2009 Pandemic Influenza A Virus Subtype H1N1 in Morocco, 2009-2010: Epidemiology, Transmissibility, and Factors Associated With Fatal Cases
Identifieur interne : 000398 ( PascalFrancis/Corpus ); précédent : 000397; suivant : 0003992009 Pandemic Influenza A Virus Subtype H1N1 in Morocco, 2009-2010: Epidemiology, Transmissibility, and Factors Associated With Fatal Cases
Auteurs : Amal Barakat ; Hassan Ihazmad ; Fatima El Falaki ; Stefano Tempia ; Imad Cherkaoui ; Rajae El AouadSource :
- The Journal of infectious diseases [ 0022-1899 ] ; 2012.
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- Pascal (Inist)
English descriptors
- KwdEn :
Abstract
Background. Following the emergence of 2009 pandemic influenza A virus subtype H1N1 (A[H1N1]pdm09) in the United States and Mexico in April 2009, A(H1N1)pdm09 spread rapidly all over the world. There is a dearth of information about the epidemiology of A(H1N1)pdm09 in Africa, including Morocco. We describe the epidemiologic characteristics of the A(H1N1)pdm09 epidemic in Morocco during 2009-2010, including transmissibility and risk factors associated with fatal disease. Methods. We implemented influenza surveillance for patients presenting with influenza-like illness (ILI) at 136 private and public clinics for patients with severe acute respiratory illness (SARI) at 16 regional public hospitals from June 2009 through February 2010. Respiratory samples and structured questionnaires were collected from all enrolled patients, and samples were tested by real-time reverse-transcription polymerase chain reaction for influenza viruses. We estimated the risk factors associated with fatal disease as well as the basic reproduction number (R0) and the serial interval of the pandemic virus. Results. From June 2009 through February 2010, we obtained 3937 specimens, of which 1452 tested positive for influenza virus. Of these, 1398 (96%) were A(H1N1)pdm09. Forty percent of specimens from ILI cases (1056 of 2646) and 27% from SARI cases (342 of 1291) were positive for A(H1N1)pdm09. Sixty-four deaths occurred among laboratory-confirmed A(H1N1)pdm09 SARI cases. Among these cases, those who had hypertension (age-adjusted odd ratio [aOR], 28.2; 95% confidence interval [CI], 2.0-398.7), had neurological disorders (aOR, 7.5; 95% CI, 1.5-36.4), or were obese (aOR, 7.1; 95% CI, 1.6-31.1), as well as women of gestational age who were pregnant (aOR, 2.5; 95% CI, 1.1-5.6), were at increased risk of death. Across the country, elevated numbers of locally acquired infections were detected 4 months after the detection of the first laboratory-confirmed case and coincided with the expected influenza season (October-January) in Morocco. We obtained an R0 estimate of 1.44 (95% CI, 1.32-1.56) and a mean serial interval (±SD) of 2.3 ± 1.4 days (95% CI, 1.6-3.0). Conclusion. Widespread but delayed community transmission of A(H1N1)pdm09 occurred in Morocco in 2009, and A(H1N1)pdm09 became the dominant influenza virus subtype during the 2009-2010 influenza season. The transmissibility characteristics were similar to those observed in other countries.
