Finding the real case-fatality rate of H5N1 avian influenza
Identifieur interne : 000766 ( Istex/Corpus ); précédent : 000765; suivant : 000767Finding the real case-fatality rate of H5N1 avian influenza
Auteurs : F C K. Li ; B C K. Choi ; T. Sly ; A W P. PakSource :
- Journal of Epidemiology and Community Health [ 0143-005X ] ; 2008-06.
English descriptors
- Teeft :
- Accurate estimation, Avian, Avian influenza, Avian influenza virus, Avian influenza viruses, Cambodia, Clade, Current outbreak, Eastern turkey, Emerg, Epidemiol, Epidemiol community health, Health policy, Healthcare workers, Hong kong, Household contacts, Human cases, Infectious disease prevention, Influenza, Influenza pandemic, Influenza pandemics, Influenza virus, International community, Major form, Mild cases, Other hand, Other reasons, Outbreak, Pandemic, Pandemic planning, Paper reviews, Poultry workers, Public health agency, Public health policy, Respiratory syndrome, Scenario, Sialic acid, Virus infection, Wkly epidemiol, World health organization.
Abstract
Background: Accurate estimation of the case-fatality (CF) rate, or the proportion of cases that die, is central to pandemic planning. While estimates of CF rates for past influenza pandemics have ranged from about 0.1% (1957 and 1968 pandemics) to 2.5% (1918 pandemic), the official World Health Organization estimate for the current outbreak of H5N1 avian influenza to date is around 60%. Methods and results: The official estimate of the H5N1 CF rate has been described by some as an over-estimate, with little relevance to the rate that would be encountered under pandemic conditions. The reasons for such opinions are typically: (i) numerous undetected asymptomatic/mild cases, (ii) under-reporting of cases by some countries for economic or other reasons, and (iii) an expected decrease in virulence if and when the virus becomes widely transmitted in humans. Neither current data nor current literature, however, adequately supports these scenarios. While the real H5N1 CF rate could be lower than the current estimate of 60%, it is unlikely that it will be at the 0.1–0.4% level currently embraced by many pandemic plans. We suggest that, based on surveillance and seroprevalence studies conducted in several countries, the real H5N1 CF rate should be closer to 14–33%. Conclusions: Clearly, if such a CF rate were to be sustained in a pandemic, H5N1 would present a truly dreadful scenario. A concerted and dedicated effort by the international community to avert a pandemic through combating avian influenza in animals and humans in affected countries needs to be a global priority.
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DOI: 10.1136/jech.2007.064030
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ISTEX:5BA5C68C5BA30E97A42BB1388C016E3E11F61B20Le document en format XML
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Li</name><affiliation><mods:affiliation>Centre for Infectious Disease Prevention and Control, Public Health Agency of Canada, Ottawa, Ontario, Canada</mods:affiliation></affiliation></author><author><name sortKey="Choi, B C K" sort="Choi, B C K" uniqKey="Choi B" first="B C K" last="Choi">B C K. Choi</name><affiliation><mods:affiliation>Department of Epidemiology and Community Medicine, University of Ottawa, Ottawa, Ontario; Department of Public Health Sciences, University of Toronto, Toronto, Ontario, Canada</mods:affiliation></affiliation></author><author><name sortKey="Sly, T" sort="Sly, T" uniqKey="Sly T" first="T" last="Sly">T. Sly</name><affiliation><mods:affiliation>School of Occupational and Public Health, Ryerson University, Toronto, Ontario, Canada</mods:affiliation></affiliation></author><author><name sortKey="Pak, A W P" sort="Pak, A W P" uniqKey="Pak A" first="A W P" last="Pak">A W P. Pak</name><affiliation><mods:affiliation>Pak Consulting, Ottawa, Ontario, Canada</mods:affiliation></affiliation></author></analytic><monogr></monogr><series><title level="j">Journal of Epidemiology and Community Health</title><title level="j" type="abbrev">J Epidemiol Community Health</title><idno type="ISSN">0143-005X</idno><idno type="eISSN">1470-2738</idno><imprint><publisher>BMJ Publishing Group Ltd</publisher><date type="published" when="2008-06">2008-06</date><biblScope unit="volume">62</biblScope><biblScope unit="issue">6</biblScope><biblScope unit="page" from="555">555</biblScope></imprint><idno type="ISSN">0143-005X</idno></series></biblStruct></sourceDesc><seriesStmt><idno type="ISSN">0143-005X</idno></seriesStmt></fileDesc><profileDesc><textClass><keywords scheme="Teeft" xml:lang="en"><term>Accurate estimation</term><term>Avian</term><term>Avian influenza</term><term>Avian influenza virus</term><term>Avian influenza viruses</term><term>Cambodia</term><term>Clade</term><term>Current outbreak</term><term>Eastern turkey</term><term>Emerg</term><term>Epidemiol</term><term>Epidemiol community health</term><term>Health policy</term><term>Healthcare workers</term><term>Hong kong</term><term>Household contacts</term><term>Human cases</term><term>Infectious disease prevention</term><term>Influenza</term><term>Influenza pandemic</term><term>Influenza pandemics</term><term>Influenza virus</term><term>International community</term><term>Major form</term><term>Mild cases</term><term>Other hand</term><term>Other reasons</term><term>Outbreak</term><term>Pandemic</term><term>Pandemic planning</term><term>Paper reviews</term><term>Poultry workers</term><term>Public health agency</term><term>Public health policy</term><term>Respiratory syndrome</term><term>Scenario</term><term>Sialic acid</term><term>Virus infection</term><term>Wkly epidemiol</term><term>World health organization</term></keywords></textClass><langUsage><language ident="en">en</language></langUsage></profileDesc></teiHeader><front><div type="abstract">Background: Accurate estimation of the case-fatality (CF) rate, or the proportion of cases that die, is central to pandemic planning. While estimates of CF rates for past influenza pandemics have ranged from about 0.1% (1957 and 1968 pandemics) to 2.5% (1918 pandemic), the official World Health Organization estimate for the current outbreak of H5N1 avian influenza to date is around 60%. Methods and results: The official estimate of the H5N1 CF rate has been described by some as an over-estimate, with little relevance to the rate that would be encountered under pandemic conditions. The reasons for such opinions are typically: (i) numerous undetected asymptomatic/mild cases, (ii) under-reporting of cases by some countries for economic or other reasons, and (iii) an expected decrease in virulence if and when the virus becomes widely transmitted in humans. Neither current data nor current literature, however, adequately supports these scenarios. While the real H5N1 CF rate could be lower than the current estimate of 60%, it is unlikely that it will be at the 0.1–0.4% level currently embraced by many pandemic plans. We suggest that, based on surveillance and seroprevalence studies conducted in several countries, the real H5N1 CF rate should be closer to 14–33%. Conclusions: Clearly, if such a CF rate were to be sustained in a pandemic, H5N1 would present a truly dreadful scenario. A concerted and dedicated effort by the international community to avert a pandemic through combating avian influenza in animals and humans in affected countries needs to be a global priority.</div></front></TEI><istex><corpusName>bmj</corpusName><keywords><teeft><json:string>avian</json:string><json:string>avian influenza</json:string><json:string>influenza</json:string><json:string>emerg</json:string><json:string>hong kong</json:string><json:string>pandemic</json:string><json:string>clade</json:string><json:string>epidemiol</json:string><json:string>human cases</json:string><json:string>world health organization</json:string><json:string>outbreak</json:string><json:string>epidemiol community health</json:string><json:string>scenario</json:string><json:string>influenza virus</json:string><json:string>public health policy</json:string><json:string>influenza pandemics</json:string><json:string>household contacts</json:string><json:string>influenza pandemic</json:string><json:string>cambodia</json:string><json:string>accurate estimation</json:string><json:string>international community</json:string><json:string>paper