Children under 10 years of age were more affected by the 2018/19 influenza A(H1N1)pdm09 epidemic in Canada: possible cohort effect following the 2009 influenza pandemic
Identifieur interne : 000086 ( Pmc/Checkpoint ); précédent : 000085; suivant : 000087Children under 10 years of age were more affected by the 2018/19 influenza A(H1N1)pdm09 epidemic in Canada: possible cohort effect following the 2009 influenza pandemic
Auteurs : Danuta M. Skowronski [Canada] ; Siobhan Leir [Canada] ; Gaston De Serres [Canada] ; Michelle Murti [Canada] ; James A. Dickinson [Canada] ; Anne-Luise Winter [Canada] ; Romy Olsha [Canada] ; Matthew A. Croxen [Canada] ; Steven J. Drews [Canada] ; Hugues Charest [Canada] ; Christine Martineau [Canada] ; Suzana Sabaiduc [Canada] ; Nathalie Bastien [Canada] ; Yan Li [Canada] ; Martin Petric [Canada] ; Agatha Jassem [Canada] ; Mel Krajden [Canada] ; Jonathan B. Gubbay [Canada]Source :
- Eurosurveillance [ 1025-496X ] ; 2019.
Abstract
Findings from the community-based Canadian Sentinel Practitioner Surveillance Network (SPSN) suggest children were more affected by the 2018/19 influenza A(H1N1)pdm09 epidemic.
To compare the age distribution of A(H1N1)pdm09 cases in 2018/19 to prior seasonal influenza epidemics in Canada.
The age distribution of unvaccinated influenza A(H1N1)pdm09 cases and test-negative controls were compared across A(H1N1)pdm09-dominant epidemics in 2018/19, 2015/16 and 2013/14 and with the general population of SPSN provinces. Similar comparisons were undertaken for influenza A(H3N2)-dominant epidemics.
In 2018/19, more influenza A(H1N1)pdm09 cases were under 10 years old than controls (29% vs 16%; p < 0.001). In particular, children aged 5–9 years comprised 14% of cases, greater than their contribution to controls (4%) or the general population (5%) and at least twice their contribution in 2015/16 (7%; p < 0.001) or 2013/14 (5%; p < 0.001). Conversely, children aged 10–19 years (11% of the population) were under-represented among A(H1N1)pdm09 cases versus controls in 2018/19 (7% vs 12%; p < 0.001), 2015/16 (7% vs 13%; p < 0.001) and 2013/14 (9% vs 12%; p = 0.12).
Children under 10 years old contributed more to outpatient A(H1N1)pdm09 medical visits in 2018/19 than prior seasonal epidemics in Canada. In 2018/19, all children under 10 years old were born after the 2009 A(H1N1)pdm09 pandemic and therefore lacked pandemic-induced immunity. In addition, more than half those born after 2009 now attend school (i.e. 5–9-year-olds), a socio-behavioural context that may enhance transmission and did not apply during prior A(H1N1)pdm09 epidemics.
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DOI: 10.2807/1560-7917.ES.2019.24.15.1900104
PubMed: 30994107
PubMed Central: 6470369
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Skowronski</name><affiliation wicri:level="1"><nlm:aff id="aff1">British Columbia Centre for Disease Control, Vancouver, Canada</nlm:aff><country xml:lang="fr">Canada</country><wicri:regionArea>British Columbia Centre for Disease Control, Vancouver</wicri:regionArea><wicri:noRegion>Vancouver</wicri:noRegion></affiliation><affiliation wicri:level="1"><nlm:aff id="aff2">University of British Columbia, Vancouver, Canada</nlm:aff><country xml:lang="fr">Canada</country><wicri:regionArea>University of British Columbia, Vancouver</wicri:regionArea><wicri:noRegion>Vancouver</wicri:noRegion></affiliation></author><author><name sortKey="Leir, Siobhan" sort="Leir, Siobhan" uniqKey="Leir S" first="Siobhan" last="Leir">Siobhan Leir</name><affiliation wicri:level="1"><nlm:aff id="aff1">British Columbia Centre for Disease Control, Vancouver, Canada</nlm:aff><country xml:lang="fr">Canada</country><wicri:regionArea>British Columbia Centre for Disease Control, Vancouver</wicri:regionArea><wicri:noRegion>Vancouver</wicri:noRegion></affiliation></author><author><name sortKey="De Serres, Gaston" sort="De Serres, Gaston" uniqKey="De Serres G" first="Gaston" last="De Serres">Gaston De Serres</name><affiliation wicri:level="1"><nlm:aff id="aff3">Institut National de Santé Publique du Québec, Quebec, Canada</nlm:aff><country xml:lang="fr">Canada</country><wicri:regionArea>Institut National de Santé Publique du Québec, Quebec</wicri:regionArea><wicri:noRegion>Quebec</wicri:noRegion></affiliation><affiliation wicri:level="1"><nlm:aff id="aff4">Laval University, Quebec, Canada</nlm:aff><country xml:lang="fr">Canada</country><wicri:regionArea>Laval University, Quebec</wicri:regionArea><wicri:noRegion>Quebec</wicri:noRegion></affiliation><affiliation wicri:level="1"><nlm:aff id="aff5">Centre Hospitalier Universitaire de Québec, Quebec, Canada</nlm:aff><country xml:lang="fr">Canada</country><wicri:regionArea>Centre Hospitalier Universitaire de Québec, Quebec</wicri:regionArea><wicri:noRegion>Quebec</wicri:noRegion></affiliation></author><author><name sortKey="Murti, Michelle" sort="Murti, Michelle" uniqKey="Murti M" first="Michelle" last="Murti">Michelle Murti</name><affiliation wicri:level="1"><nlm:aff id="aff6">Public Health Ontario, Toronto, Canada</nlm:aff><country xml:lang="fr">Canada</country><wicri:regionArea>Public Health Ontario, Toronto</wicri:regionArea><wicri:noRegion>Toronto</wicri:noRegion></affiliation><affiliation wicri:level="4"><nlm:aff id="aff7">University of Toronto, Toronto, Canada</nlm:aff><country xml:lang="fr">Canada</country><wicri:regionArea>University of Toronto, Toronto</wicri:regionArea><orgName type="university">Université de Toronto</orgName><placeName><settlement type="city">Toronto</settlement><region type="state">Ontario</region></placeName></affiliation></author><author><name sortKey="Dickinson, James A" sort="Dickinson, James A" uniqKey="Dickinson J" first="James A" last="Dickinson">James A. 