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| NO : | PASCAL 13-0059283 INIST |
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| ET : | 2009 Pandemic Influenza A Virus Subtype H1N1 in Morocco, 2009-2010: Epidemiology, Transmissibility, and Factors Associated With Fatal Cases |
| AU : | BARAKAT (Amal); IHAZMAD (Hassan); EL FALAKI (Fatima); TEMPIA (Stefano); CHERKAOUI (Imad); EL AOUAD (Rajae); KATZ (Mark A.); SCHOUB (Barry D.); HERAUD (Jean-Michel); WIDDOWSON (Marc-Alain) |
| AF : | Centre National de Reference de la Grippe, Institut National d'Hygiène, Ministère de la Santé/Maroc (1 aut., 2 aut., 3 aut.); Faculté des Sciences, Université Mohammed V-Agdal/Maroc (1 aut.); Institut National d'Hygiène, Ministère de la Santé/Rabat/Maroc (5 aut., 6 aut.); Influenza Division, US Centers for Diseases Control and Prevention-National Institute for Communicable Diseases/Johannesburg/Afrique du Sud (4 aut.); Global Disease Detection Division, Centers for Disease Control and Prevention/Nairobi/Kenya (1 aut.); University of the Witwatersrand/Johannesburg/Afrique du Sud (2 aut.); National Influenza Center, Institut Pasteur de Madagascar/Antanarivo/Madagascar (3 aut.); Centre for Vaccines and Immunology, National Institute for Communicable Diseases, National Health Laboratory Service/Johannesburg/Afrique du Sud (2 aut.); International Epidemiology and Research Team, Epidemiology and Prevention Branch Influenza Division, National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention/Atlanta, GA/Etats-Unis (4 aut.) |
| DT : | Publication en série; Niveau analytique |
| SO : | The Journal of infectious diseases; ISSN 0022-1899; Coden JIDIAQ; Royaume-Uni; Da. 2012; Vol. 206; No. SUP1; S94-S100; Bibl. 23 ref. |
| LA : | Anglais |
| EA : | Background. Following the emergence of 2009 pandemic influenza A virus subtype H1N1 (A[H1N1]pdm09) in the United States and Mexico in April 2009, A(H1N1)pdm09 spread rapidly all over the world. There is a dearth of information about the epidemiology of A(H1N1)pdm09 in Africa, including Morocco. We describe the epidemiologic characteristics of the A(H1N1)pdm09 epidemic in Morocco during 2009-2010, including transmissibility and risk factors associated with fatal disease. Methods. We implemented influenza surveillance for patients presenting with influenza-like illness (ILI) at 136 private and public clinics for patients with severe acute respiratory illness (SARI) at 16 regional public hospitals from June 2009 through February 2010. Respiratory samples and structured questionnaires were collected from all enrolled patients, and samples were tested by real-time reverse-transcription polymerase chain reaction for influenza viruses. We estimated the risk factors associated with fatal disease as well as the basic reproduction number (R0) and the serial interval of the pandemic virus. Results. From June 2009 through February 2010, we obtained 3937 specimens, of which 1452 tested positive for influenza virus. Of these, 1398 (96%) were A(H1N1)pdm09. Forty percent of specimens from ILI cases (1056 of 2646) and 27% from SARI cases (342 of 1291) were positive for A(H1N1)pdm09. Sixty-four deaths occurred among laboratory-confirmed A(H1N1)pdm09 SARI cases. Among these cases, those who had hypertension (age-adjusted odd ratio [aOR], 28.2; 95% confidence interval [CI], 2.0-398.7), had neurological disorders (aOR, 7.5; 95% CI, 1.5-36.4), or were obese (aOR, 7.1; 95% CI, 1.6-31.1), as well as women of gestational age who were pregnant (aOR, 2.5; 95% CI, 1.1-5.6), were at increased risk of death. Across the country, elevated numbers of locally acquired infections were detected 4 months