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Age-Dependent Estimates of the Epidemiological Impact of Pandemic Influenza (H1N1-2009) in Japan

tetano

Editor, Senior Moderator
Comput Math Methods Med. 2013;2013:637064. doi: 10.1155/2013/637064. Epub 2013 Feb 21.
Age-Dependent Estimates of the Epidemiological Impact of Pandemic Influenza (H1N1-2009) in Japan.
Mizumoto K, Yamamoto T, Nishiura H.
Source

School of Public Health, The University of Hong Kong, Level 6, Core F, Cyberport 3, 100 Cyberport Road, Pokfulam, Hong Kong ; Department of International Health, Nagasaki University Institute of Tropical Medicine and GCOE, Sakamoto, Nagasaki 852-8523, Japan.
Abstract

The total number of influenza cases with medical attendance has been estimated from sentinel surveillance data in Japan under a random sampling assumption of sentinel medical institutions among the total medical institutions. The 2009 pandemic offered a research opportunity to validate the sentinel-based estimation method using the estimated proportion of infections measured by the population-wide seroepidemiological survey employing hemagglutinin inhibition (HI) assay. For the entire population, we estimated the age-standardized proportion of infections at 28.5% and 23.5% using cut-off values of HI titer at 1 : 20 and 1 : 40, respectively. Investigating the age profiles, we show that the estimated influenza-like illness (ILI) cases with medical attendance exceeded the estimated infections among those aged from 0 to 19 years, indicating an overestimation of the magnitude by sentinel-based estimation method. The ratio of estimated cases to estimated infections decreased as a function of age. Examining the geographic distributions, no positive correlation was identified between the estimated cases and infections. Our findings indicate a serious technical limitation of the so-called multiplier method in appropriately quantifying the risk of influenza due to limited specificity of ILI and reporting bias. A seroepidemiological study should be planned in advance of a pandemic.

PMID:
23509599
[PubMed - in process]
PMCID:
PMC3594908

Free PMC Article

http://www.ncbi.nlm.nih.gov/pubmed/23509599
 
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