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Croxen</name><affiliation wicri:level="1"><nlm:aff id="aff9">Provincial Laboratory for Public Health, Edmonton, Canada</nlm:aff><country xml:lang="fr">Canada</country><wicri:regionArea>Provincial Laboratory for Public Health, Edmonton</wicri:regionArea><wicri:noRegion>Edmonton</wicri:noRegion></affiliation><affiliation wicri:level="1"><nlm:aff id="aff10">University of Alberta, Edmonton, Canada</nlm:aff><country xml:lang="fr">Canada</country><wicri:regionArea>University of Alberta, Edmonton</wicri:regionArea><wicri:noRegion>Edmonton</wicri:noRegion></affiliation></author><author><name sortKey="Drews, Steven J" sort="Drews, Steven J" uniqKey="Drews S" first="Steven J" last="Drews">Steven J. Drews</name><affiliation wicri:level="1"><nlm:aff id="aff9">Provincial Laboratory for Public Health, Edmonton, Canada</nlm:aff><country xml:lang="fr">Canada</country><wicri:regionArea>Provincial Laboratory for Public Health, Edmonton</wicri:regionArea><wicri:noRegion>Edmonton</wicri:noRegion></affiliation><affiliation wicri:level="1"><nlm:aff id="aff10">University of Alberta, Edmonton, Canada</nlm:aff><country xml:lang="fr">Canada</country><wicri:regionArea>University of Alberta, Edmonton</wicri:regionArea><wicri:noRegion>Edmonton</wicri:noRegion></affiliation></author><author><name sortKey="Charest, Hugues" sort="Charest, Hugues" uniqKey="Charest H" first="Hugues" last="Charest">Hugues Charest</name><affiliation wicri:level="1"><nlm:aff id="aff3">Institut National de Santé Publique du Québec, Quebec, Canada</nlm:aff><country xml:lang="fr">Canada</country><wicri:regionArea>Institut National de Santé Publique du Québec, Quebec</wicri:regionArea><wicri:noRegion>Quebec</wicri:noRegion></affiliation></author><author><name sortKey="Martineau, Christine" sort="Martineau, Christine" uniqKey="Martineau C" first="Christine" last="Martineau">Christine Martineau</name><affiliation wicri:level="1"><nlm:aff id="aff3">Institut National de Santé Publique du Québec, Quebec, Canada</nlm:aff><country xml:lang="fr">Canada</country><wicri:regionArea>Institut National de Santé Publique du Québec, Quebec</wicri:regionArea><wicri:noRegion>Quebec</wicri:noRegion></affiliation></author><author><name sortKey="Sabaiduc, Suzana" sort="Sabaiduc, Suzana" uniqKey="Sabaiduc S" first="Suzana" last="Sabaiduc">Suzana Sabaiduc</name><affiliation wicri:level="1"><nlm:aff id="aff1">British Columbia Centre for Disease Control, Vancouver, Canada</nlm:aff><country xml:lang="fr">Canada</country><wicri:regionArea>British Columbia Centre for Disease Control, Vancouver</wicri:regionArea><wicri:noRegion>Vancouver</wicri:noRegion></affiliation></author><author><name sortKey="Bastien, Nathalie" sort="Bastien, Nathalie" uniqKey="Bastien N" first="Nathalie" last="Bastien">Nathalie Bastien</name><affiliation wicri:level="1"><nlm:aff id="aff11">National Microbiology Laboratory, Public Health Agency of Canada, Winnipeg, Canada</nlm:aff><country xml:lang="fr">Canada</country><wicri:regionArea>National Microbiology Laboratory, Public Health Agency of Canada, Winnipeg</wicri:regionArea><wicri:noRegion>Winnipeg</wicri:noRegion></affiliation></author><author><name sortKey="Li, Yan" sort="Li, Yan" uniqKey="Li Y" first="Yan" last="Li">Yan Li</name><affiliation wicri:level="1"><nlm:aff id="aff11">National Microbiology Laboratory, Public Health Agency of Canada, Winnipeg, Canada</nlm:aff><country xml:lang="fr">Canada</country><wicri:regionArea>National Microbiology Laboratory, Public Health Agency of Canada, Winnipeg</wicri:regionArea><wicri:noRegion>Winnipeg</wicri:noRegion></affiliation></author><author><name sortKey="Petric, Martin" sort="Petric, Martin" uniqKey="Petric M" first="Martin" last="Petric">Martin Petric</name><affiliation wicri:level="1"><nlm:aff id="aff2">University of British Columbia, Vancouver, Canada</nlm:aff><country xml:lang="fr">Canada</country><wicri:regionArea>University of British Columbia, Vancouver</wicri:regionArea><wicri:noRegion>Vancouver</wicri:noRegion></affiliation></author><author><name sortKey="Jassem, Agatha" sort="Jassem, Agatha" uniqKey="Jassem A" first="Agatha" last="Jassem">Agatha Jassem</name><affiliation wicri:level="1"><nlm:aff id="aff1">British Columbia Centre for Disease