after the detection of the first laboratory-confirmed case and coincided with the expected influenza season (October-January) in Morocco. We obtained an R0 estimate of 1.44 (95% CI, 1.32-1.56) and a mean serial interval (±SD) of 2.3 ± 1.4 days (95% CI, 1.6-3.0). Conclusion. Widespread but delayed community transmission of A(H1N1)pdm09 occurred in Morocco in 2009, and A(H1N1)pdm09 became the dominant influenza virus subtype during the 2009-2010 influenza season. The transmissibility characteristics were similar to those observed in other countries. |
| CC : | 002A05; 002B05 |
| FD : | Soustype; Maroc; Epidémiologie; Infection; Virus grippal A(H1N1) |
| FG : | Afrique; Afrique du Nord |
| ED : | Subtype; Morocco; Epidemiology; Infection; Influenzavirus A(H1N1) |
| EG : | Africa; North Africa |
| SD : | Subtipo; Marruecos; Epidemiología; Infección |
| LO : | INIST-2052.354000505499230140 |
| ID : | 13-0059283 |
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Associated With Fatal Cases</title><author><name sortKey="Barakat, Amal" sort="Barakat, Amal" uniqKey="Barakat A" first="Amal" last="Barakat">Amal Barakat</name><affiliation><inist:fA14 i1="01"><s1>Centre National de Reference de la Grippe, Institut National d'Hygiène, Ministère de la Santé</s1><s3>MAR</s3><sZ>1 aut.</sZ><sZ>2 aut.</sZ><sZ>3 aut.</sZ></inist:fA14></affiliation><affiliation><inist:fA14 i1="02"><s1>Faculté des Sciences, Université Mohammed V-Agdal</s1><s3>MAR</s3><sZ>1 aut.</sZ></inist:fA14></affiliation></author><author><name sortKey="Ihazmad, Hassan" sort="Ihazmad, Hassan" uniqKey="Ihazmad H" first="Hassan" last="Ihazmad">Hassan Ihazmad</name><affiliation><inist:fA14 i1="01"><s1>Centre National de Reference de la Grippe, Institut National d'Hygiène, Ministère de la Santé</s1><s3>MAR</s3><sZ>1 aut.</sZ><sZ>2 aut.</sZ><sZ>3 aut.</sZ></inist:fA14></affiliation></author><author><name sortKey="El Falaki, Fatima" sort="El Falaki, Fatima" uniqKey="El Falaki F" first="Fatima" last="El Falaki">Fatima El Falaki</name><affiliation><inist:fA14 i1="01"><s1>Centre National de Reference de la Grippe, Institut National d'Hygiène, Ministère de la Santé</s1><s3>MAR</s3><sZ>1 aut.</sZ><sZ>2 aut.</sZ><sZ>3 aut.</sZ></inist:fA14></affiliation></author><author><name sortKey="Tempia, Stefano" sort="Tempia, Stefano" uniqKey="Tempia S" first="Stefano" last="Tempia">Stefano Tempia</name><affiliation><inist:fA14 i1="04"><s1>Influenza Division, US Centers for Diseases Control and Prevention-National Institute for Communicable Diseases</s1><s2>Johannesburg</s2><s3>ZAF</s3><sZ>4 aut.</sZ></inist:fA14></affiliation></author><author><name sortKey="Cherkaoui, Imad" sort="Cherkaoui, Imad" uniqKey="Cherkaoui I" first="Imad" last="Cherkaoui">Imad Cherkaoui</name><affiliation><inist:fA14 i1="03"><s1>Institut National d'Hygiène, Ministère de la Santé</s1><s2>Rabat</s2><s3>MAR</s3><sZ>5 aut.</sZ><sZ>6 aut.</sZ></inist:fA14></affiliation></author><author><name sortKey="El Aouad, Rajae" sort="El Aouad, Rajae" uniqKey="El Aouad R" first="Rajae" last="El Aouad">Rajae El Aouad</name><affiliation><inist:fA14 i1="03"><s1>Institut National d'Hygiène, Ministère de la Santé</s1><s2>Rabat</s2><s3>MAR</s3><sZ>5 aut.</sZ><sZ>6 aut.</sZ></inist:fA14></affiliation></author></analytic><series><title level="j" type="main">The Journal of infectious diseases</title><title level="j" type="abbreviated">J. infect. dis.</title><idno type="ISSN">0022-1899</idno><imprint><date when="2012">2012</date></imprint></series></biblStruct></sourceDesc><seriesStmt><title level="j" type="main">The Journal of infectious diseases</title><title level="j" type="abbreviated">J. infect. dis.