Yan, Lei, Gao, Yan, Zhang, Yong, Tildesley, Michael J., Liu, L, Zhang, Y, Wen, Leying, Wang, Wei, Li, Xiaodan, Hu, Ying, Bai, Tian, Wang, Min, Zeng, Yuhong, Wang, Dingming, Wang, Xianjun, Lan, Yu, Wang, Shiwen and Shu, Yuelong. (2012) Epidemiological and virological characteristics of pandemic influenza A (H1N1) 2009 in school outbreaks in China. PLoS One, Vol.7 (No.9). e45898. ISSN 1932-6203

Preview

Text WRAP_Tildesley_journal.pone.0045898.pdf - Published Version Download (376Kb) | Preview

Abstract

Background: During the 2009 pandemic influenza H1N1 (2009) virus (pH1N1) outbreak, school students were at an increased risk of infection by the pH1N1 virus. However, the estimation of the attack rate showed significant variability. Methods: Two school outbreaks were investigated in this study. A questionnaire was designed to collect information by interview. Throat samples were collected from all the subjects in this study 6 times and sero samples 3 times to confirm the infection and to determine viral shedding. Data analysis was performed using the software STATA 9.0. Findings: The attack rate of the pH1N1 outbreak was 58.3% for the primary school, and 52.9% for the middle school. The asymptomatic infection rates of the two schools were 35.8% and 37.6% respectively. Peak virus shedding occurred on the day of ARI symptoms onset, followed by a steady decrease over subsequent days (p = 0.026). No difference was found either in viral shedding or HI titer between the symptomatic and the asymptomatic infectious groups. Conclusions: School children were found to be at a high risk of infection by the novel virus. This may be because of a heightened risk of transmission owing to increased mixing at boarding school, or a lack of immunity owing to socioeconomic status. We conclude that asymptomatically infectious cases may play an important role in transmission of the pH1N1 virus.

