Methods We used 2011/12 to 2016/17 I‐MOVE primary care multicentre test‐negative data. Fo...

Background: Echocardiographic screening of acute Q-fever patients and antibiotic prophylaxis for patients with cardiac valvulopathy are considered an important approach to prevent chronic Q-fever-related endocarditis. During a large Q-fever epidemic in the Netherlands, routine screening echocardiography was discontinued, raising controversy in the...

Background: Data on the relative contribution of influenza virus and other respiratory pathogens to respiratory infections in community-dwelling older adults (≥60 years) are needed. Methods: A prospective observational cohort study was performed in the Netherlands during 2 winters. Nasopharyngeal and oropharyngeal swabs were collected during inf...

Doel Het onderzoeken van de relatie tussen de circulerende influenza A-virustypes en influenza B-lijnen, de ‘match’ hiervan met het vaccin en de effectiviteit van het influenzavaccin (‘influenza vaccine effectiveness’, IVE). Opzet Test-negatief patiënt-controleonderzoek. Methode We maakten gebruik van gegevens van de peilstations van NIVEL Zorgr...

Objective Weekly numbers of deaths are monitored to increase the capacityto deal with both expected and unusual (disease) events such aspandemic influenza, other infections and non-infectious incidents.The monitoring information can potentially be used to detect, trackand estimate the impact of an outbreak or incident on all-causemortality.Introduc...

Serious infections in humans with avian influenza virus A(H5N1) were first documented twenty years ago. Worldwide, the number of avian influenza virus A(H7N9) infections, first detected in 2013 in China, has now surpassed the number of H5N1 infections. In The Netherlands, the last human patients with avian influenza infection were in 2003, with the...

Influenza vaccine effectiveness (IVE) varies over different influenza seasons and virus (sub)types/lineages. To assess the association between IVE and circulating influenza virus (sub)types/lineages, we estimated the overall and (sub)type specific IVE in the Netherlands. We conducted a test-negative case control study among subjects with influenza-...

Objective: To investigate the relationship between circulating influenza virus A types and subtypes and influenza B lineages, their match with the vaccine and the effectiveness of the influenza vaccine (IVE). Design: Test negative case control study. Method: We used data from the Dutch Sentinel Practices of the Netherlands Institute for Health...

The influenza epidemic in the 2015/2016 season in the Netherlands lasted for 11 weeks. The antigenically unchanged A(H1N1)pdm09-viruses prevailed. Also influenza B viruses from the phylogenetic lineage B/Victoria/2/87 were frequently detected. These were shown to differ antigenically from viruses of this lineage circulating since the 2013/2014 seas...

We aimed to examine the long-term correlation between influenza vaccination coverage and the incidence of influenza-like illness (ILI) in the total and elderly populations of European countries for which data was available on at least six consecutive influenza seasons. We graphically visualised vaccination coverage and ILI incidence trends and calc...

Background: During the 2009/2010 season, information on adverse events after administration of seasonal and pandemic influenza vaccines was collected by different active surveys in the Netherlands. In the present paper, we compared data from a paper-based questionnaire with data from a web-based questionnaire with respect to outcomes and target po...

Lasting a total of 21 weeks, the influenza epidemic in the Netherlands in the winter of 2014/2015 had the longest duration since more than 40 years.The high number of influenza cases has probably led to more pneumonia cases, which is a known complication of influenza, and to higher mortality. During the epidemic period, more than 65,000 persons die...

Objective Whether areas affected by Q fever during a large outbreak (2008–2010) had higher rates of adverse pregnancy outcomes than areas not affected by Q fever. Design Nationwide registry-based ecological study. Setting Pregnant women in areas affected and not affected by Q fever in the Netherlands, 2003–2004 and 2008–2010. Participants Index gro...

Since December 2014 and up to February 2015, the weekly number of excess deaths from all-causes among individuals ≥ 65 years of age in 14 European countries have been significantly higher than in the four previous winter seasons. The rise in unspecified excess mortality coincides with increased proportion of influenza detection in the European infl...

The influenza season 2014/15 started in Europe in week 50 2014 with influenza A(H3N2) viruses predominating. The majority of the A(H3N2) viruses characterised antigenically and/or genetically differ from the northern hemisphere vaccine component which may result in reduced vaccine effectiveness for the season. We therefore anticipate that this seas...

Samenvatting Er was weinig influenza in het seizoen 2013/2014. De incidentie van influenza-achtige ziektebeelden (IAZ) fluctueerde tussen week 2 en 16 rond de epidemische drempel, die in drie korte perioden werd overschreden, met een piekwaarde in week 7 van 8,6 IAZ per 10.000 inwoners. Type A was dominant, waarbij A(H3N2)-virussen overheersten. Bi...

Coxiella burnetii seroprevalence was assessed on Dutch dairy and non-dairy sheep farms using ELISA. Risk factors for seropositivity on non-dairy sheep farms were identified at farm and sheep level by univariate and multivariate multilevel analyses. Based on 953 dairy and 5671 non-dairy serum samples, sheep seroprevalences were 18.7 per cent and 2.0...

Weekly monitoring of nation-wide number of deaths in the Netherlands (population 16 million) was set up to track events or outbreaks and estimate their impact. The system monitors reported number of deaths from all causes at 3 different time-lags: deaths reported within 1, 2 and 3 weeks (43%-98% complete). Baselines and prediction limits are calcul...

De influenza-epidemie van het seizoen 2012/2013 was in vergelijking met vorige epidemieën van grote omvang, gevarieerd van etiologie en vooral langdurig: 18 weken terwijl een gemiddelde epidemie acht weken aanhoudt. Aanvankelijk waren A(H1)pdm09- en A(H3)-virussen dominant, later werden voornamelijk B/Yamagata/16/88- achtige virussen gedetecteerd....

During the 2009 influenza pandemic period, routine surveillance of influenza-like-illness (ILI) was conducted in the Netherlands by a network of sentinel general practitioners (GPs). In addition during the pandemic period, four other ILI/influenza surveillance systems existed. For pandemic preparedness, we evaluated the performance of the sentinel...

SUMMARY In this study, Coxiella burnetii seroprevalence was assessed for dairy and non-dairy sheep farm residents in The Netherlands for 2009-2010. Risk factors for seropositivity were identified for non-dairy sheep farm residents. Participants completed farm-based and individual questionnaires. In addition, participants were tested for IgG and IgM...

Acquired resistance to antifungal agents now supports the introduction of susceptibility testing for species-drug combinations for which this was previously thought unnecessary. For pathogenic yeasts, conventional phenotypic testing needs at least 24 h. Culture on a porous aluminum oxide (PAO) support combined with microscopy offers a route to more...