</title><idno type="ISSN">0022-1899</idno></seriesStmt></fileDesc><profileDesc><textClass><keywords scheme="KwdEn" xml:lang="en"><term>Epidemiology</term><term>Infection</term><term>Influenzavirus A(H1N1)</term><term>Morocco</term><term>Subtype</term></keywords><keywords scheme="Pascal" xml:lang="fr"><term>Soustype</term><term>Maroc</term><term>Epidémiologie</term><term>Infection</term><term>Virus grippal A(H1N1)</term></keywords></textClass></profileDesc></teiHeader><front><div type="abstract" xml:lang="en">Background. Following the emergence of 2009 pandemic influenza A virus subtype H1N1 (A[H1N1]pdm09) in the United States and Mexico in April 2009, A(H1N1)pdm09 spread rapidly all over the world. There is a dearth of information about the epidemiology of A(H1N1)pdm09 in Africa, including Morocco. We describe the epidemiologic characteristics of the A(H1N1)pdm09 epidemic in Morocco during 2009-2010, including transmissibility and risk factors associated with fatal disease. Methods. We implemented influenza surveillance for patients presenting with influenza-like illness (ILI) at 136 private and public clinics for patients with severe acute respiratory illness (SARI) at 16 regional public hospitals from June 2009 through February 2010. Respiratory samples and structured questionnaires were collected from all enrolled patients, and samples were tested by real-time reverse-transcription polymerase chain reaction for influenza viruses. We estimated the risk factors associated with fatal disease as well as the basic reproduction number (R<sub>0</sub>) and the serial interval of the pandemic virus. Results. From June 2009 through February 2010, we obtained 3937 specimens, of which 1452 tested positive for influenza virus. Of these, 1398 (96%) were A(H1N1)pdm09. Forty percent of specimens from ILI cases (1056 of 2646) and 27% from SARI cases (342 of 1291) were positive for A(H1N1)pdm09. Sixty-four deaths occurred among laboratory-confirmed A(H1N1)pdm09 SARI cases. Among these cases, those who had hypertension (age-adjusted odd ratio [aOR], 28.2; 95% confidence interval [CI], 2.0-398.7), had neurological disorders (aOR, 7.5; 95% CI, 1.5-36.4), or were obese (aOR, 7.1; 95% CI, 1.6-31.1), as well as women of gestational age who were pregnant (aOR, 2.5; 95% CI, 1.1-5.6), were at increased risk of death. Across the country, elevated numbers of locally acquired infections were detected 4 months after the detection of the first laboratory-confirmed case and coincided with the expected influenza season (October-January) in Morocco. We obtained an R<sub>0</sub> estimate of 1.44 (95% CI, 1.32-1.56) and a mean serial interval (±SD) of 2.3 ± 1.4 days (95% CI, 1.6-3.0). Conclusion. Widespread but delayed community transmission of A(H1N1)pdm09 occurred in Morocco in 2009, and A(H1N1)pdm09 became the dominant influenza virus subtype during the 2009-2010 influenza season. The transmissibility characteristics were similar to those observed in other countries.</div></front></TEI><inist><standard h6="B"><pA><fA01 i1="01" i2="1"><s0>0022-1899</s0></fA01><fA02 i1="01"><s0>JIDIAQ</s0></fA02><fA03 i2="1"><s0>J. infect. dis.</s0></fA03><fA05><s2>206</s2></fA05><fA06><s3>SUP1</s3></fA06><fA08 i1="01" i2="1" l="ENG"><s1>2009 Pandemic Influenza A Virus Subtype H1N1 in Morocco, 2009-2010: Epidemiology, Transmissibility, and Factors Associated With Fatal Cases</s1></fA08><fA09 i1="01" i2="1" l="ENG"><s1>INFLUENZA IN AFRICA</s1></fA09><fA11 i1="01" i2="1"><s1>BARAKAT (Amal)</s1></fA11><fA11 i1="02" i2="1"><s1>IHAZMAD (Hassan)</s1></fA11><fA11 i1="03" i2="1"><s1>EL FALAKI (Fatima)</s1></fA11><fA11 i1="04" i2="1"><s1>TEMPIA (Stefano)</s1></fA11><fA11 i1="05" i2="1"><s1>CHERKAOUI (Imad)</s1></fA11><fA11 i1="06" i2="1"><s1>EL AOUAD (Rajae)</s1></fA11><fA12 i1="01" i2="1"><s1>KATZ (Mark A.)