Comparative community burden and severity of seasonal and pandemic influenza: results of the Flu Watch cohort study
| العنوان: | Comparative community burden and severity of seasonal and pandemic influenza: results of the Flu Watch cohort study |
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| المؤلفون: | Maria Zambon, Lili Wang, Jana Kovar, W. John Edmunds, Andrew J. McMichael, Alison Bermingham, Andrew Copas, Megan S. C. Lim, Faiza Tabassum, Neil M. Ferguson, Richard Pebody, Elizabeth R C Millett, Fatima Wurie, Irwin Nazareth, John M Watson, Jonathan S. Nguyen-Van-Tam, Anne M Johnson, Ellen Fragaszy, Andrew Hayward, Nilu Goonetilleke, Gabrielle Harvey |
| المصدر: | The Lancet. Respiratory Medicine |
| بيانات النشر: | Elsevier BV, 2014. |
| سنة النشر: | 2014 |
| مصطلحات موضوعية: | Adult, Male, Pulmonary and Respiratory Medicine, medicine.medical_specialty, Adolescent, Disease, Real-Time Polymerase Chain Reaction, medicine.disease_cause, Severity of Illness Index, Asymptomatic, Article, Young Adult, 03 medical and health sciences, 0302 clinical medicine, Influenza, Human, Pandemic, Severity of illness, Epidemiology, medicine, Influenza A virus, Humans, Registries, 030212 general & internal medicine, Child, Pandemics, Aged, Retrospective Studies, 030304 developmental biology, 0303 health sciences, business.industry, Influenza A Virus, H3N2 Subtype, Infant, Newborn, Infant, Middle Aged, 3. Good health, England, Child, Preschool, DNA, Viral, Immunology, Human mortality from H5N1, Female, Seasons, medicine.symptom, business, Follow-Up Studies, Cohort study, Demography |
| الوصف: | Summary Background Assessment of the effect of influenza on populations, including risk of infection, illness if infected, illness severity, and consultation rates, is essential to inform future control and prevention. We aimed to compare the community burden and severity of seasonal and pandemic influenza across different age groups and study years and gain insight into the extent to which traditional surveillance underestimates this burden. Methods Using preseason and postseason serology, weekly illness reporting, and RT-PCR identification of influenza from nasal swabs, we tracked the course of seasonal and pandemic influenza over five successive cohorts (England 2006–11; 5448 person-seasons' follow-up). We compared burden and severity of seasonal and pandemic strains. We weighted analyses to the age and regional structure of England to give nationally representative estimates. We compared symptom profiles over the first week of illness for different strains of PCR-confirmed influenza and non-influenza viruses using ordinal logistic regression with symptom severity grade as the outcome variable. Findings Based on four-fold titre rises in strain-specific serology, on average influenza infected 18% (95% CI 16–22) of unvaccinated people each winter. Of those infected there were 69 respiratory illnesses per 100 person-influenza-seasons compared with 44 per 100 in those not infected with influenza. The age-adjusted attributable rate of illness if infected was 23 illnesses per 100 person-seasons (13–34), suggesting most influenza infections are asymptomatic. 25% (18–35) of all people with serologically confirmed infections had PCR-confirmed disease. 17% (10–26) of people with PCR-confirmed influenza had medically attended illness. These figures did not differ significantly when comparing pandemic with seasonal influenza. Of PCR-confirmed cases, people infected with the 2009 pandemic strain had markedly less severe symptoms than those infected with seasonal H3N2. Interpretation Seasonal influenza and the 2009 pandemic strain were characterised by similar high rates of mainly asymptomatic infection with most symptomatic cases self-managing without medical consultation. In the community the 2009 pandemic strain caused milder symptoms than seasonal H3N2. Funding Medical Research Council and the Wellcome Trust. |
| وصف الملف: | |
| تدمد: | 2213-2600 2213-2619 |
| URL الوصول: | https://explore.openaire.eu/search/publication?articleId=doi_dedup___::1e2be6f33c78254293c7da8618dfef72 https://doi.org/10.1016/s2213-2600(14)70034-7 |
| حقوق: | OPEN |
| رقم الأكسشن: | edsair.doi.dedup.....1e2be6f33c78254293c7da8618dfef72 |
| قاعدة البيانات: | OpenAIRE |
Full Text via ClinicalKey | تدمد: | 22132600 22132619 |
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