Control, Vancouver, Canada</nlm:aff><country xml:lang="fr">Canada</country><wicri:regionArea>British Columbia Centre for Disease Control, Vancouver</wicri:regionArea><wicri:noRegion>Vancouver</wicri:noRegion></affiliation><affiliation wicri:level="1"><nlm:aff id="aff2">University of British Columbia, Vancouver, Canada</nlm:aff><country xml:lang="fr">Canada</country><wicri:regionArea>University of British Columbia, Vancouver</wicri:regionArea><wicri:noRegion>Vancouver</wicri:noRegion></affiliation></author><author><name sortKey="Krajden, Mel" sort="Krajden, Mel" uniqKey="Krajden M" first="Mel" last="Krajden">Mel Krajden</name><affiliation wicri:level="1"><nlm:aff id="aff1">British Columbia Centre for Disease Control, Vancouver, Canada</nlm:aff><country xml:lang="fr">Canada</country><wicri:regionArea>British Columbia Centre for Disease Control, Vancouver</wicri:regionArea><wicri:noRegion>Vancouver</wicri:noRegion></affiliation><affiliation wicri:level="1"><nlm:aff id="aff2">University of British Columbia, Vancouver, Canada</nlm:aff><country xml:lang="fr">Canada</country><wicri:regionArea>University of British Columbia, Vancouver</wicri:regionArea><wicri:noRegion>Vancouver</wicri:noRegion></affiliation></author><author><name sortKey="Gubbay, Jonathan B" sort="Gubbay, Jonathan B" uniqKey="Gubbay J" first="Jonathan B" last="Gubbay">Jonathan B. Gubbay</name><affiliation wicri:level="1"><nlm:aff id="aff6">Public Health Ontario, Toronto, Canada</nlm:aff><country xml:lang="fr">Canada</country><wicri:regionArea>Public Health Ontario, Toronto</wicri:regionArea><wicri:noRegion>Toronto</wicri:noRegion></affiliation><affiliation wicri:level="4"><nlm:aff id="aff7">University of Toronto, Toronto, Canada</nlm:aff><country xml:lang="fr">Canada</country><wicri:regionArea>University of Toronto, Toronto</wicri:regionArea><orgName type="university">Université de Toronto</orgName><placeName><settlement type="city">Toronto</settlement><region type="state">Ontario</region></placeName></affiliation></author></titleStmt><publicationStmt><idno type="wicri:source">PMC</idno><idno type="pmid">30994107</idno><idno type="pmc">6470369</idno><idno type="url">http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6470369</idno><idno type="RBID">PMC:6470369</idno><idno type="doi">10.2807/1560-7917.ES.2019.24.15.1900104</idno><date when="2019">2019</date><idno type="wicri:Area/Pmc/Corpus">000A28</idno><idno type="wicri:explorRef" wicri:stream="Pmc" wicri:step="Corpus" wicri:corpus="PMC">000A28</idno><idno type="wicri:Area/Pmc/Curation">000A28</idno><idno type="wicri:explorRef" wicri:stream="Pmc" wicri:step="Curation">000A28</idno><idno type="wicri:Area/Pmc/Checkpoint">000086</idno><idno type="wicri:explorRef" wicri:stream="Pmc" wicri:step="Checkpoint">000086</idno></publicationStmt><sourceDesc><biblStruct><analytic><title xml:lang="en" level="a" type="main">Children under 10 years of age were more affected by the 2018/19 influenza A(H1N1)pdm09 epidemic in Canada: possible cohort effect following the 2009 influenza pandemic</title><author><name sortKey="Skowronski, Danuta M" sort="Skowronski, Danuta M" uniqKey="Skowronski D" first="Danuta M" last="Skowronski">Danuta M. Skowronski</name><affiliation wicri:level="1"><nlm:aff id="aff1">British Columbia Centre for Disease Control, Vancouver, Canada</nlm:aff><country xml:lang="fr">Canada</country><wicri:regionArea>British Columbia Centre for Disease Control, Vancouver</wicri:regionArea><wicri:noRegion>Vancouver</wicri:noRegion></affiliation><affiliation wicri:level="1"><nlm:aff id="aff2">University of British Columbia, Vancouver, Canada</nlm:aff><country xml:lang="fr">Canada</country><wicri:regionArea>University of British Columbia, Vancouver</wicri:regionArea><wicri:noRegion>Vancouver</wicri:noRegion></affiliation></author><author><name sortKey="Leir, Siobhan" sort="Leir, Siobhan" uniqKey="Leir S" first="Siobhan" last="Leir">Siobhan Leir</name><affiliation wicri:level="1"><nlm:aff id="aff1">British Columbia Centre for Disease Control, Vancouver, Canada</nlm:aff><country xml:lang="fr">Canada</country><wicri:regionArea>British Columbia Centre for Disease Control, Vancouver</wicri:regionArea><wicri:noRegion>Vancouver</wicri:noRegion></affiliation></author><author><name sortKey="De Serres, Gaston" sort="De Serres, Gaston" uniqKey="De Serres G" first="Gaston" last="De Serres">Gaston De Serres</name><affiliation wicri:level="1"><nlm:aff id="aff3">Institut National de Santé Publique du Québec, Quebec, Canada</nlm:aff><country xml:lang="fr">Canada</country><wicri:regionArea>Institut National de Santé Publique du Québec, Quebec</wicri:regionArea><wicri:noRegion>Quebec</wicri:noRegion></affiliation><affiliation wicri:level="1"><nlm:aff id="aff4">Laval University, Quebec, Canada</nlm:aff><country xml:lang="fr">Canada</country><wicri:regionArea>Laval University, Quebec</wicri:regionArea><wicri:noRegion>Quebec</wicri:noRegion></affiliation><affiliation wicri:level="1"><nlm:aff id="aff5">Centre Hospitalier Universitaire de Québec, Quebec, Canada</nlm:aff><country