</s1><s9>ed.</s9></fA12><fA12 i1="02" i2="1"><s1>SCHOUB (Barry D.)</s1><s9>ed.</s9></fA12><fA12 i1="03" i2="1"><s1>HERAUD (Jean-Michel)</s1><s9>ed.</s9></fA12><fA12 i1="04" i2="1"><s1>WIDDOWSON (Marc-Alain)</s1><s9>ed.</s9></fA12><fA14 i1="01"><s1>Centre National de Reference de la Grippe, Institut National d'Hygiène, Ministère de la Santé</s1><s3>MAR</s3><sZ>1 aut.</sZ><sZ>2 aut.</sZ><sZ>3 aut.</sZ></fA14><fA14 i1="02"><s1>Faculté des Sciences, Université Mohammed V-Agdal</s1><s3>MAR</s3><sZ>1 aut.</sZ></fA14><fA14 i1="03"><s1>Institut National d'Hygiène, Ministère de la Santé</s1><s2>Rabat</s2><s3>MAR</s3><sZ>5 aut.</sZ><sZ>6 aut.</sZ></fA14><fA14 i1="04"><s1>Influenza Division, US Centers for Diseases Control and Prevention-National Institute for Communicable Diseases</s1><s2>Johannesburg</s2><s3>ZAF</s3><sZ>4 aut.</sZ></fA14><fA15 i1="01"><s1>Global Disease Detection Division, Centers for Disease Control and Prevention</s1><s2>Nairobi</s2><s3>KEN</s3><sZ>1 aut.</sZ></fA15><fA15 i1="02"><s1>University of the Witwatersrand</s1><s2>Johannesburg</s2><s3>ZAF</s3><sZ>2 aut.</sZ></fA15><fA15 i1="03"><s1>National Influenza Center, Institut Pasteur de Madagascar</s1><s2>Antanarivo</s2><s3>MDG</s3><sZ>3 aut.</sZ></fA15><fA15 i1="04"><s1>Centre for Vaccines and Immunology, National Institute for Communicable Diseases, National Health Laboratory Service</s1><s2>Johannesburg</s2><s3>ZAF</s3><sZ>2 aut.</sZ></fA15><fA15 i1="05"><s1>International Epidemiology and Research Team, Epidemiology and Prevention Branch Influenza Division, National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention</s1><s2>Atlanta, GA</s2><s3>USA</s3><sZ>4 aut.</sZ></fA15><fA20><s2>S94-S100</s2></fA20><fA21><s1>2012</s1></fA21><fA23 i1="01"><s0>ENG</s0></fA23><fA43 i1="01"><s1>INIST</s1><s2>2052</s2><s5>354000505499230140</s5></fA43><fA44><s0>0000</s0><s1>© 2013 INIST-CNRS. All rights reserved.</s1></fA44><fA45><s0>23 ref.</s0></fA45><fA47 i1="01" i2="1"><s0>13-0059283</s0></fA47><fA60><s1>P</s1></fA60><fA61><s0>A</s0></fA61><fA64 i1="01" i2="1"><s0>The Journal of infectious diseases</s0></fA64><fA66 i1="01"><s0>GBR</s0></fA66><fC01 i1="01" l="ENG"><s0>Background. Following the emergence of 2009 pandemic influenza A virus subtype H1N1 (A[H1N1]pdm09) in the United States and Mexico in April 2009, A(H1N1)pdm09 spread rapidly all over the world. There is a dearth of information about the epidemiology of A(H1N1)pdm09 in Africa, including Morocco. We describe the epidemiologic characteristics of the A(H1N1)pdm09 epidemic in Morocco during 2009-2010, including transmissibility and risk factors associated with fatal disease. Methods. We implemented influenza surveillance for patients presenting with influenza-like illness (ILI) at 136 private and public clinics for patients with severe acute respiratory illness (SARI) at 16 regional public hospitals from June 2009 through February 2010. Respiratory samples and structured questionnaires were collected from all enrolled patients, and samples were tested by real-time reverse-transcription polymerase chain reaction for influenza viruses. We estimated the risk factors associated with fatal disease as well as the basic reproduction number (R<sub>0</sub>) and the serial interval of the pandemic virus. Results. From June 2009 through February 2010, we obtained 3937 specimens, of which 1452 tested positive for influenza virus. Of these, 1398 (96%) were A(H1N1)pdm09. Forty percent of specimens from ILI cases (1056 of 2646) and 27% from SARI cases (342 of 1291) were positive for A(H1N1)pdm09. Sixty-four deaths occurred among laboratory-confirmed A(H1N1)pdm09 SARI cases. Among these cases, those who had hypertension (age-adjusted odd ratio [aOR], 28.2; 95% confidence interval [CI], 2.0-398.7), had neurological disorders (aOR, 7.5; 95% CI, 1.5-36.4), or were obese (aOR, 7.1; 95% CI, 1.6-31.1), as well as women of gestational age who were pregnant (aOR, 2.5; 95% CI, 1.1-5.6), were at increased risk of death. Across the country, elevated numbers of locally acquired infections were detected 4 months after the detection of the first laboratory-confirmed case and coincided with the expected influenza season (October-January) in Morocco. We obtained an R<sub>0</sub> estimate of 1.44 (95% CI, 1.32-1.56) and a mean serial interval (±SD) of 2.3 ± 1.4 days (95% CI, 1.6-3.0). Conclusion. Widespread but delayed community transmission of A(H1N1)pdm09 occurred in Morocco in 2009, and A(H1N1)pdm09 became the dominant influenza virus subtype during the 2009-2010 influenza season. The transmissibility characteristics were similar to those observed in other countries.</s0></fC01><fC02 i1="01" i2="X"><s0>002A05</s0></fC02><fC02 i1="02" i2="X"><s0>002B05</s0></fC02><fC03 i1="01" i2="X" l="FRE"><s0>Soustype</s0><s5>05</s5></fC03><fC03 i1="01" i2="X" l="ENG"><s0>Subtype</s0><s5>05</s5></fC03><fC03 i1="01" i2="X" l="SPA"><s0>Subtipo</s0><s5>05</s5></fC03><fC03 i1="02" i2="X" l="FRE"><s0>Maroc</s0><s2>NG</s2><s5>06</s5></fC03><fC03 i1="02" i2="X" l="ENG"><s0>Morocco</s0><s2>NG</s2><s5>06</s5></fC03><fC03 i1="02" i2="X" l="SPA"><s0>Marruecos</s0><s2>NG</s2><s5>06</s5></fC03><fC03 i1="03" i2="X" l="FRE"><s0>Epidémiologie</s0><s5>07</s5></fC03><fC03 i1="03" i2="X" l="ENG"><s0>Epidemiology</s0><s5>07</s5></fC03><fC03 i1="03" i2="X" l="SPA"><s0>Epidemiología</s0><s5>07</s5></fC03><fC03 i1="04" i2="X" l="FRE"><s0>Infection</s0><s5>08</s5></fC03><fC03 i1="04" i2="X" l="ENG"><s0>Infection</s0><s5>08</s5></fC03><fC03 i1="04" i2="X" l="SPA"><s0>Infección</s0><s5>08</s5></fC03><fC03 i1="05" i2="X" l="FRE"><s0>Virus grippal A(H1N1)</s0><s4>CD</s4><s5>96</s5></fC03><fC03 i1="05" i2="X" l="ENG"><s0>Influenzavirus A(H1N1)</s0><s4>CD</s4><s5>96</s5></fC03><fC07 i1="01" i2="X" l="FRE"><s0>Afrique</s0><s2>NG</s2></fC07><fC07 i1="01" i2="X" l="ENG"><s0>Africa</s0><s2>NG</s2></fC07><fC07 i1="01" i2="X" l="SPA"><s0>Africa</s0><s2>NG</s2></fC07><fC07 i1="02" i2="X" l="FRE"><s0>Afrique du Nord</s0><s2>NG</s2><s5>13</s5></fC07><fC07 i1="02" i2="X" l="ENG"><s0>North Africa</s0><s2>NG</s2><s5>13</s5></fC07><fC07 i1="02" i2="X" l="SPA"><s0>Africa del norte</s0><s2>NG</s2><s5>13</s5></fC07><fN21><s1>035</s1></fN21><fN44 i1="01"><s1>OTO</s1></fN44><fN82><s1>OTO</s1></fN82></pA></standard><server><NO>PASCAL 13-0059283 INIST</NO><ET>2009 Pandemic Influenza A Virus Subtype H1N1 in Morocco, 2009-2010: Epidemiology, Transmissibility, and Factors Associated With Fatal Cases</ET><AU>BARAKAT (Amal); IHAZMAD (Hassan); EL FALAKI (Fatima); TEMPIA (Stefano); CHERKAOUI (Imad); EL AOUAD (Rajae); KATZ (Mark A.); SCHOUB (Barry D.); HERAUD (Jean-Michel); WIDDOWSON (Marc-Alain)</AU><AF>Centre National de Reference de la Grippe, Institut National d'Hygiène, Ministère de la Santé/Maroc (1 aut., 2 aut., 3 aut.); Faculté des Sciences, Université Mohammed V-Agdal/Maroc (1 aut.); Institut National d'Hygiène, Ministère de la Santé/Rabat/Maroc (5 aut., 6 aut.); Influenza Division, US Centers for Diseases Control and Prevention-National Institute for Communicable Diseases/Johannesburg/Afrique du Sud (4 aut.); Global Disease Detection Division, Centers for Disease Control and Prevention/Nairobi/Kenya (1 aut.); University of the Witwatersrand/Johannesburg/Afrique du Sud (2 aut.); National Influenza Center, Institut Pasteur de Madagascar/Antanarivo/Madagascar (3 aut.); Centre for Vaccines and Immunology, National Institute for Communicable Diseases, National Health Laboratory Service/Johannesburg/Afrique du Sud (2 aut.); International Epidemiology and Research Team, Epidemiology and Prevention Branch Influenza Division, National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention/Atlanta, GA/Etats-Unis (4 aut.)