reviews</json:string><json:string>other hand</json:string><json:string>mild cases</json:string><json:string>healthcare workers</json:string><json:string>other reasons</json:string><json:string>current outbreak</json:string><json:string>pandemic planning</json:string><json:string>health policy</json:string><json:string>avian influenza virus</json:string><json:string>respiratory syndrome</json:string><json:string>poultry workers</json:string><json:string>public health agency</json:string><json:string>avian influenza viruses</json:string><json:string>sialic acid</json:string><json:string>major form</json:string><json:string>infectious disease prevention</json:string><json:string>virus infection</json:string><json:string>eastern turkey</json:string><json:string>wkly epidemiol</json:string></teeft></keywords><author><json:item><name>F C K Li</name><affiliations><json:string>Centre for Infectious Disease Prevention and Control, Public Health Agency of Canada, Ottawa, Ontario, Canada</json:string></affiliations></json:item><json:item><name>B C K Choi</name><affiliations><json:string>Department of Epidemiology and Community Medicine, University of Ottawa, Ottawa, Ontario; Department of Public Health Sciences, University of Toronto, Toronto, Ontario, Canada</json:string></affiliations></json:item><json:item><name>T Sly</name><affiliations><json:string>School of Occupational and Public Health, Ryerson University, Toronto, Ontario, Canada</json:string></affiliations></json:item><json:item><name>A W P Pak</name><affiliations><json:string>Pak Consulting, Ottawa, Ontario, Canada</json:string></affiliations></json:item></author><articleId><json:string>ch64030</json:string></articleId><arkIstex>ark:/67375/NVC-KP9CZ780-C</arkIstex><language><json:string>eng</json:string></language><originalGenre><json:string>research-article</json:string></originalGenre><abstract>Background: Accurate estimation of the case-fatality (CF) rate, or the proportion of cases that die, is central to pandemic planning. While estimates of CF rates for past influenza pandemics have ranged from about 0.1% (1957 and 1968 pandemics) to 2.5% (1918 pandemic), the official World Health Organization estimate for the current outbreak of H5N1 avian influenza to date is around 60%. Methods and results: The official estimate of the H5N1 CF rate has been described by some as an over-estimate, with little relevance to the rate that would be encountered under pandemic conditions. The reasons for such opinions are typically: (i) numerous undetected asymptomatic/mild cases, (ii) under-reporting of cases by some countries for economic or other reasons, and (iii) an expected decrease in virulence if and when the virus becomes widely transmitted in humans. Neither current data nor current literature, however, adequately supports these scenarios. While the real H5N1 CF rate could be lower than the current estimate of 60%, it is unlikely that it will be at the 0.1–0.4% level currently embraced by many pandemic plans. We suggest that, based on surveillance and seroprevalence studies conducted in several countries, the real H5N1 CF rate should be closer to 14–33%. Conclusions: Clearly, if such a CF rate were to be sustained in a pandemic, H5N1 would present a truly dreadful scenario. 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While estimates of CF rates for past influenza pandemics have ranged from about 0.1% (1957 and 1968 pandemics) to 2.5% (1918 pandemic), the official World Health Organization estimate for the current outbreak of H5N1 avian influenza to date is around 60%. Methods and results: The official estimate of the H5N1 CF rate has been described by some as an over-estimate, with little relevance to the rate that would be encountered under pandemic conditions. The reasons for such opinions are typically: (i) numerous undetected asymptomatic/mild cases, (ii) under-reporting of cases by some countries for economic or other reasons, and (iii) an expected decrease in virulence if and when the virus becomes widely transmitted in humans. Neither current data nor current literature, however, adequately supports these scenarios. While the real H5N1 CF rate could be lower than the current estimate of 60%, it is unlikely that it will be at the 0.1–0.4% level currently embraced by many pandemic plans. We suggest that, based on surveillance and seroprevalence studies conducted in several countries, the real H5N1 CF rate should be closer to 14–33%. Conclusions: Clearly, if such a CF rate were to be sustained in a pandemic, H5N1 would present a truly dreadful scenario. A concerted and dedicated effort by the international community to avert a pandemic through combating avian influenza in animals and humans in affected countries needs to be a global priority.