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Article: Interpreting Seroepidemiologic Studies of Influenza in a Context of Nonbracketing Sera

TitleInterpreting Seroepidemiologic Studies of Influenza in a Context of Nonbracketing Sera
Authors
Issue Date2016
PublisherLippincott Williams & Wilkins. The Journal's web site is located at http://www.epidem.com
Citation
Epidemiology, 2016, v. 27 n. 1, p. 152-158 How to Cite?
AbstractBackground: In influenza epidemiology, analysis of paired sera collected from people before and after influenza seasons has been used for decades to study the cumulative incidence of influenza virus infections in populations. However, interpretation becomes challenging when sera are collected after the start or before the end of an epidemic, and do not neatly bracket the epidemic. Methods: Serum samples were collected longitudinally in a community-based study. Most participants provided their first serum after the start of circulation of influenza A(H1N1)pdm09 virus in 2009. We developed a Bayesian hierarchical model to correct for nonbracketing sera and estimate the cumulative incidence of infection from the serological data and surveillance data in Hong Kong. Results: We analyzed 4,843 sera from 2,097 unvaccinated participants in the study, collected from April 2009 to December 2010. After accounting for nonbracketing, we estimated that the cumulative incidence of H1N1pdm09 virus infection was 45% (95% credible interval [CI] = 40%, 49%), 17% (95% CI = 13%, 20%), and 11% (95% CI = 6%, 18%) for children ages 0–18 years, adults 19–50 years, and older adults >50 years, respectively. Including all available data substantially increased precision compared with a simpler analysis based only on sera collected at 6-month intervals in a subset of participants. Conclusions: We developed a framework for the analysis of antibody titers that accounted for the timing of sera collection with respect to influenza activity and permitted robust estimation of the cumulative incidence of infection during an epidemic.
Persistent Identifierhttp://hdl.handle.net/10722/223367
ISSN
2015 Impact Factor: 6.075
2015 SCImago Journal Rankings: 2.981

 

DC FieldValueLanguage
dc.contributor.authorTsang, TKL-
dc.contributor.authorFang, VJ-
dc.contributor.authorPerera, RAPM-
dc.contributor.authorIp, DKM-
dc.contributor.authorLeung, GM-
dc.contributor.authorPeiris, JSM-
dc.contributor.authorCauchemez, ST-
dc.contributor.authorCowling, BJ-
dc.date.accessioned2016-02-23T01:57:31Z-
dc.date.available2016-02-23T01:57:31Z-
dc.date.issued2016-
dc.identifier.citationEpidemiology, 2016, v. 27 n. 1, p. 152-158-
dc.identifier.issn1044-3983-
dc.identifier.urihttp://hdl.handle.net/10722/223367-
dc.description.abstractBackground: In influenza epidemiology, analysis of paired sera collected from people before and after influenza seasons has been used for decades to study the cumulative incidence of influenza virus infections in populations. However, interpretation becomes challenging when sera are collected after the start or before the end of an epidemic, and do not neatly bracket the epidemic. Methods: Serum samples were collected longitudinally in a community-based study. Most participants provided their first serum after the start of circulation of influenza A(H1N1)pdm09 virus in 2009. We developed a Bayesian hierarchical model to correct for nonbracketing sera and estimate the cumulative incidence of infection from the serological data and surveillance data in Hong Kong. Results: We analyzed 4,843 sera from 2,097 unvaccinated participants in the study, collected from April 2009 to December 2010. After accounting for nonbracketing, we estimated that the cumulative incidence of H1N1pdm09 virus infection was 45% (95% credible interval [CI] = 40%, 49%), 17% (95% CI = 13%, 20%), and 11% (95% CI = 6%, 18%) for children ages 0–18 years, adults 19–50 years, and older adults >50 years, respectively. Including all available data substantially increased precision compared with a simpler analysis based only on sera collected at 6-month intervals in a subset of participants. Conclusions: We developed a framework for the analysis of antibody titers that accounted for the timing of sera collection with respect to influenza activity and permitted robust estimation of the cumulative incidence of infection during an epidemic.-
dc.languageeng-
dc.publisherLippincott Williams & Wilkins. The Journal's web site is located at http://www.epidem.com-
dc.relation.ispartofEpidemiology-
dc.rightsThis is a non-final version of an article published in final form in Epidemiology, 2016, v. 27 n. 1, p. 152-158-
dc.rightsThis work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.-
dc.titleInterpreting Seroepidemiologic Studies of Influenza in a Context of Nonbracketing Sera-
dc.typeArticle-
dc.identifier.emailFang, VJ: vickyf@hku.hk-
dc.identifier.emailPerera, RAPM: mahenp@hku.hk-
dc.identifier.emailIp, DKM: dkmip@hku.hk-
dc.identifier.emailLeung, GM: gmleung@hku.hk-
dc.identifier.emailPeiris, JSM: malik@hkucc.hku.hk-
dc.identifier.emailCowling, BJ: bcowling@hku.hk-
dc.identifier.authorityIp, DKM=rp00256-
dc.identifier.authorityLeung, GM=rp00460-
dc.identifier.authorityPeiris, JSM=rp00410-
dc.identifier.authorityCowling, BJ=rp01326-
dc.description.naturepostprint-
dc.identifier.doi10.1097/EDE.0000000000000408-
dc.identifier.pmid26427725-
dc.identifier.hkuros256962-
dc.identifier.volume27-
dc.identifier.issue1-
dc.identifier.spage152-
dc.identifier.epage158-
dc.publisher.placeUnited States-

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