xml:lang="fr">Canada</country><wicri:regionArea>Centre Hospitalier Universitaire de Québec, Quebec</wicri:regionArea><wicri:noRegion>Quebec</wicri:noRegion></affiliation></author><author><name sortKey="Murti, Michelle" sort="Murti, Michelle" uniqKey="Murti M" first="Michelle" last="Murti">Michelle Murti</name><affiliation wicri:level="1"><nlm:aff id="aff6">Public Health Ontario, Toronto, Canada</nlm:aff><country xml:lang="fr">Canada</country><wicri:regionArea>Public Health Ontario, Toronto</wicri:regionArea><wicri:noRegion>Toronto</wicri:noRegion></affiliation><affiliation wicri:level="4"><nlm:aff id="aff7">University of Toronto, Toronto, Canada</nlm:aff><country xml:lang="fr">Canada</country><wicri:regionArea>University of Toronto, Toronto</wicri:regionArea><orgName type="university">Université de Toronto</orgName><placeName><settlement type="city">Toronto</settlement><region type="state">Ontario</region></placeName></affiliation></author><author><name sortKey="Dickinson, James A" sort="Dickinson, James A" uniqKey="Dickinson J" first="James A" last="Dickinson">James A. Dickinson</name><affiliation wicri:level="4"><nlm:aff id="aff8">University of Calgary, Calgary, Canada</nlm:aff><country xml:lang="fr">Canada</country><wicri:regionArea>University of Calgary, Calgary</wicri:regionArea><orgName type="university">Université de Calgary</orgName><placeName><settlement type="city">Calgary</settlement><region type="state">Alberta</region></placeName></affiliation></author><author><name sortKey="Winter, Anne Luise" sort="Winter, Anne Luise" uniqKey="Winter A" first="Anne-Luise" last="Winter">Anne-Luise Winter</name><affiliation wicri:level="1"><nlm:aff id="aff6">Public Health Ontario, Toronto, Canada</nlm:aff><country xml:lang="fr">Canada</country><wicri:regionArea>Public Health Ontario, Toronto</wicri:regionArea><wicri:noRegion>Toronto</wicri:noRegion></affiliation></author><author><name sortKey="Olsha, Romy" sort="Olsha, Romy" uniqKey="Olsha R" first="Romy" last="Olsha">Romy Olsha</name><affiliation wicri:level="1"><nlm:aff id="aff6">Public Health Ontario, Toronto, Canada</nlm:aff><country xml:lang="fr">Canada</country><wicri:regionArea>Public Health Ontario, Toronto</wicri:regionArea><wicri:noRegion>Toronto</wicri:noRegion></affiliation></author><author><name sortKey="Croxen, Matthew A" sort="Croxen, Matthew A" uniqKey="Croxen M" first="Matthew A" last="Croxen">Matthew A. Croxen</name><affiliation wicri:level="1"><nlm:aff id="aff9">Provincial Laboratory for Public Health, Edmonton, Canada</nlm:aff><country xml:lang="fr">Canada</country><wicri:regionArea>Provincial Laboratory for Public Health, Edmonton</wicri:regionArea><wicri:noRegion>Edmonton</wicri:noRegion></affiliation><affiliation wicri:level="1"><nlm:aff id="aff10">University of Alberta, Edmonton, Canada</nlm:aff><country xml:lang="fr">Canada</country><wicri:regionArea>University of Alberta, Edmonton</wicri:regionArea><wicri:noRegion>Edmonton</wicri:noRegion></affiliation></author><author><name sortKey="Drews, Steven J" sort="Drews, Steven J" uniqKey="Drews S" first="Steven J" last="Drews">Steven J. Drews</name><affiliation wicri:level="1"><nlm:aff id="aff9">Provincial Laboratory for Public Health, Edmonton, Canada</nlm:aff><country xml:lang="fr">Canada</country><wicri:regionArea>Provincial Laboratory for Public Health, Edmonton</wicri:regionArea><wicri:noRegion>Edmonton</wicri:noRegion></affiliation><affiliation wicri:level="1"><nlm:aff id="aff10">University of Alberta, Edmonton, Canada</nlm:aff><country xml:lang="fr">Canada</country><wicri:regionArea>University of Alberta, Edmonton</wicri:regionArea><wicri:noRegion>Edmonton</wicri:noRegion></affiliation></author><author><name sortKey="Charest, Hugues" sort="Charest, Hugues" uniqKey="Charest H" first="Hugues" last="Charest">Hugues Charest</name><affiliation wicri:level="1"><nlm:aff id="aff3">Institut National de Santé Publique du Québec, Quebec, Canada</nlm:aff><country xml:lang="fr">Canada</country><wicri:regionArea>Institut National de Santé Publique du Québec, Quebec</wicri:regionArea><wicri:noRegion>Quebec</wicri:noRegion></affiliation></author><author><name sortKey="Martineau, Christine" sort="Martineau, Christine" uniqKey="Martineau C" first="Christine" last="Martineau">Christine Martineau</name><affiliation wicri:level="1"><nlm:aff id="aff3">Institut National de Santé Publique du Québec, Quebec, Canada</nlm:aff><country xml:lang="fr">Canada</country><wicri:regionArea>Institut National de Santé Publique du Québec, Quebec</wicri:regionArea><wicri:noRegion>Quebec</wicri:noRegion></affiliation></author><author><name sortKey="Sabaiduc, Suzana" sort="Sabaiduc, Suzana" uniqKey="Sabaiduc S" first="Suzana" last="Sabaiduc">Suzana Sabaiduc</name><affiliation wicri:level="1"><nlm:aff id="aff1">British Columbia Centre for Disease Control, Vancouver, Canada</nlm:aff><country xml:lang="fr">Canada</country><wicri:regionArea>British Columbia Centre for Disease