</p></abstract></profileDesc><revisionDesc><change when="2008-05-13">Created</change><change when="2008-06">Published</change></revisionDesc></teiHeader></istex:fulltextTEI><json:item><extension>txt</extension><original>false</original><mimetype>text/plain</mimetype><uri>https://api.istex.fr/ark:/67375/NVC-KP9CZ780-C/fulltext.txt</uri></json:item></fulltext><metadata><istex:metadataXml wicri:clean="corpus bmj" wicri:toSee="no header"><istex:xmlDeclaration>version="1.0" encoding="UTF-8" standalone="no"</istex:xmlDeclaration><istex:docType PUBLIC="-//NLM//DTD Journal Archiving and Interchange DTD v2.3 20070202//EN" URI="archivearticle.dtd" name="istex:docType"></istex:docType><istex:document><article article-type="research-article" xml:lang="EN"><front><journal-meta><journal-id journal-id-type="hwp">jech</journal-id><journal-id journal-id-type="nlm-ta">J Epidemiol Community Health</journal-id><journal-id journal-id-type="publisher-id">jech</journal-id><journal-title>Journal of Epidemiology and Community Health</journal-title><abbrev-journal-title abbrev-type="publisher">J Epidemiol Community Health</abbrev-journal-title><issn pub-type="ppub">0143-005X</issn><issn pub-type="epub">1470-2738</issn><publisher><publisher-name>BMJ Publishing Group Ltd</publisher-name></publisher></journal-meta><article-meta><article-id pub-id-type="publisher-id">ch64030</article-id><article-id pub-id-type="doi">10.1136/jech.2007.064030</article-id><article-id pub-id-type="other">jech;62/6/555</article-id><article-id pub-id-type="pmid">18477756</article-id><article-id pub-id-type="other">555</article-id><article-id pub-id-type="other">jech.2007.064030</article-id><article-categories><subj-group subj-group-type="heading"><subject>Evidence-based public health policy and practice</subject></subj-group></article-categories><title-group><article-title>Finding the real case-fatality rate of H5N1 avian influenza</article-title><alt-title alt-title-type="running-head">Evidence-based public health policy and practice</alt-title></title-group><contrib-group><contrib contrib-type="author" xlink:type="simple"><name name-style="western"><surname>Li</surname><given-names>F C K</given-names></name><xref ref-type="aff" rid="aff1">1</xref></contrib><contrib contrib-type="author" xlink:type="simple"><name name-style="western"><surname>Choi</surname><given-names>B C K</given-names></name><xref ref-type="aff" rid="aff2">2</xref></contrib><contrib contrib-type="author" xlink:type="simple"><name name-style="western"><surname>Sly</surname><given-names>T</given-names></name><xref ref-type="aff" rid="aff3">3</xref></contrib><contrib contrib-type="author" xlink:type="simple"><name name-style="western"><surname>Pak</surname><given-names>A W P</given-names></name><xref ref-type="aff" rid="aff4">4</xref></contrib></contrib-group><aff id="aff1"><label>1</label><addr-line>Centre for Infectious Disease Prevention and Control, Public Health Agency of Canada, Ottawa, Ontario, Canada</addr-line> </aff><aff id="aff2"><label>2</label><addr-line>Department of Epidemiology and Community Medicine, University of Ottawa, Ottawa, Ontario; Department of Public Health Sciences, University of Toronto, Toronto, Ontario, Canada</addr-line> </aff><aff id="aff3"><label>3</label><addr-line>School of Occupational and Public Health, Ryerson University, Toronto, Ontario, Canada</addr-line> </aff><aff id="aff4"><label>4</label><addr-line>Pak Consulting, Ottawa, Ontario, Canada</addr-line> </aff><author-notes><corresp>Dr F Li, Centre for Infectious Disease Prevention and Control, Public