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Onset of a pandemic: characterizing the initial phase of the swine flu (H1N1) epidemic in Israel

tetano

Editor, Senior Moderator
The swine influenza H1N1 first identified in Mexico, spread rapidly across the globe and is considered as the fastest moving pandemic in history. The early phase of an outbreak presents scientific challenges on key issues such as: scale, severity and immunity which are fundamental for establishing sound and rapid policy schemes, as high quality data are scarce.

Our analysis aims at understanding the spatio-temporal dynamics of the H1N1 in its initial phase.

Methods: We constructed and analyzed a unique dataset from Israel on all confirmed cases (between April 26 to July 7, 2009), representing most swine flu cases in this period. We estimated and characterized fundamental epidemiological features of the pandemic in Israel (e.g.

reproductive number, age-class distribution, at-risk social groups, infections between sexes, &spatial dynamics). Contact data of the Israeli population, allowed us to estimate the generation time distribution of the pandemic.

Results: We found a low reproductive number (Re=1.06), an age-class distribution of infected individuals (skewed towards ages 18-25), at-risk social groups (soldiers and ultra Orthodox Jews), and significant differences in infections between sexes (skewed towards males).

In terms of spatial dynamics, the pandemic spread from the central coastal plain of Israel to other regions, with higher infection rates in more densely populated sub-districts with higher income households.

Conclusions: Analysis of high quality data holds much promise in reducing uncertainty regarding fundamental aspects of the initial phase of an outbreak. Our finding of a low Re (close to unity threshold), combined with identification of social groups with high transmission rates would have enabled the containment of swine flu during the summer in Israel.

Our unique use of contact data provided new insights into the differential dynamics of influenza in different ages and sexes, and should be promoted in future epidemiological studies. Altogether, our attempts to study the disease dynamics comprehensively, as it spread in space and time in different sects of the society, enabled us to illuminate interesting and important features of the initial phase of the swine flu pandemic.

Author: Uri RollRami YaariGuy KatrielOren BarneaLewi StoneElla MendelsonMichal MendelboimAmit Huppert
Credits/Source: BMC Infectious Diseases 2011, 11:92

http://7thspace.com/headlines/37915...of_the_swine_flu_h1n1_epidemic_in_israel.html
 
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