New variants and age shift to high fatality groups contribute to severe successive waves in the 2009 influenza pandemic in Taiwan.
Identifieur interne : 000F10 ( PubMed/Checkpoint ); précédent : 000F09; suivant : 000F11New variants and age shift to high fatality groups contribute to severe successive waves in the 2009 influenza pandemic in Taiwan.
Auteurs : Ji-Rong Yang [République populaire de Chine] ; Yuan-Pin Huang ; Feng-Yee Chang ; Li-Ching Hsu ; Yu-Cheng Lin ; Chun-Hui Su ; Pei-Jer Chen ; Ho-Sheng Wu ; Ming-Tsan LiuSource :
- PloS one [ 1932-6203 ] ; 2011.
Descripteurs français
- KwdFr :
- Adolescent, Adulte, Adulte d'âge moyen, Données de séquences moléculaires, Enfant, Enfant d'âge préscolaire, Grippe humaine (mortalité), Grippe humaine (virologie), Hospitalisation (), Humains, Indice de gravité médicale, Jeune adulte, Mutation (génétique), Nourrisson, Nouveau-né, Pandémies (), Phylogénie, Répartition par âge, Saisons, Sous-type H1N1 du virus de la grippe A (génétique), Sous-type H1N1 du virus de la grippe A (isolement et purification), Sujet âgé, Taïwan (épidémiologie), Vieillissement (anatomopathologie).
- MESH :
- anatomopathologie : Vieillissement.
- génétique : Mutation, Sous-type H1N1 du virus de la grippe A.
- isolement et purification : Sous-type H1N1 du virus de la grippe A.
- mortalité : Grippe humaine.
- virologie : Grippe humaine.
- épidémiologie : Taïwan.
- Adolescent, Adulte, Adulte d'âge moyen, Données de séquences moléculaires, Enfant, Enfant d'âge préscolaire, Hospitalisation, Humains, Indice de gravité médicale, Jeune adulte, Nourrisson, Nouveau-né, Pandémies, Phylogénie, Répartition par âge, Saisons, Sujet âgé.
- Wicri :
- geographic : Taïwan.
English descriptors
- KwdEn :
- Adolescent, Adult, Age Distribution, Aged, Aging (pathology), Child, Child, Preschool, Hospitalization (statistics & numerical data), Humans, Infant, Infant, Newborn, Influenza A Virus, H1N1 Subtype (genetics), Influenza A Virus, H1N1 Subtype (isolation & purification), Influenza, Human (mortality), Influenza, Human (virology), Middle Aged, Molecular Sequence Data, Mutation (genetics), Pandemics (statistics & numerical data), Phylogeny, Seasons, Severity of Illness Index, Taiwan (epidemiology), Young Adult.
- MESH :
- geographic , epidemiology : Taiwan.
- genetics : Influenza A Virus, H1N1 Subtype, Mutation.
- isolation & purification : Influenza A Virus, H1N1 Subtype.
- mortality : Influenza, Human.
- pathology : Aging.
- statistics & numerical data : Hospitalization, Pandemics.
- virology : Influenza, Human.
- Adolescent, Adult, Age Distribution, Aged, Child, Child, Preschool, Humans, Infant, Infant, Newborn, Middle Aged, Molecular Sequence Data, Phylogeny, Seasons, Severity of Illness Index, Young Adult.
Abstract
Past influenza pandemics have been characterized by the signature feature of multiple waves. However, the reasons for multiple waves in a pandemic are not understood. Successive waves in the 2009 influenza pandemic, with a sharp increase in hospitalized and fatal cases, occurred in Taiwan during the winter of 2010. In this study, we sought to discover possible contributors to the multiple waves in this influenza pandemic. We conducted a large-scale analysis of 4703 isolates in an unbiased manner to monitor the emergence, dominance and replacement of various variants. Based on the data from influenza surveillance and epidemic curves of each variant clade, we defined virologically and temporally distinct waves of the 2009 pandemic in Taiwan from May 2009 to April 2011 as waves 1 and 2, an interwave period and wave 3. Except for wave 3, each wave was dominated by one distinct variant. In wave 3, three variants emerged and co-circulated, and formed distinct phylogenetic clades, based on the hemagglutinin (HA) genes and other segments. The severity of influenza was represented as the case fatality ratio (CFR) in the hospitalized cases. The CFRs in waves 1 and 2, the interwave period and wave 3 were 6.4%, 5.1%, 15.2% and 9.8%, respectively. The results highlight the association of virus evolution and variable influenza severity. Further analysis revealed that the major affected groups were shifted in the waves to older individuals, who had higher age-specific CFRs. The successive pandemic waves create challenges for the strategic preparedness of health authorities and make the pandemic uncertain and variable. Our findings indicate that the emergence of new variants and age shift to high fatality groups might contribute potentially to the occurrence of successive severe pandemic waves and offer insights into the adjustment of national responses to mitigate influenza pandemics.
