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Pandemic potential of a strain of influenza A (H1N1) : early findings

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Fraser, C., Donnelly, C. A., Cauchemez, S., Hanage, W. P., Van Kerkhove, M. D., Hollingsworth, T. Déirdre, Griffin, J., Baggaley, Rebecca F., Jenkins, H. E., Lyons, E. J. et al.
(2009) Pandemic potential of a strain of influenza A (H1N1) : early findings. Science, Vol.324 (No.5934). pp. 1557-1561. doi:10.1126/science.1176062 ISSN 0036-8075.

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Official URL: http://dx.doi.org/10.1126/science.1176062

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Abstract

A novel influenza A (H1N1) virus has spread rapidly across the globe. Judging its pandemic potential is difficult with limited data, but nevertheless essential to inform appropriate health responses. By analyzing the outbreak in Mexico, early data on international spread, and viral genetic diversity, we make an early assessment of transmissibility and severity. Our estimates suggest that 23,000 (range 6000 to 32,000) individuals had been infected in Mexico by late April, giving an estimated case fatality ratio (CFR) of 0.4% (range: 0.3 to 1.8%) based on confirmed and suspected deaths reported to that time. In a community outbreak in the small community of La Gloria, Veracruz, no deaths were attributed to infection, giving an upper 95% bound on CFR of 0.6%. Thus, although substantial uncertainty remains, clinical severity appears less than that seen in the 1918 influenza pandemic but comparable with that seen in the 1957 pandemic. Clinical attack rates in children in La Gloria were twice that in adults (<15 years of age: 61%; ≥15 years: 29%). Three different epidemiological analyses gave basic reproduction number (R0) estimates in the range of 1.4 to 1.6, whereas a genetic analysis gave a central estimate of 1.2. This range of values is consistent with 14 to 73 generations of human-to-human transmission having occurred in Mexico to late April. Transmissibility is therefore substantially higher than that of seasonal flu, and comparable with lower estimates of R0 obtained from previous influenza pandemics.

Item Type: Journal Article
Divisions: Faculty of Science, Engineering and Medicine > Science > Life Sciences (2010- )
Faculty of Science, Engineering and Medicine > Science > Mathematics
Journal or Publication Title: Science
Publisher: American Association for the Advancement of Science
ISSN: 0036-8075
Official Date: 2009
Dates:
DateEvent
2009Published
Volume: Vol.324
Number: No.5934
Page Range: pp. 1557-1561
DOI: 10.1126/science.1176062
Status: Peer Reviewed
Publication Status: Published
Access rights to Published version: Restricted or Subscription Access

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