Article: The infection attack rate and severity of 2009 pandemic H1N1 influenza in Hong Kong

TitleThe infection attack rate and severity of 2009 pandemic H1N1 influenza in Hong Kong
Authors
Issue Date2010
PublisherOxford University Press. The Journal's web site is located at http://www.oxfordjournals.org/our_journals/cid/
Citation
Clinical Infectious Diseases, 2010, v. 51 n. 10, p. 1184-1191 How to Cite?
Abstract
Background. Serial cross-sectional data on antibody levels to the 2009 pandemic H1N1 influenza A virus from a population can be used to estimate the infection attack rates and immunity against future infection in the community. Methods. From April through December 2009, we obtained 12,217 serum specimens from blood donors (aged 16-59 years), 2520 specimens from hospital outpatients (aged 5-59 years), and 917 specimens from subjects involved in a community pediatric cohort study (aged 5-14 years). We estimated infection attack rates by comparing the proportions of specimens with antibody titers ≥1:40 by viral microneutralization before and after the first wave of the pandemic. Estimates were validated using paired serum samples from 324 individuals that spanned the first wave. Combining these estimates with epidemiologic surveillance data, we calculated the proportion of infections that led to hospitalization, admission to the intensive care unit (ICU), and death. Results. We found that 3.3% and 14% of persons aged 5-59 years had antibody titers ≥1:40 before and after the first wave, respectively. The overall attack rate was 10.7%, with age stratification as follows: 43.4% in persons aged 5-14 years, 15.8% in persons aged 15-19 years, 11.8% in persons aged 20-29 years, and 4%-4.6% in persons aged 30-59 years. Case-hospitalization rates were 0.47%-0.87% among persons aged 5-59 years. Case-ICU rates were 7.9 cases per 100,000 infections in persons aged 5-14 years and 75 cases per 100,000 infections in persons aged 50-59 years, respectively. Case-fatality rates were 0.4 cases per 100,000 infections in persons aged 5-14 years and 26.5 cases per 100,000 infections in persons aged 50-59 years, respectively. Conclusions. Almost half of all school-aged children in Hong Kong were infected during the first wave. Compared with school children aged 5-14 years, older adults aged 50-59 years had 9.5 and 66 times higher risks of ICU admission and death if infected, respectively. © 2010 by the Infectious Diseases Society of America. All rights reserved.
Persistent Identifierhttp://hdl.handle.net/10722/129464
ISSN
2013 Impact Factor: 9.416
ISI Accession Number ID
Funding AgencyGrant Number
Government of the Hong Kong SARPHE-20
PHE-2
Hong Kong University Grants CommitteeAoE/M-12/06
Harvard Center for Communicable Disease Dynamics from the US National Institutes of Health1 U54 GM088558
EMPERIE (EU)223498
National Institute of Allergy and Infectious Diseases
National Institutes of HealthHHSN266200700005C
N01-AI-70005
Funding Information:

Financial support. Research Fund for the Control of Infectious Disease, Food and Health Bureau, Government of the Hong Kong SAR (PHE-20 and PHE-2), the Area of Excellence Scheme of the Hong Kong University Grants Committee (AoE/M-12/06), the Harvard Center for Communicable Disease Dynamics from the US National Institutes of Health Models of Infectious Disease Agent Study program (1 U54 GM088558), EMPERIE (EU FP7 grant 223498), the National Institute of Allergy and Infectious Diseases, and the National Institutes of Health (HHSN266200700005C; ADB no. N01-AI-70005).