Health Agency of Canada, 100 Colonnade Road Ottawa, Ontario, K1A 0K9, Canada; <email xlink:type="simple">Felix_Li@phac-aspc.gc.ca</email></corresp></author-notes><pub-date pub-type="ppub"><month>6</month><year>2008</year></pub-date><pub-date pub-type="epub"><day>13</day><month>5</month><year>2008</year></pub-date><volume>62</volume><volume-id pub-id-type="other">62</volume-id><volume-id pub-id-type="other">62</volume-id><issue>6</issue><issue-id pub-id-type="other">jech;62/6</issue-id><issue-id pub-id-type="other">6</issue-id><issue-id pub-id-type="other">62/6</issue-id><fpage>555</fpage><history><date date-type="accepted"><day>2</day><month>12</month><year>2007</year></date></history><permissions><copyright-statement>2008 the BMJ Publishing Group</copyright-statement><copyright-year>2008</copyright-year></permissions><self-uri content-type="pdf" xlink:role="full-text" xlink:href="jech-62-555.pdf"></self-uri><abstract><sec><title>Background:</title><p>Accurate estimation of the case-fatality (CF) rate, or the proportion of cases that die, is central to pandemic planning. While estimates of CF rates for past influenza pandemics have ranged from about 0.1% (1957 and 1968 pandemics) to 2.5% (1918 pandemic), the official World Health Organization estimate for the current outbreak of H5N1 avian influenza to date is around 60%.</p></sec><sec><title>Methods and results:</title><p>The official estimate of the H5N1 CF rate has been described by some as an over-estimate, with little relevance to the rate that would be encountered under pandemic conditions. The reasons for such opinions are typically: (i) numerous undetected asymptomatic/mild cases, (ii) under-reporting of cases by some countries for economic or other reasons, and (iii) an expected decrease in virulence if and when the virus becomes widely transmitted in humans. Neither current data nor current literature, however, adequately supports these scenarios. While the real H5N1 CF rate could be lower than the current estimate of 60%, it is unlikely that it will be at the 0.1–0.4% level currently embraced by many pandemic plans. We suggest that, based on surveillance and seroprevalence studies conducted in several countries, the real H5N1 CF rate should be closer to 14–33%.</p></sec><sec><title>Conclusions:</title><p>Clearly, if such a CF rate were to be sustained in a pandemic, H5N1 would present a truly dreadful scenario. A concerted and dedicated effort by the international community to avert a pandemic through combating avian influenza in animals and humans in affected countries needs to be a global priority.</p></sec></abstract></article-meta></front></article></istex:document></istex:metadataXml><mods version="3.6"><titleInfo lang="en"><title>Finding the real case-fatality rate of H5N1 avian influenza</title></titleInfo><titleInfo type="alternative" lang="en" contentType="CDATA"><title>Finding the real case-fatality rate of H5N1 avian influenza</title></titleInfo><name type="personal"><namePart type="given">F C K</namePart><namePart type="family">Li</namePart><affiliation>Centre for Infectious Disease Prevention and Control, Public Health Agency of Canada, Ottawa, Ontario, Canada</affiliation><role><roleTerm type="text">author</roleTerm></role></name><name type="personal"><namePart type="given">B C K</namePart><namePart type="family">Choi</namePart><affiliation>Department of Epidemiology and Community Medicine, University of Ottawa, Ottawa, Ontario; Department of Public Health Sciences, University of Toronto, Toronto, Ontario, Canada</affiliation><role><roleTerm type="text">author</roleTerm></role></name><name type="personal"><namePart type="given">T</namePart><namePart type="family">Sly</namePart><affiliation>School of Occupational and Public Health, Ryerson University, Toronto, Ontario, Canada</affiliation><role><roleTerm type="text">author</roleTerm></role></name><name type="personal"><namePart type="given">A W P</namePart><namePart type="family">Pak</namePart><affiliation>Pak Consulting, Ottawa, Ontario, Canada</affiliation><role><roleTerm type="text">author</roleTerm></role></name><typeOfResource>text</typeOfResource><genre