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Use of cumulative incidence of novel influenza A/H1N1 in foreign travelers to estimate lower bounds on cumulative incidence in Mexico.

Identifieur interne : 000511 ( Main/Exploration ); précédent : 000510; suivant : 000512

Use of cumulative incidence of novel influenza A/H1N1 in foreign travelers to estimate lower bounds on cumulative incidence in Mexico.

Auteurs : Marc Lipsitch [États-Unis] ; Martin Lajous ; Justin J. O'Hagan ; Ted Cohen ; Joel C. Miller ; Edward Goldstein ; Leon Danon ; Jacco Wallinga ; Steven Riley ; Scott F. Dowell ; Carrie Reed ; Meg Mccarron

Source :

RBID : pubmed:19742302

Descripteurs français

English descriptors

Abstract

BACKGROUND

An accurate estimate of the total number of cases and severity of illness of an emerging infectious disease is required both to define the burden of the epidemic and to determine the severity of disease. When a novel pathogen first appears, affected individuals with severe symptoms are more likely to be diagnosed. Accordingly, the total number of cases will be underestimated and disease severity overestimated. This problem is manifest in the current epidemic of novel influenza A/H1N1.

METHODS AND RESULTS

We used a simple approach to leverage measures of incident influenza A/H1N1 among a relatively small and well observed group of US, UK, Spanish and Canadian travelers who had visited Mexico to estimate the incidence among a much larger and less well surveyed population of Mexican residents. We estimate that a minimum of 113,000 to 375,000 cases of novel influenza A/H1N1 have occurred in Mexicans during the month of April, 2009. Such an estimate serves as a lower bound because it does not account for underreporting of cases in travelers or for nonrandom mixing between Mexican residents and visitors, which together could increase the estimates by more than an order of magnitude.

CONCLUSIONS

We find that the number of cases in Mexican residents may exceed the number of confirmed cases by two to three orders of magnitude. While the extent of disease spread is greater than previously appreciated, our estimate suggests that severe disease is uncommon since the total number of cases is likely to be much larger than those of confirmed cases.


DOI: 10.1371/journal.pone.0006895
PubMed: 19742302
PubMed Central: PMC2731883


Affiliations:


Links toward previous steps (curation, corpus...)


Le document en format XML

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<term>Incidence (MeSH)</term>
<term>Influenza A Virus, H1N1 Subtype (genetics)</term>
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<term>Grippe humaine (épidémiologie)</term>
<term>Humains (MeSH)</term>
<term>Incidence (MeSH)</term>
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<b>BACKGROUND</b>
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<p>An accurate estimate of the total number of cases and severity of illness of an emerging infectious disease is required both to define the burden of the epidemic and to determine the severity of disease. When a novel pathogen first appears, affected individuals with severe symptoms are more likely to be diagnosed. Accordingly, the total number of cases will be underestimated and disease severity overestimated. This problem is manifest in the current epidemic of novel influenza A/H1N1.</p>
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<b>METHODS AND RESULTS</b>
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<p>We used a simple approach to leverage measures of incident influenza A/H1N1 among a relatively small and well observed group of US, UK, Spanish and Canadian travelers who had visited Mexico to estimate the incidence among a much larger and less well surveyed population of Mexican residents. We estimate that a minimum of 113,000 to 375,000 cases of novel influenza A/H1N1 have occurred in Mexicans during the month of April, 2009. Such an estimate serves as a lower bound because it does not account for underreporting of cases in travelers or for nonrandom mixing between Mexican residents and visitors, which together could increase the estimates by more than an order of magnitude.</p>
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<p>We find that the number of cases in Mexican residents may exceed the number of confirmed cases by two to three orders of magnitude. While the extent of disease spread is greater than previously appreciated, our estimate suggests that severe disease is uncommon since the total number of cases is likely to be much larger than those of confirmed cases.</p>
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<name sortKey="Goldstein, Edward" sort="Goldstein, Edward" uniqKey="Goldstein E" first="Edward" last="Goldstein">Edward Goldstein</name>
<name sortKey="Lajous, Martin" sort="Lajous, Martin" uniqKey="Lajous M" first="Martin" last="Lajous">Martin Lajous</name>
<name sortKey="Mccarron, Meg" sort="Mccarron, Meg" uniqKey="Mccarron M" first="Meg" last="Mccarron">Meg Mccarron</name>
<name sortKey="Miller, Joel C" sort="Miller, Joel C" uniqKey="Miller J" first="Joel C" last="Miller">Joel C. Miller</name>
<name sortKey="O Hagan, Justin J" sort="O Hagan, Justin J" uniqKey="O Hagan J" first="Justin J" last="O'Hagan">Justin J. O'Hagan</name>
<name sortKey="Reed, Carrie" sort="Reed, Carrie" uniqKey="Reed C" first="Carrie" last="Reed">Carrie Reed</name>
<name sortKey="Riley, Steven" sort="Riley, Steven" uniqKey="Riley S" first="Steven" last="Riley">Steven Riley</name>
<name sortKey="Wallinga, Jacco" sort="Wallinga, Jacco" uniqKey="Wallinga J" first="Jacco" last="Wallinga">Jacco Wallinga</name>
</noCountry>
<country name="États-Unis">
<region name="Massachusetts">
<name sortKey="Lipsitch, Marc" sort="Lipsitch, Marc" uniqKey="Lipsitch M" first="Marc" last="Lipsitch">Marc Lipsitch</name>
</region>
</country>
</tree>
</affiliations>
</record>

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{{Explor lien
   |wiki=    Sante
   |area=    GrippeEspagneV1
   |flux=    Main
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   |clé=     pubmed:19742302
   |texte=   Use of cumulative incidence of novel influenza A/H1N1 in foreign travelers to estimate lower bounds on cumulative incidence in Mexico.
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