Control, Vancouver</wicri:regionArea><wicri:noRegion>Vancouver</wicri:noRegion></affiliation></author><author><name sortKey="Bastien, Nathalie" sort="Bastien, Nathalie" uniqKey="Bastien N" first="Nathalie" last="Bastien">Nathalie Bastien</name><affiliation wicri:level="1"><nlm:aff id="aff11">National Microbiology Laboratory, Public Health Agency of Canada, Winnipeg, Canada</nlm:aff><country xml:lang="fr">Canada</country><wicri:regionArea>National Microbiology Laboratory, Public Health Agency of Canada, Winnipeg</wicri:regionArea><wicri:noRegion>Winnipeg</wicri:noRegion></affiliation></author><author><name sortKey="Li, Yan" sort="Li, Yan" uniqKey="Li Y" first="Yan" last="Li">Yan Li</name><affiliation wicri:level="1"><nlm:aff id="aff11">National Microbiology Laboratory, Public Health Agency of Canada, Winnipeg, Canada</nlm:aff><country xml:lang="fr">Canada</country><wicri:regionArea>National Microbiology Laboratory, Public Health Agency of Canada, Winnipeg</wicri:regionArea><wicri:noRegion>Winnipeg</wicri:noRegion></affiliation></author><author><name sortKey="Petric, Martin" sort="Petric, Martin" uniqKey="Petric M" first="Martin" last="Petric">Martin Petric</name><affiliation wicri:level="1"><nlm:aff id="aff2">University of British Columbia, Vancouver, Canada</nlm:aff><country xml:lang="fr">Canada</country><wicri:regionArea>University of British Columbia, Vancouver</wicri:regionArea><wicri:noRegion>Vancouver</wicri:noRegion></affiliation></author><author><name sortKey="Jassem, Agatha" sort="Jassem, Agatha" uniqKey="Jassem A" first="Agatha" last="Jassem">Agatha Jassem</name><affiliation wicri:level="1"><nlm:aff id="aff1">British Columbia Centre for Disease Control, Vancouver, Canada</nlm:aff><country xml:lang="fr">Canada</country><wicri:regionArea>British Columbia Centre for Disease Control, Vancouver</wicri:regionArea><wicri:noRegion>Vancouver</wicri:noRegion></affiliation><affiliation wicri:level="1"><nlm:aff id="aff2">University of British Columbia, Vancouver, Canada</nlm:aff><country xml:lang="fr">Canada</country><wicri:regionArea>University of British Columbia, Vancouver</wicri:regionArea><wicri:noRegion>Vancouver</wicri:noRegion></affiliation></author><author><name sortKey="Krajden, Mel" sort="Krajden, Mel" uniqKey="Krajden M" first="Mel" last="Krajden">Mel Krajden</name><affiliation wicri:level="1"><nlm:aff id="aff1">British Columbia Centre for Disease Control, Vancouver, Canada</nlm:aff><country xml:lang="fr">Canada</country><wicri:regionArea>British Columbia Centre for Disease Control, Vancouver</wicri:regionArea><wicri:noRegion>Vancouver</wicri:noRegion></affiliation><affiliation wicri:level="1"><nlm:aff id="aff2">University of British Columbia, Vancouver, Canada</nlm:aff><country xml:lang="fr">Canada</country><wicri:regionArea>University of British Columbia, Vancouver</wicri:regionArea><wicri:noRegion>Vancouver</wicri:noRegion></affiliation></author><author><name sortKey="Gubbay, Jonathan B" sort="Gubbay, Jonathan B" uniqKey="Gubbay J" first="Jonathan B" last="Gubbay">Jonathan B. Gubbay</name><affiliation wicri:level="1"><nlm:aff id="aff6">Public Health Ontario, Toronto, Canada</nlm:aff><country xml:lang="fr">Canada</country><wicri:regionArea>Public Health Ontario, Toronto</wicri:regionArea><wicri:noRegion>Toronto</wicri:noRegion></affiliation><affiliation wicri:level="4"><nlm:aff id="aff7">University of Toronto, Toronto, Canada</nlm:aff><country xml:lang="fr">Canada</country><wicri:regionArea>University of Toronto, Toronto</wicri:regionArea><orgName type="university">Université de Toronto</orgName><placeName><settlement type="city">Toronto</settlement><region type="state">Ontario</region></placeName></affiliation></author></analytic><series><title level="j">Eurosurveillance</title><idno type="ISSN">1025-496X</idno><idno type="eISSN">1560-7917</idno><imprint><date when="2019">2019</date></imprint></series></biblStruct></sourceDesc></fileDesc><profileDesc><textClass></textClass></profileDesc></teiHeader><front><div type="abstract" xml:lang="en"><sec><title>Introduction</title><p>Findings from the community-based Canadian Sentinel Practitioner Surveillance Network (SPSN) suggest children were more affected by the 2018/19 influenza A(H1N1)pdm09 epidemic.</p></sec><sec><title>Aim</title><p>To compare the age distribution of A(H1N1)pdm09 cases in 2018/19 to prior seasonal influenza epidemics in Canada.</p></sec><sec><title>Methods</title><p>The age distribution of unvaccinated influenza A(H1N1)pdm09 cases and test-negative controls were compared across A(H1N1)pdm09-dominant epidemics in 2018/19, 2015/16 and 2013/14 and with the general population of SPSN provinces. Similar comparisons were undertaken for influenza A(H3N2)-dominant epidemics.</p></sec><sec><title>Results</title><p>In 2018/19, more influenza A(H1N1)pdm09 cases were under 10 years old than controls (29% vs 16%; p < 0.001). In particular, children aged 5–9 years comprised 14% of cases, greater than their contribution to controls (4%) or the general population (5%) and at least twice their contribution in 2015/16 (7%; p < 0.001) or 2013/14 (5%; p < 0.001). Conversely, children aged 10–19 years (11% of the population) were under-represented among A(H1N1)pdm09 cases versus controls in 2018/19 (7% vs 12%; p < 0.001), 2015/16 (7% vs 13%; p < 0.001) and 2013/14 (9% vs 12%; p = 0.12).