type="research-article" displayLabel="research-article" authority="ISTEX" authorityURI="https://content-type.data.istex.fr" valueURI="https://content-type.data.istex.fr/ark:/67375/XTP-1JC4F85T-7">research-article</genre><originInfo><publisher>BMJ Publishing Group Ltd</publisher><dateIssued encoding="w3cdtf">2008-06</dateIssued><dateCreated encoding="w3cdtf">2008-05-13</dateCreated><copyrightDate encoding="w3cdtf">2008</copyrightDate></originInfo><language><languageTerm type="code" authority="iso639-2b">eng</languageTerm><languageTerm type="code" authority="rfc3066">en</languageTerm></language><abstract>Background: Accurate estimation of the case-fatality (CF) rate, or the proportion of cases that die, is central to pandemic planning. While estimates of CF rates for past influenza pandemics have ranged from about 0.1% (1957 and 1968 pandemics) to 2.5% (1918 pandemic), the official World Health Organization estimate for the current outbreak of H5N1 avian influenza to date is around 60%. Methods and results: The official estimate of the H5N1 CF rate has been described by some as an over-estimate, with little relevance to the rate that would be encountered under pandemic conditions. The reasons for such opinions are typically: (i) numerous undetected asymptomatic/mild cases, (ii) under-reporting of cases by some countries for economic or other reasons, and (iii) an expected decrease in virulence if and when the virus becomes widely transmitted in humans. Neither current data nor current literature, however, adequately supports these scenarios. While the real H5N1 CF rate could be lower than the current estimate of 60%, it is unlikely that it will be at the 0.1–0.4% level currently embraced by many pandemic plans. We suggest that, based on surveillance and seroprevalence studies conducted in several countries, the real H5N1 CF rate should be closer to 14–33%. Conclusions: Clearly, if such a CF rate were to be sustained in a pandemic, H5N1 would present a truly dreadful scenario. A concerted and dedicated effort by the international community to avert a pandemic through combating avian influenza in animals and humans in affected countries needs to be a global priority.</abstract><relatedItem type="host"><titleInfo><title>Journal of Epidemiology and Community Health</title></titleInfo><titleInfo type="abbreviated"><title>J Epidemiol Community Health</title></titleInfo><genre type="journal" authority="ISTEX" authorityURI="https://publication-type.data.istex.fr" valueURI="https://publication-type.data.istex.fr/ark:/67375/JMC-0GLKJH51-B">journal</genre><identifier type="ISSN">0143-005X</identifier><identifier type="eISSN">1470-2738</identifier><identifier type="PublisherID">jech</identifier><identifier type="PublisherID-hwp">jech</identifier><identifier type="PublisherID-nlm-ta">J Epidemiol Community Health</identifier><part><date>2008</date><detail type="volume"><caption>vol.</caption><number>62</number></detail><detail type="issue"><caption>no.</caption><number>6</number></detail><extent unit="pages"><start>555</start></extent></part></relatedItem><identifier type="istex">5BA5C68C5BA30E97A42BB1388C016E3E11F61B20</identifier><identifier type="ark">ark:/67375/NVC-KP9CZ780-C</identifier><identifier type="DOI">10.1136/jech.2007.064030</identifier><identifier type="href">jech-62-555.pdf</identifier><identifier type="ArticleID">ch64030</identifier><identifier type="PMID">18477756</identifier><identifier type="local">jech;62/6/555</identifier><accessCondition type="use and reproduction" contentType="copyright">2008 the BMJ Publishing Group</accessCondition><recordInfo><recordContentSource authority="ISTEX" authorityURI="https://loaded-corpus.data.istex.fr" valueURI="https://loaded-corpus.data.istex.fr/ark:/67375/XBH-7M42M2QJ-2">bmj</recordContentSource><recordOrigin>2008 the BMJ Publishing Group</recordOrigin></recordInfo></mods><json:item><extension>json</extension><original>false</original><mimetype>application/json</mimetype><uri>https://api.istex.fr/ark:/67375/NVC-KP9CZ780-C/record.json</uri></json:item></metadata><serie></serie></istex></record>Pour manipuler ce document sous Unix (Dilib)
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