References
Grants

 

DC FieldValueLanguage
dc.contributor.authorWu, JTen_HK
dc.contributor.authorMa, ESKen_HK
dc.contributor.authorLee, CKen_HK
dc.contributor.authorChu, DKWen_HK
dc.contributor.authorHo, PLen_HK
dc.contributor.authorShen, ALen_HK
dc.contributor.authorHo, Aen_HK
dc.contributor.authorHung, IFNen_HK
dc.contributor.authorRiley, Sen_HK
dc.contributor.authorHo, LMen_HK
dc.contributor.authorLin, CKen_HK
dc.contributor.authorTsang, Ten_HK
dc.contributor.authorLo, SVen_HK
dc.contributor.authorLau, YLen_HK
dc.contributor.authorLeung, GMen_HK
dc.contributor.authorCowling, BJen_HK
dc.contributor.authorPeiris, JSMen_HK
dc.date.accessioned2010-12-23T08:37:41Z-
dc.date.available2010-12-23T08:37:41Z-
dc.date.issued2010en_HK
dc.identifier.citationClinical Infectious Diseases, 2010, v. 51 n. 10, p. 1184-1191en_HK
dc.identifier.issn1058-4838en_HK
dc.identifier.urihttp://hdl.handle.net/10722/129464-
dc.description.abstractBackground. Serial cross-sectional data on antibody levels to the 2009 pandemic H1N1 influenza A virus from a population can be used to estimate the infection attack rates and immunity against future infection in the community. Methods. From April through December 2009, we obtained 12,217 serum specimens from blood donors (aged 16-59 years), 2520 specimens from hospital outpatients (aged 5-59 years), and 917 specimens from subjects involved in a community pediatric cohort study (aged 5-14 years). We estimated infection attack rates by comparing the proportions of specimens with antibody titers ≥1:40 by viral microneutralization before and after the first wave of the pandemic. Estimates were validated using paired serum samples from 324 individuals that spanned the first wave. Combining these estimates with epidemiologic surveillance data, we calculated the proportion of infections that led to hospitalization, admission to the intensive care unit (ICU), and death. Results. We found that 3.3% and 14% of persons aged 5-59 years had antibody titers ≥1:40 before and after the first wave, respectively. The overall attack rate was 10.7%, with age stratification as follows: 43.4% in persons aged 5-14 years, 15.8% in persons aged 15-19 years, 11.8% in persons aged 20-29 years, and 4%-4.6% in persons aged 30-59 years. Case-hospitalization rates were 0.47%-0.87% among persons aged 5-59 years. Case-ICU rates were 7.9 cases per 100,000 infections in persons aged 5-14 years and 75 cases per 100,000 infections in persons aged 50-59 years, respectively. Case-fatality rates were 0.4 cases per 100,000 infections in persons aged 5-14 years and 26.5 cases per 100,000 infections in persons aged 50-59 years, respectively. Conclusions. Almost half of all school-aged children in Hong Kong were infected during the first wave. Compared with school children aged 5-14 years, older adults aged 50-59 years had 9.5 and 66 times higher risks of ICU admission and death if infected, respectively. © 2010 by the Infectious Diseases Society of America. All rights reserved.en_HK
dc.languageengen_US
dc.publisherOxford University Press. The Journal's web site is located at http://www.oxfordjournals.org/our_journals/cid/en_HK
dc.relation.ispartofClinical Infectious Diseasesen_HK
dc.rightsCreative Commons: Attribution 3.0 Hong Kong License-
dc.subject.meshAdolescenten_HK
dc.subject.meshAdulten_HK
dc.subject.meshAntibodies, Viral - blooden_HK
dc.subject.meshChilden_HK
dc.subject.meshChild, Preschoolen_HK