Item Type:	Journal Article
Subjects:	R Medicine > RA Public aspects of medicine
Divisions:	Faculty of Science > Centre for Complexity Science Faculty of Science > Mathematics
Library of Congress Subject Headings (LCSH):	H1N1 influenza -- Transmission, School children -- Health and hygiene -- China
Journal or Publication Title:	PLoS One
Publisher:	Public Library of Science
ISSN:	1932-6203
Date:	September 2012
Volume:	Vol.7
Number:	No.9
Page Range:	e45898
Identification Number:	10.1371/journal.pone.0045898
Status:	Peer Reviewed
Publication Status:	Published
Access rights to Published version:	Open Access
Funder:	National Institutes of Health (U.S.) (NIH), National Institute of Allergy and Infectious Diseases (U.S.) (NIAID), Wellcome Trust (London, England), United States. Dept. of Homeland Security. Science and Technology Directorate
Grant number:	2008ZX10004-012 (NIH), 5-U54-AI-057157-08 (NIH/NIAID)
References:	1. Ginsberg M, Hopkins J, Maroufi A, Dunne G, Sunega DR, et al. (2009) Swine influenza A (H1N1) infection in two children–Southern California, March–April 2009. MMWR Morb Mortal Wkly Rep 58: 400–402. 2. San Diego County Health and Human Svcs, Imperial County Public Health Dept,California Dept of Public Health, Dallas County Health and Human Svcs, Texas Dept of State Health Svcs, et al. (2009) Update: swine influenza A (H1N1) infections–California and Texas, April 2009. MMWR Morb Mortal Wkly Rep 58: 435–437. 3. Chan M (2009) World now at the start of 2009 influenza pandemic. WHO website. Available: http://www.who.int/mediacentre/news/statements/2009/ h1n1_pandemic_phase6_20090611/en/. Accessed 2012 Sep 4. 4. Chan M (2010) H1N1 in post-pandemic period. WHO website. Available: http://www.who.int/mediacentre/news/statements/2010/h1n1_vpc_ 20100810/en/. Accessed 2012 Sep 4. 5. Lipsitch M, Hayden FG, Cowling BJ, Leung GM (2009) How to maintain surveillance for novel influenza A H1N1 when there are too many cases to count. Lancet 374: 1209–1211. 6. Lessler J, Reich NG, Cummings DA, Nair HP, Jordan HT, et al. (2009) Outbreak of 2009 pandemic influenza A (H1N1) at a New York City school. N Engl J Med 361: 2628–2636. 7. Witkop CT, Duffy MR, Macias EA, Gibbons TF, Escobar JD, et al. (2010) Novel Influenza A (H1N1) outbreak at the U.S. Air Force Academy: epidemiology and viral shedding duration. Am J Prev Med 38: 121–126. 8. Miller E, Hoschler K, Hardelid P, Stanford E, Andrews N, et al. (2010) Incidence of 2009 pandemic influenza A H1N1 infection in England: a crosssectional serological study. Lancet 375: 1100–1108. 9. Donaldson LJ, Rutter PD, Ellis BM, Greaves FE, Mytton OT, et al. (2009) Mortality from pandemic A/H1N1 2009 influenza in England: public health surveillance study. Bmj 339: b5213. 10. Louie JK, Acosta M, Winter K, Jean C, Gavali S, et al. (2009) Factors associated with death or hospitalization due to pandemic 2009 influenza A(H1N1) infection in California. Jama 302: 1896–1902. 11. Jain S, Kamimoto L, Bramley AM, Schmitz AM, Benoit SR, et al. (2009) Hospitalized patients with 2009 H1N1 influenza in the United States, April– June 2009. N Engl J Med 361: 1935–1944. 12. Ross T, Zimmer S, Burke D, Crevar C, Carter D, et al. (2010) Seroprevalence Following the Second Wave of Pandemic 2009 H1N1 Influenza. PLoS Curr Influenza: RRN1148. 13. Xu C, Bai T, Iuliano AD, Wang M, Yang L, et al. (2011) The seroprevalence of pandemic influenza H1N1 (2009) virus in China. PLoS One 6: e17919. 14. Gurav YK, Pawar SD, Chadha MS, Potdar VA, Deshpande AS, et al. (2010) Pandemic influenza A(H1N1) 2009 outbreak in a residential school at Panchgani, Maharashtra, India. Indian J Med Res 132: 67–71. 15. Huai Y, Lin J, Varma JK, Peng Z, He J, et al. (2010) A primary school outbreak of pandemic 2009 influenza A (H1N1) in China. Influenza Other Respi Viruses 4: 259–266. 16. Laguna-Torres VA, Benavides JG (2009) Infection and death from influenza A H1N1 virus in Mexico. Lancet 374: 2032–2033. 17. Cowling BJ, Chan KH, Fang VJ, Lau LL, So HC, et al. (2010) Comparative epidemiology of pandemic and seasonal influenza A in households. N Engl J Med 362: 2175–2184. 18. Lee N, Chan PK, Hui DS, Rainer TH, Wong E, et al. (2009) Viral loads and duration of viral shedding in adult patients hospitalized with influenza. J Infect Dis 200: 492–500. 19. Zhang X, Yan HP, Ma YX, Wang Y, Zhao Y, et al. (2011) Evaluation of nucleic acid amplification assay and rapid antigen assay of nasopharynx swabs and oropharynx swabs from glu-like patients in diagnosis of flu A. Chin J Infect Dis 29: 154–157. 20. Bautista E, Chotpitayasunondh T, Gao Z, Harper SA, Shaw M, et al. (2010) Clinical aspects of pandemic 2009 influenza A (H1N1) virus infection. N Engl J Med 362: 1708–1719. 21. Lau LL, Cowling BJ, Fang VJ, Chan KH, Lau EH, et al. (2010) Viral shedding and clinical illness in naturally acquired influenza virus infections. J Infect Dis 201: 1509–1516. 22. Carrat F, Vergu E, Ferguson NM, Lemaitre M, Cauchemez S, et al. (2008) Time lines of infection and disease in human influenza: a review of volunteer challenge studies. Am J Epidemiol 167: 775–785. 23. Wang W, Pan M, Chang GH, Li XD, Li TS, et al. (2009) Laboratory Confirmation of the First Influenza A(H1N1) Imported Case in Mainland China. Chinese Journal of Virology 25 4–7. 24. WHO CDC protocol of real-time RT-PCR for influenza A(H1N1). 25. World health organization (2005) Recommended laboratory tests to identify avian influenza A virus in specimens from humans. WHO website. Available: http://www.who.int/csr/disease/avian_influenza/guidelines/avian_labtests2. pdf. Accessed 2012 Sep 4. 26. Zhou J, Law HK, Cheung CY, Ng IH, Peiris JS, et al. (2006) Differential Expression of Chemokines and Their Receptors in Adult and Neonatal Macrophages Infected with Human or Avian Influenza Viruses. J Infect Dis194(1): 61–70. 27. Di Trani L, Bedini B, Donatelli I, Campitelli L, Chiappini B, et al. (2006) A sensitive one-step real-time PCR for detection of avian influenza viruses using a MGB probe and an internal positive control. BMC Infect Dis 6: 87–94. 28. Kendal AP, Skehel JJ, Pereira MS (1982) World Health Organization Collaborating Centers from Reference and Research on Influenza: concepts and procedures for laboratory-based influenza surveillance, pB 17–35. 29. WHO, WHO Manual on animal influenza diagnosis and surveillance 2002.5. WHO website. Available: http://www.who.int/vaccine_research/diseases/ influenza/WHO_manual_on_animal-diagnosis_and_surveillance_2002_5.pdf. Accessed 2012 Sep 4.
URI:	http://wrap.warwick.ac.uk/id/eprint/49732

Request changes to a record

Actions (login required)

View Item