</p></sec><sec><title>Conclusion</title><p>Children under 10 years old contributed more to outpatient A(H1N1)pdm09 medical visits in 2018/19 than prior seasonal epidemics in Canada. In 2018/19, all children under 10 years old were born after the 2009 A(H1N1)pdm09 pandemic and therefore lacked pandemic-induced immunity. In addition, more than half those born after 2009 now attend school (i.e. 5–9-year-olds), a socio-behavioural context that may enhance transmission and did not apply during prior A(H1N1)pdm09 epidemics.</p></sec></div></front><back><div1 type="bibliography"><listBibl><biblStruct></biblStruct><biblStruct></biblStruct><biblStruct></biblStruct><biblStruct><analytic><author><name sortKey="Segaloff, H" uniqKey="Segaloff H">H Segaloff</name></author><author><name sortKey="Melidou, A" uniqKey="Melidou A">A Melidou</name></author><author><name sortKey="Adlhoch, C" uniqKey="Adlhoch C">C Adlhoch</name></author><author><name sortKey="Pereyaslov, D" uniqKey="Pereyaslov D">D Pereyaslov</name></author><author><name sortKey="Robesyn, E" uniqKey="Robesyn E">E Robesyn</name></author><author><name sortKey="Penttinen, P" uniqKey="Penttinen P">P Penttinen</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Skowronski, Dm" uniqKey="Skowronski D">DM 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sortKey="Finelli, L" uniqKey="Finelli L">L Finelli</name></author><author><name sortKey="Cheng, P Y" uniqKey="Cheng P">P-Y Cheng</name></author><author><name sortKey="Gargiullo, Pm" uniqKey="Gargiullo P">PM Gargiullo</name></author><author><name sortKey="Shay, Dk" uniqKey="Shay D">DK Shay</name></author></analytic></biblStruct><biblStruct></biblStruct><biblStruct></biblStruct></listBibl></div1></back></TEI><pmc article-type="research-article"><pmc-dir>properties open_access</pmc-dir>
<front><journal-meta><journal-id journal-id-type="nlm-ta">Euro Surveill</journal-id><journal-id journal-id-type="iso-abbrev">Euro Surveill</journal-id><journal-id journal-id-type="publisher-id">ES</journal-id><journal-title-group><journal-title>Eurosurveillance</journal-title></journal-title-group><issn pub-type="ppub">1025-496X</issn><issn pub-type="epub">1560-7917</issn><publisher><publisher-name>European Centre for Disease Prevention and Control (ECDC)</publisher-name></publisher></journal-meta><article-meta><article-id pub-id-type="pmid">30994107</article-id><article-id pub-id-type="pmc">6470369</article-id><article-id pub-id-type="publisher-id">1900104</article-id><article-id pub-id-type="doi">10.2807/1560-7917.ES.2019.24.15.1900104</article-id><article-id pub-id-type="publisher-id">1900104</article-id><article-categories><subj-group subj-group-type="heading"><subject>Research</subject></subj-group></article-categories><title-group><article-title>Children under 10 years of age were more affected by the 2018/19 influenza A(H1N1)pdm09 epidemic in Canada: possible cohort effect following the 2009 influenza pandemic</article-title></title-group><contrib-group><contrib contrib-type="author"><name><surname>Skowronski</surname><given-names>Danuta M</given-names></name><xref ref-type="aff" rid="aff1"><sup>1</sup></xref><xref ref-type="aff" rid="aff2"><sup>2</sup></xref></contrib><contrib contrib-type="author"><name><surname>Leir</surname><given-names>Siobhan</given-names></name><xref ref-type="aff" rid="aff1"><sup>1</sup></xref></contrib><contrib contrib-type="author"><name><surname>De Serres</surname><given-names>Gaston</given-names></name><xref ref-type="aff" rid="aff3"><sup>3</sup></xref><xref ref-type="aff" rid="aff4"><sup>4</sup></xref><xref ref-type="aff" rid="aff5"><sup>5</sup></xref></contrib><contrib contrib-type="author"><name><surname>Murti</surname><given-names>Michelle</given-names></name><xref ref-type="aff" rid="aff6"><sup>6</sup></xref><xref ref-type="aff" rid="aff7"><sup>7</sup></xref></contrib><contrib contrib-type="author"><name><surname>Dickinson</surname><given-names>James A</given-names></name><xref ref-type="aff" rid="aff8"><sup>8</sup></xref></contrib><contrib contrib-type="author"><name><surname>Winter</surname><given-names>Anne-Luise</given-names></name><xref ref-type="aff" rid="aff6"><sup>6</sup></xref></contrib><contrib contrib-type="author"><name><surname>Olsha</surname><given-names>Romy</given-names></name><xref ref-type="aff" rid="aff6"><sup>6</sup></xref></contrib><contrib contrib-type="author"><name><surname>Croxen</surname><given-names>Matthew A</given-names></name><xref ref-type="aff" rid="aff9"><sup>9</sup></xref><xref ref-type="aff" rid="aff10"><sup>10</sup></xref></contrib><contrib contrib-type="author"><name><surname>Drews</surname><given-names>Steven J</given-names></name><xref ref-type="aff" rid="aff9"><sup>9</sup></xref><xref ref-type="aff" rid="aff10"><sup>10</sup></xref></contrib><contrib