DOI: 10.1371/journal.pone.0028288
PubMed: 22140569
Affiliations:
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pubmed:22140569Le document en format XML
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<front><div type="abstract" xml:lang="en">Past influenza pandemics have been characterized by the signature feature of multiple waves. However, the reasons for multiple waves in a pandemic are not understood. Successive waves in the 2009 influenza pandemic, with a sharp increase in hospitalized and fatal cases, occurred in Taiwan during the winter of 2010. In this study, we sought to discover possible contributors to the multiple waves in this influenza pandemic. We conducted a large-scale analysis of 4703 isolates in an unbiased manner to monitor the emergence, dominance and replacement of various variants. Based on the data from influenza surveillance and epidemic curves of each variant clade, we defined virologically and temporally distinct waves of the 2009 pandemic in Taiwan from May 2009 to April 2011 as waves 1 and 2, an interwave period and wave 3. Except for wave 3, each wave was dominated by one distinct variant. In wave 3, three variants emerged and co-circulated, and formed distinct phylogenetic clades, based on the hemagglutinin (HA) genes and other segments. The severity of influenza was represented as the case fatality ratio (CFR) in the hospitalized cases. The CFRs in waves 1 and 2, the interwave period and wave 3 were 6.4%, 5.1%, 15.2% and 9.8%, respectively. The results highlight the association of virus evolution and variable influenza severity. Further analysis revealed that the major affected groups were shifted in the waves to older individuals, who had higher age-specific CFRs. The successive pandemic waves create challenges for the strategic preparedness of health authorities and make the pandemic uncertain and variable. Our findings indicate that the emergence of new variants and age shift to high fatality groups might contribute potentially to the occurrence of successive severe pandemic waves and offer insights into the adjustment of national responses to mitigate influenza pandemics.</div>
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<Abstract><AbstractText>Past influenza pandemics have been characterized by the signature feature of multiple waves. However, the reasons for multiple waves in a pandemic are not understood. Successive waves in the 2009 influenza pandemic, with a sharp increase in hospitalized and fatal cases, occurred in Taiwan during the winter of 2010. In this study, we sought to discover possible contributors to the multiple waves in this influenza pandemic. We conducted a large-scale analysis of 4703 isolates in an unbiased manner to monitor the emergence, dominance and replacement of various variants. Based on the data from influenza surveillance and epidemic curves of each variant clade, we defined virologically and temporally distinct waves of the 2009 pandemic in Taiwan from May 2009 to April 2011 as waves 1 and 2, an interwave period and wave 3. Except for wave 3, each wave was dominated by one distinct variant. In wave 3, three variants emerged and co-circulated, and formed distinct phylogenetic clades, based on the hemagglutinin (HA) genes and other segments. The severity of influenza was represented as the case fatality ratio (CFR) in the hospitalized cases. The CFRs in waves 1 and 2, the interwave period and wave 3 were 6.4%, 5.1%, 15.2% and 9.8%, respectively. The results highlight the association of virus evolution and variable influenza severity. Further analysis revealed that the major affected groups were shifted in the waves to older individuals, who had higher age-specific CFRs. The successive pandemic waves create challenges for the strategic preparedness of health authorities and make the pandemic uncertain and variable. Our findings indicate that the emergence of new variants and age shift to high fatality groups might contribute potentially to the occurrence of successive severe pandemic waves and offer insights into the adjustment of national responses to mitigate influenza pandemics.</AbstractText>
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