Age-specific differences in influenza A epidemic curves: do children drive the spread of influenza epidemics?
Age-specific differences in influenza A epidemic curves: do children drive the spread of influenza epidemics?
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DOI：
10.1093/aje/kwr037
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发表时间：
2011-07-01
影响因子：
5
通讯作者：
Pelletier L
中科院分区：
文献类型：
--
作者：
Schanzer D;Vachon J;Pelletier L
越来越多的证据表明，儿童可能会推动流感流行的传播。本研究的目的是使用加拿大社区 1995/1996–2005/2006 季节甲型流感实验室确诊病例和 H1N1/2009 大流行毒株实验室确诊的入院病例，按年龄量化提前时间。随着病例聚集之前局部流行病曲线的对齐，感染时间的轻微年龄差异变得明显。对于季节性流感，10-19岁和20-29岁年龄组均比其他年龄组提前1周达到峰值，而在2009年流感大流行的秋季浪潮中，只有10-19岁年龄组的感染峰值较早。在 H3N2 季节，20-29 岁年龄组的感染发生时间比 10-19 岁青少年平均早 3.9 天（95% 置信区间：1.7, 6.1）天，而在秋季大流行期间，10-19 岁年龄组比 4-9 岁年龄较小的儿童和 20-29 岁成年人领先 3 天（P < 0.0001）。这一分析对学龄儿童实际上引领流感流行浪潮的假设提出了质疑。
There is accumulating evidence suggesting that children may drive the spread of influenza epidemics. The objective of this study was to quantify the lead time by age using laboratory-confirmed cases of influenza A for the 1995/1996–2005/2006 seasons from Canadian communities and laboratory-confirmed hospital admissions for the H1N1/2009 pandemic strain. With alignment of the epidemic curves locally before aggregation of cases, slight age-specific differences in the timing of infection became apparent. For seasonal influenza, both the 10–19- and 20–29-year age groups peaked 1 week earlier than other age groups, while during the fall wave of the 2009 pandemic, infections peaked earlier among only the 10–19-year age group. In the H3N2 seasons, infections occurred an average of 3.9 (95% confidence interval: 1.7, 6.1) days earlier in the 20–29-year age group than for youth aged 10–19 years, while during the fall pandemic wave, the 10–19-year age group had a statistically significant lead of 3 days compared with both younger children aged 4–9 years and adults aged 20–29 years (P < 0.0001). This analysis casts doubt on the hypothesis that younger school-age children actually lead influenza epidemic waves.
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