dc.subject.meshCross-Sectional Studiesen_HK
dc.subject.meshDisease Outbreaks - statistics & numerical dataen_HK
dc.subject.meshHong Kong - epidemiologyen_HK
dc.subject.meshHumansen_HK
dc.subject.meshImmunoglobulin G - blooden_HK
dc.subject.meshInfluenza A Virus, H1N1 Subtype - immunologyen_HK
dc.subject.meshInfluenza, Human - epidemiology - immunology - virologyen_HK
dc.subject.meshMarkov Chainsen_HK
dc.subject.meshMiddle Ageden_HK
dc.subject.meshMonte Carlo Methoden_HK
dc.subject.meshNeutralization Testsen_HK
dc.subject.meshReproducibility of Resultsen_HK
dc.subject.meshSeroepidemiologic Studiesen_HK
dc.titleThe infection attack rate and severity of 2009 pandemic H1N1 influenza in Hong Kongen_HK
dc.typeArticleen_HK
dc.identifier.emailWu, JT: joewu@hkucc.hku.hken_HK
dc.identifier.emailHung, IFN: ivanhung@hkucc.hku.hken_HK
dc.identifier.emailRiley, S: steven.riley@hku.hken_HK
dc.identifier.emailHo, LM: lmho@hkucc.hku.hken_HK
dc.identifier.emailLau, YL: lauylung@hku.hken_HK
dc.identifier.emailLeung, GM: gmleung@hku.hken_HK
dc.identifier.emailCowling, BJ: bcowling@hku.hken_HK
dc.identifier.emailPeiris, JSM: malik@hkucc.hku.hken_HK
dc.identifier.authorityWu, JT=rp00517en_HK
dc.identifier.authorityHung, IFN=rp00508en_HK
dc.identifier.authorityRiley, S=rp00511en_HK
dc.identifier.authorityHo, LM=rp00360en_HK
dc.identifier.authorityLau, YL=rp00361en_HK
dc.identifier.authorityLeung, GM=rp00460en_HK
dc.identifier.authorityCowling, BJ=rp01326en_HK
dc.identifier.authorityPeiris, JSM=rp00410en_HK
dc.description.naturepublished_or_final_version-
dc.identifier.doi10.1086/656740en_HK
dc.identifier.pmid20964521en_HK
dc.identifier.scopuseid_2-s2.0-78349253122en_HK
dc.identifier.hkuros183402en_US
dc.identifier.hkuros203201-
dc.relation.referenceshttp://www.scopus.com/mlt/select.url?eid=2-s2.0-78349253122&selection=ref&src=s&origin=recordpageen_HK
dc.identifier.volume51en_HK
dc.identifier.issue10en_HK
dc.identifier.spage1184en_HK
dc.identifier.epage1191en_HK
dc.identifier.eissn1537-6591-
dc.identifier.isiWOS:000283331800012-
dc.publisher.placeUnited Statesen_HK
dc.relation.projectThe attack rate, transmission dynamics and viral evolution in a cohort of Hong Kong families during an epidemic of novel influenza virus (H1N1)-
dc.relation.projectA detailed longitudinal study of infection attack rates among healthy adults in Hong Kong during the epidemic of the human swine influenza A/H1N1 virus in 2009-
dc.relation.projectControl of Pandemic and Inter-pandemic Influenza-
dc.identifier.scopusauthoridWu, JT=7409256423en_HK
dc.identifier.scopusauthoridMa, ESK=24725277400en_HK
dc.identifier.scopusauthoridLee, CK=36087620900en_HK
dc.identifier.scopusauthoridChu, DKW=7201734326en_HK
dc.identifier.scopusauthoridHo, PL=55276473900en_HK
dc.identifier.scopusauthoridShen, AL=37038347500en_HK
dc.identifier.scopusauthoridHo, A=7402675209en_HK
dc.identifier.scopusauthoridHung, IFN=7006103457en_HK
dc.identifier.scopusauthoridRiley, S=7102619416en_HK
dc.identifier.scopusauthoridHo, LM=7402955625en_HK
dc.identifier.scopusauthoridLin, CK=12752556900en_HK
dc.identifier.scopusauthoridTsang, T=7101832378en_HK
dc.identifier.scopusauthoridLo, SV=8426498400en_HK
dc.identifier.scopusauthoridLau, YL=7201403380en_HK
dc.identifier.scopusauthoridLeung, GM=7007159841en_HK
dc.identifier.scopusauthoridCowling, BJ=8644765500en_HK
dc.identifier.scopusauthoridPeiris, JSM=7005486823en_HK
dc.identifier.citeulike8122359-

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