contrib-type="author"><name><surname>Charest</surname><given-names>Hugues</given-names></name><xref ref-type="aff" rid="aff3"><sup>3</sup></xref></contrib><contrib contrib-type="author"><name><surname>Martineau</surname><given-names>Christine</given-names></name><xref ref-type="aff" rid="aff3"><sup>3</sup></xref></contrib><contrib contrib-type="author"><name><surname>Sabaiduc</surname><given-names>Suzana</given-names></name><xref ref-type="aff" rid="aff1"><sup>1</sup></xref></contrib><contrib contrib-type="author"><name><surname>Bastien</surname><given-names>Nathalie</given-names></name><xref ref-type="aff" rid="aff11"><sup>11</sup></xref></contrib><contrib contrib-type="author"><name><surname>Li</surname><given-names>Yan</given-names></name><xref ref-type="aff" rid="aff11"><sup>11</sup></xref></contrib><contrib contrib-type="author"><name><surname>Petric</surname><given-names>Martin</given-names></name><xref ref-type="aff" rid="aff2"><sup>2</sup></xref></contrib><contrib contrib-type="author"><name><surname>Jassem</surname><given-names>Agatha</given-names></name><xref ref-type="aff" rid="aff1"><sup>1</sup></xref><xref ref-type="aff" rid="aff2"><sup>2</sup></xref></contrib><contrib contrib-type="author"><name><surname>Krajden</surname><given-names>Mel</given-names></name><xref ref-type="aff" rid="aff1"><sup>1</sup></xref><xref ref-type="aff" rid="aff2"><sup>2</sup></xref></contrib><contrib contrib-type="author"><name><surname>Gubbay</surname><given-names>Jonathan B</given-names></name><xref ref-type="aff" rid="aff6"><sup>6</sup></xref><xref ref-type="aff" rid="aff7"><sup>7</sup></xref></contrib><aff id="aff1"><label>1</label>British Columbia Centre for Disease Control, Vancouver, Canada</aff><aff id="aff2"><label>2</label>University of British Columbia, Vancouver, Canada</aff><aff id="aff3"><label>3</label>Institut National de Santé Publique du Québec, Quebec, Canada</aff><aff id="aff4"><label>4</label>Laval University, Quebec, Canada</aff><aff id="aff5"><label>5</label>Centre Hospitalier Universitaire de Québec, Quebec, Canada</aff><aff id="aff6"><label>6</label>Public Health Ontario, Toronto, Canada</aff><aff id="aff7"><label>7</label>University of Toronto, Toronto, Canada</aff><aff id="aff8"><label>8</label>University of Calgary, Calgary, Canada</aff><aff id="aff9"><label>9</label>Provincial Laboratory for Public Health, Edmonton, Canada</aff><aff id="aff10"><label>10</label>University of Alberta, Edmonton, Canada</aff><aff id="aff11"><label>11</label>National Microbiology Laboratory, Public Health Agency of Canada, Winnipeg, Canada</aff></contrib-group><author-notes><fn id="afn1"><p>Correspondence: Danuta M Skowronski (<email xlink:href="danuta.skowronski@bccdc.ca">danuta.skowronski@bccdc.ca</email>)</p></fn></author-notes><pub-date pub-type="ppub"><day>11</day><month>4</month><year>2019</year></pub-date><volume>24</volume><issue>15</issue><elocation-id>1900104</elocation-id><history><date date-type="received"><day>10</day><month>2</month><year>2019</year></date><date date-type="accepted"><day>12</day><month>3</month><year>2019</year></date></history><permissions><copyright-statement>This article is copyright of the authors or their affiliated institutions, 2019.</copyright-statement><copyright-year>2019</copyright-year><copyright-holder>The authors or their affiliated institutions</copyright-holder><license license-type="open-access" xlink:href="http://creativecommons.org/licenses/by/4.0/"><license-p>This is an open-access article distributed under the terms of the Creative Commons Attribution (CC BY 4.0) Licence. You may share and adapt the material, but must give appropriate credit to the source, provide a link to the licence, and indicate if changes were made.</license-p></license></permissions><abstract><sec><title>Introduction</title><p>Findings from the community-based Canadian Sentinel Practitioner Surveillance Network (SPSN) suggest children were more affected by the 2018/19 influenza A(H1N1)pdm09 epidemic.</p></sec><sec><title>Aim</title><p>To compare the age distribution of A(H1N1)pdm09 cases in 2018/19 to prior seasonal influenza epidemics in Canada.</p></sec><sec><title>Methods</title><p>The age distribution of unvaccinated influenza A(H1N1)pdm09 cases and test-negative controls were compared across A(H1N1)pdm09-dominant epidemics in 2018/19, 2015/16 and 2013/14 and with the general population of SPSN provinces. Similar comparisons were undertaken for influenza A(H3N2)-dominant epidemics.</p></sec><sec><title>Results</title><p>In 2018/19, more influenza A(H1N1)pdm09 cases were under 10 years old than controls (29% vs 16%; p < 0.001). In particular, children aged 5–9 years comprised 14% of cases, greater than their contribution to controls (4%) or the general population (5%) and at least twice their contribution in 2015/16 (7%; p < 0.001) or 2013/14 (5%; p < 0.001). Conversely, children aged 10–19 years (11% of the population) were under-represented among A(H1N1)pdm09 cases versus controls in 2018/19 (7% vs 12%; p < 0.001), 2015/16 (7% vs 13%; p < 0.001) and 2013/14 (9% vs 12%; p = 0.12).