Estimates of the number of human infections with influenza A(H3N2) variant virus, United States, August 2011-April 2012.
Estimates of the number of human infections with influenza A(H3N2) variant virus, United States, August 2011-April 2012.
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DOI：
10.1093/cid/cit273
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发表时间：
2013-07
期刊：
影响因子：
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通讯作者：
Finelli L
中科院分区：
文献类型：
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作者：
Biggerstaff M;Reed C;Epperson S;Jhung MA;Gambhir M;Bresee JS;Jernigan DB;Swerdlow DL;Finelli L
2011年8月至2012年4月，在美国发现了13例人类感染甲型H3N2v流感病毒变异株(H3N2v)病毒的病例，该病毒含有以前与人类疾病无关的基因片段组合。由于只对少数患者进行流感病毒感染的实验室确认，而常规临床测试可能无法确定H3N2v病毒，因此实验室确认的H3N2v流感病毒感染人数低估了疾病的真实负担。为了解释这种不确定的情况，我们采用了在甲型H1N1流感pdm09大流行开始时创建的乘数模型来估计H3N2v疾病的真实负担。为每个参数提供信息的数据来自文献以及在2009年H1N1大流行和2010-11年流感季节期间开展的特别项目。乘数计算为每一步比例的简单倒数，我们使用概率或蒙特卡洛方法考虑了模型参数的可变性和不确定性。使用这种方法，我们估计儿童的中位数乘数为200(90%范围115-369)，成人的中位数乘数为255(90%范围152-479)，并可能在2011年8月至2012年4月发生2,055例(90%范围1,187-3,800)H3N2v感染，表明新病毒的传播比之前想象的更广泛。由这种变种流感病毒引起的疾病比之前认为的更频繁。需要继续监测，以确保及时发现和应对H3N2v病毒感染。
Thirteen human infections with an influenza A (H3N2)variant (H3N2v) virus containing a combination of gene segments not previously associated with human illness were identified in the United States from August 2011 to April 2012. Because laboratory confirmation of influenza virus infection is only performed for a minority of those ill and routine clinical tests may not identify H3N2v virus, the count of laboratory-confirmed H3N2v influenza virus infections underestimates the true burden of illness. To account for this under-ascertainment, we adapted a multiplier model created at the beginning of the influenza A(H1N1)pdm09 pandemic to estimate the true burden of H3N2v illness. Data to inform each of these parameters came from the literature and from special projects conducted during the 2009 H1N1 pandemic and the 2010–11 influenza season. The multipliers were calculated as the simple inverses of the proportions at each step, and we accounted for variability and uncertainty in model parameters by using a probabilistic or Monte Carlo approach Using this approach, we estimate that the median multiplier for children was 200 (90% range 115–369) and for adults was 255 (90% range 152–479) and that 2,055 (90% range 1,187–3,800) H3N2v infections may have occurred from August 2011 to April 2012, suggesting that the new virus was more widespread than previously thought. Illness from this variant influenza virus was more frequent than previously thought. Continued surveillance is needed to ensure timely detection and response to H3N2v virus infections.