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Article: The infection attack rate and severity of 2009 pandemic H1N1 influenza in Hong Kong
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TitleThe infection attack rate and severity of 2009 pandemic H1N1 influenza in Hong Kong
 
AuthorsWu, JT1
Ma, ESK1
Lee, CK2
Chu, DKW1
Ho, PL1
Shen, AL1
Ho, A1
Hung, IFN1
Riley, S1
Ho, LM1
Lin, CK2
Tsang, T3
Lo, SV2 5
Lau, YL1
Leung, GM1
Cowling, BJ1
Peiris, JSM1 4
 
Issue Date2010
 
PublisherOxford University Press. The Journal's web site is located at http://www.oxfordjournals.org/our_journals/cid/
 
CitationClinical Infectious Diseases, 2010, v. 51 n. 10, p. 1184-1191 [How to Cite?]
DOI: http://dx.doi.org/10.1086/656740
 
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.
 
ISSN1058-4838
2013 Impact Factor: 9.416
 
DOIhttp://dx.doi.org/10.1086/656740
 
ISI Accession Number IDWOS:000283331800012
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).

 
ReferencesReferences in Scopus
 
GrantsThe attack rate, transmission dynamics and viral evolution in a cohort of Hong Kong families during an epidemic of novel influenza virus (H1N1)
A 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
Control of Pandemic and Inter-pandemic Influenza
 
DC FieldValue
dc.contributor.authorWu, JT
 
dc.contributor.authorMa, ESK
 
dc.contributor.authorLee, CK
 
dc.contributor.authorChu, DKW
 
dc.contributor.authorHo, PL
 
dc.contributor.authorShen, AL
 
dc.contributor.authorHo, A
 
dc.contributor.authorHung, IFN
 
dc.contributor.authorRiley, S
 
dc.contributor.authorHo, LM
 
dc.contributor.authorLin, CK
 
dc.contributor.authorTsang, T
 
dc.contributor.authorLo, SV
 
dc.contributor.authorLau, YL
 
dc.contributor.authorLeung, GM
 
dc.contributor.authorCowling, BJ
 
dc.contributor.authorPeiris, JSM
 
dc.date.accessioned2010-12-23T08:37:41Z
 
dc.date.available2010-12-23T08:37:41Z
 
dc.date.issued2010
 
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.
 
dc.description.naturepublished_or_final_version
 
dc.identifier.citationClinical Infectious Diseases, 2010, v. 51 n. 10, p. 1184-1191 [How to Cite?]
DOI: http://dx.doi.org/10.1086/656740
 
dc.identifier.citeulike8122359
 
dc.identifier.doihttp://dx.doi.org/10.1086/656740
 
dc.identifier.eissn1537-6591
 
dc.identifier.epage1191
 
dc.identifier.hkuros183402
 
dc.identifier.hkuros203201
 
dc.identifier.isiWOS:000283331800012
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).

 
dc.identifier.issn1058-4838
2013 Impact Factor: 9.416
 
dc.identifier.issue10
 
dc.identifier.pmid20964521
 
dc.identifier.scopuseid_2-s2.0-78349253122
 
dc.identifier.spage1184
 
dc.identifier.urihttp://hdl.handle.net/10722/129464
 
dc.identifier.volume51
 
dc.languageeng
 
dc.publisherOxford University Press. The Journal's web site is located at http://www.oxfordjournals.org/our_journals/cid/
 
dc.publisher.placeUnited States
 
dc.relation.ispartofClinical Infectious Diseases
 
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.relation.referencesReferences in Scopus
 
dc.rightsCreative Commons: Attribution 3.0 Hong Kong License
 
dc.subject.meshAdolescent
 
dc.subject.meshAdult
 
dc.subject.meshAntibodies, Viral - blood
 
dc.subject.meshChild
 
dc.subject.meshChild, Preschool
 
dc.subject.meshCross-Sectional Studies
 
dc.subject.meshDisease Outbreaks - statistics & numerical data
 
dc.subject.meshHong Kong - epidemiology
 
dc.subject.meshHumans
 
dc.subject.meshImmunoglobulin G - blood
 
dc.subject.meshInfluenza A Virus, H1N1 Subtype - immunology
 
dc.subject.meshInfluenza, Human - epidemiology - immunology - virology
 
dc.subject.meshMarkov Chains
 
dc.subject.meshMiddle Aged
 
dc.subject.meshMonte Carlo Method
 
dc.subject.meshNeutralization Tests
 
dc.subject.meshReproducibility of Results
 
dc.subject.meshSeroepidemiologic Studies
 
dc.titleThe infection attack rate and severity of 2009 pandemic H1N1 influenza in Hong Kong
 
dc.typeArticle
 
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Author Affiliations
  1. The University of Hong Kong Li Ka Shing Faculty of Medicine
  2. Hong Kong Hospital Authority
  3. Centre for Health Protection
  4. HKU-Pasteur Research Centre
  5. Food and Health Bureau