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Article: Estimating the distribution of the incubation periods of human avian influenza A(H7N9) virus infections

TitleEstimating the distribution of the incubation periods of human avian influenza A(H7N9) virus infections
Authors
Issue Date2015
PublisherOxford University Press. The Journal's web site is located at http://aje.oxfordjournals.org/
Citation
American Journal of Epidemiology, 2015, v. 182 n. 8, p. 723-729 How to Cite?
AbstractA novel avian influenza virus, influenza A(H7N9), emerged in China in early 2013 and caused severe disease in humans, with infections occurring most frequently after recent exposure to live poultry. The distribution of A(H7N9) incubation periods is of interest to epidemiologists and public health officials, but estimation of the distribution is complicated by interval censoring of exposures. Imputation of the midpoint of intervals was used in some early studies, resulting in estimated mean incubation times of approximately 5 days. In this study, we estimated the incubation period distribution of human influenza A(H7N9) infections using exposure data available for 229 patients with laboratory-confirmed A(H7N9) infection from mainland China. A nonparametric model (Turnbull) and several parametric models accounting for the interval censoring in some exposures were fitted to the data. For the best-fitting parametric model (Weibull), the mean incubation period was 3.4 days (95% confidence interval: 3.0, 3.7) and the variance was 2.9 days; results were very similar for the nonparametric Turnbull estimate. Under the Weibull model, the 95th percentile of the incubation period distribution was 6.5 days (95% confidence interval: 5.9, 7.1). The midpoint approximation for interval-censored exposures led to overestimation of the mean incubation period. Public health observation of potentially exposed persons for 7 days after exposure would be appropriate.
Persistent Identifierhttp://hdl.handle.net/10722/233546
ISSN
2015 Impact Factor: 5.036
2015 SCImago Journal Rankings: 3.047

 

DC FieldValueLanguage
dc.contributor.authorVirlogeux, VML-
dc.contributor.authorLi, M-
dc.contributor.authorTsang, KL-
dc.contributor.authorFeng, L-
dc.contributor.authorFang, J-
dc.contributor.authorJiang, H-
dc.contributor.authorWu, P-
dc.contributor.authorZheng, J-
dc.contributor.authorLau, EHY-
dc.contributor.authorCao, Y-
dc.contributor.authorQin, Y-
dc.contributor.authorLiao, Q-
dc.contributor.authorYu, H-
dc.contributor.authorCowling, BJ-
dc.date.accessioned2016-09-20T05:37:31Z-
dc.date.available2016-09-20T05:37:31Z-
dc.date.issued2015-
dc.identifier.citationAmerican Journal of Epidemiology, 2015, v. 182 n. 8, p. 723-729-
dc.identifier.issn0002-9262-
dc.identifier.urihttp://hdl.handle.net/10722/233546-
dc.description.abstractA novel avian influenza virus, influenza A(H7N9), emerged in China in early 2013 and caused severe disease in humans, with infections occurring most frequently after recent exposure to live poultry. The distribution of A(H7N9) incubation periods is of interest to epidemiologists and public health officials, but estimation of the distribution is complicated by interval censoring of exposures. Imputation of the midpoint of intervals was used in some early studies, resulting in estimated mean incubation times of approximately 5 days. In this study, we estimated the incubation period distribution of human influenza A(H7N9) infections using exposure data available for 229 patients with laboratory-confirmed A(H7N9) infection from mainland China. A nonparametric model (Turnbull) and several parametric models accounting for the interval censoring in some exposures were fitted to the data. For the best-fitting parametric model (Weibull), the mean incubation period was 3.4 days (95% confidence interval: 3.0, 3.7) and the variance was 2.9 days; results were very similar for the nonparametric Turnbull estimate. Under the Weibull model, the 95th percentile of the incubation period distribution was 6.5 days (95% confidence interval: 5.9, 7.1). The midpoint approximation for interval-censored exposures led to overestimation of the mean incubation period. Public health observation of potentially exposed persons for 7 days after exposure would be appropriate.-
dc.languageeng-
dc.publisherOxford University Press. The Journal's web site is located at http://aje.oxfordjournals.org/-
dc.relation.ispartofAmerican Journal of Epidemiology-
dc.rightsThis is a pre-copy-editing, author-produced PDF of an article accepted for publication in American Journal of Epidemiology following peer review. The definitive publisher-authenticated version American Journal of Epidemiology, 2015, v. 182 n. 8, p. 723-729 is available online at: http://aje.oxfordjournals.org/content/182/8/723-
dc.rightsCreative Commons: Attribution 3.0 Hong Kong License-
dc.titleEstimating the distribution of the incubation periods of human avian influenza A(H7N9) virus infections-
dc.typeArticle-
dc.identifier.emailTsang, KL: matklab@hku.hk-
dc.identifier.emailFang, J: vickyf@hku.hk-
dc.identifier.emailWu, P: pengwu@hku.hk-
dc.identifier.emailLau, EHY: ehylau@hku.hk-
dc.identifier.emailCowling, BJ: bcowling@hku.hk-
dc.identifier.authorityWu, P=rp02025-
dc.identifier.authorityLau, EHY=rp01349-
dc.identifier.authorityCowling, BJ=rp01326-
dc.description.naturepostprint-
dc.identifier.doi10.1093/aje/kwv115-
dc.identifier.hkuros263737-
dc.identifier.volume182-
dc.identifier.issue8-
dc.identifier.spage723-
dc.identifier.epage729-
dc.publisher.placeUnited States-

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