</p></sec><sec><title>Conclusion</title><p>Children under 10 years old contributed more to outpatient A(H1N1)pdm09 medical visits in 2018/19 than prior seasonal epidemics in Canada. In 2018/19, all children under 10 years old were born after the 2009 A(H1N1)pdm09 pandemic and therefore lacked pandemic-induced immunity. In addition, more than half those born after 2009 now attend school (i.e. 5–9-year-olds), a socio-behavioural context that may enhance transmission and did not apply during prior A(H1N1)pdm09 epidemics.</p></sec></abstract><kwd-group><title>Keywords: </title><kwd>influenza</kwd><kwd>A(H1N1)pdm09</kwd><kwd>A(H3N2)</kwd><kwd>age</kwd><kwd>epidemic</kwd><kwd>pandemic</kwd><kwd>Canada</kwd><kwd>air-borne infections</kwd><kwd>viral infections</kwd><kwd>influenza</kwd><kwd>influenza-like illness</kwd><kwd>ILI</kwd><kwd>influenza virus</kwd><kwd>laboratory surveillance</kwd><kwd>sentinel surveillance</kwd><kwd>epidemiology</kwd><kwd>laboratory</kwd></kwd-group></article-meta></front></pmc><affiliations><list><country><li>Canada</li></country><region><li>Alberta</li><li>Ontario</li></region><settlement><li>Calgary</li><li>Toronto</li></settlement><orgName><li>Université de Calgary</li><li>Université de Toronto</li></orgName></list><tree><country name="Canada"><noRegion><name sortKey="Skowronski, Danuta M" sort="Skowronski, Danuta M" uniqKey="Skowronski D" first="Danuta M" last="Skowronski">Danuta M. Skowronski</name></noRegion><name sortKey="Bastien, Nathalie" sort="Bastien, Nathalie" uniqKey="Bastien N" first="Nathalie" last="Bastien">Nathalie Bastien</name><name sortKey="Charest, Hugues" sort="Charest, Hugues" uniqKey="Charest H" first="Hugues" last="Charest">Hugues Charest</name><name sortKey="Croxen, Matthew A" sort="Croxen, Matthew A" uniqKey="Croxen M" first="Matthew A" last="Croxen">Matthew A. Croxen</name><name sortKey="Croxen, Matthew A" sort="Croxen, Matthew A" uniqKey="Croxen M" first="Matthew A" last="Croxen">Matthew A. Croxen</name><name sortKey="De Serres, Gaston" sort="De Serres, Gaston" uniqKey="De Serres G" first="Gaston" last="De Serres">Gaston De Serres</name><name sortKey="De Serres, Gaston" sort="De Serres, Gaston" uniqKey="De Serres G" first="Gaston" last="De Serres">Gaston De Serres</name><name sortKey="De Serres, Gaston" sort="De Serres, Gaston" uniqKey="De Serres G" first="Gaston" last="De Serres">Gaston De Serres</name><name sortKey="Dickinson, James A" sort="Dickinson, James A" uniqKey="Dickinson J" first="James A" last="Dickinson">James A. Dickinson</name><name sortKey="Drews, Steven J" sort="Drews, Steven J" uniqKey="Drews S" first="Steven J" last="Drews">Steven J. Drews</name><name sortKey="Drews, Steven J" sort="Drews, Steven J" uniqKey="Drews S" first="Steven J" last="Drews">Steven J. Drews</name><name sortKey="Gubbay, Jonathan B" sort="Gubbay, Jonathan B" uniqKey="Gubbay J" first="Jonathan B" last="Gubbay">Jonathan B. Gubbay</name><name sortKey="Gubbay, Jonathan B" sort="Gubbay, Jonathan B" uniqKey="Gubbay J" first="Jonathan B" last="Gubbay">Jonathan B. Gubbay</name><name sortKey="Jassem, Agatha" sort="Jassem, Agatha" uniqKey="Jassem A" first="Agatha" last="Jassem">Agatha Jassem</name><name sortKey="Jassem, Agatha" sort="Jassem, Agatha" uniqKey="Jassem A" first="Agatha" last="Jassem">Agatha Jassem</name><name sortKey="Krajden, Mel" sort="Krajden, Mel" uniqKey="Krajden M" first="Mel" last="Krajden">Mel Krajden</name><name sortKey="Krajden, Mel" sort="Krajden, Mel" uniqKey="Krajden M" first="Mel" last="Krajden">Mel Krajden</name><name sortKey="Leir, Siobhan" sort="Leir, Siobhan" uniqKey="Leir S" first="Siobhan" last="Leir">Siobhan Leir</name><name sortKey="Li, Yan" sort="Li, Yan" uniqKey="Li Y" first="Yan" last="Li">Yan Li</name><name sortKey="Martineau, Christine" sort="Martineau, Christine" uniqKey="Martineau C" first="Christine" last="Martineau">Christine Martineau</name><name sortKey="Murti, Michelle" sort="Murti, Michelle" uniqKey="Murti M" first="Michelle" last="Murti">Michelle Murti</name><name sortKey="Murti, Michelle" sort="Murti, Michelle" uniqKey="Murti M" first="Michelle" last="Murti">Michelle Murti</name><name sortKey="Olsha, Romy" sort="Olsha, Romy" uniqKey="Olsha R" first="Romy" last="Olsha">Romy Olsha</name><name sortKey="Petric, Martin" sort="Petric, Martin" uniqKey="Petric M" first="Martin" last="Petric">Martin Petric</name><name sortKey="Sabaiduc, Suzana" sort="Sabaiduc, Suzana" uniqKey="Sabaiduc S" first="Suzana" last="Sabaiduc">Suzana Sabaiduc</name><name sortKey="Skowronski, Danuta M" sort="Skowronski, Danuta M" uniqKey="Skowronski D" first="Danuta M" last="Skowronski">Danuta M. Skowronski</name><name sortKey="Winter, Anne Luise" sort="Winter, Anne Luise" uniqKey="Winter A" first="Anne-Luise" last="Winter">Anne-Luise Winter</name></country></tree></affiliations></record>Pour manipuler ce document sous Unix (Dilib)
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