</AF><DT>Publication en série; Niveau analytique</DT><SO>The Journal of infectious diseases; ISSN 0022-1899; Coden JIDIAQ; Royaume-Uni; Da. 2012; Vol. 206; No. SUP1; S94-S100; Bibl. 23 ref.</SO><LA>Anglais</LA><EA>Background. Following the emergence of 2009 pandemic influenza A virus subtype H1N1 (A[H1N1]pdm09) in the United States and Mexico in April 2009, A(H1N1)pdm09 spread rapidly all over the world. There is a dearth of information about the epidemiology of A(H1N1)pdm09 in Africa, including Morocco. We describe the epidemiologic characteristics of the A(H1N1)pdm09 epidemic in Morocco during 2009-2010, including transmissibility and risk factors associated with fatal disease. Methods. We implemented influenza surveillance for patients presenting with influenza-like illness (ILI) at 136 private and public clinics for patients with severe acute respiratory illness (SARI) at 16 regional public hospitals from June 2009 through February 2010. Respiratory samples and structured questionnaires were collected from all enrolled patients, and samples were tested by real-time reverse-transcription polymerase chain reaction for influenza viruses. We estimated the risk factors associated with fatal disease as well as the basic reproduction number (R<sub>0</sub>) and the serial interval of the pandemic virus. Results. From June 2009 through February 2010, we obtained 3937 specimens, of which 1452 tested positive for influenza virus. Of these, 1398 (96%) were A(H1N1)pdm09. Forty percent of specimens from ILI cases (1056 of 2646) and 27% from SARI cases (342 of 1291) were positive for A(H1N1)pdm09. Sixty-four deaths occurred among laboratory-confirmed A(H1N1)pdm09 SARI cases. Among these cases, those who had hypertension (age-adjusted odd ratio [aOR], 28.2; 95% confidence interval [CI], 2.0-398.7), had neurological disorders (aOR, 7.5; 95% CI, 1.5-36.4), or were obese (aOR, 7.1; 95% CI, 1.6-31.1), as well as women of gestational age who were pregnant (aOR, 2.5; 95% CI, 1.1-5.6), were at increased risk of death. Across the country, elevated numbers of locally acquired infections were detected 4 months after the detection of the first laboratory-confirmed case and coincided with the expected influenza season (October-January) in Morocco. We obtained an R<sub>0</sub> estimate of 1.44 (95% CI, 1.32-1.56) and a mean serial interval (±SD) of 2.3 ± 1.4 days (95% CI, 1.6-3.0). Conclusion. Widespread but delayed community transmission of A(H1N1)pdm09 occurred in Morocco in 2009, and A(H1N1)pdm09 became the dominant influenza virus subtype during the 2009-2010 influenza season. The transmissibility characteristics were similar to those observed in other countries.</EA><CC>002A05; 002B05</CC><FD>Soustype; Maroc; Epidémiologie; Infection; Virus grippal A(H1N1)</FD><FG>Afrique; Afrique du Nord</FG><ED>Subtype; Morocco; Epidemiology; Infection; Influenzavirus A(H1N1)</ED><EG>Africa; North Africa</EG><SD>Subtipo; Marruecos; Epidemiología; Infección</SD><LO>INIST-2052.354000505499230140</LO><ID>13-0059283</ID></server></inist></record>Pour manipuler ce document sous Unix (Dilib)
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