Infection Fatality Risk of the Pandemic A(H1N1)2009 Virus in Hong Kong
Infection Fatality Risk of the Pandemic A(H1N1)2009 Virus in Hong Kong
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DOI：
10.1093/aje/kws314
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发表时间：
2013-04-15
影响因子：
5
通讯作者：
Cowling, Benjamin J.
中科院分区：
文献类型：
--
作者：
Wong, Jessica Y.;Wu, Peng;Cowling, Benjamin J.
在个人层面上衡量大流行性流感暴发严重程度的一个指标是感染新病毒的人的死亡风险。然而，同时估计分子和分母是复杂的。关于分子，对与流感病毒感染有关的额外死亡人数的统计估计往往超过与实验室确认的感染有关的死亡人数。关于分母，很少有感染得到实验室确认，而病例定义和病例确定方法的不同可能导致病例死亡风险估计的巨大差异。血清学监测可以用来估计累计感染发生率，作为一个分母，在不同研究中更具可比性。我们估计，2009年第一波甲型H1N1流感pdm09病毒与香港所有年龄段约232人(95可信区间：136,328)的超额死亡有关，主要是老年人。每次感染基础上死亡风险的点估计随着年龄的增加而大幅增加，从儿童中每10万名感染中不到1人增加到6069岁人群中每10万名感染中1,099人。年龄相关感染致死风险的显著差异使不同流感毒株的严重程度比较复杂化。
One measure of the severity of a pandemic influenza outbreak at the individual level is the risk of death among people infected by the new virus. However, there are complications in estimating both the numerator and denominator. Regarding the numerator, statistical estimates of the excess deaths associated with influenza virus infections tend to exceed the number of deaths associated with laboratory-confirmed infection. Regarding the denominator, few infections are laboratory confirmed, while differences in case definitions and approaches to case ascertainment can lead to wide variation in case fatality risk estimates. Serological surveillance can be used to estimate the cumulative incidence of infection as a denominator that is more comparable across studies. We estimated that the first wave of the influenza A(H1N1)pdm09 virus in 2009 was associated with approximately 232 (95 confidence interval: 136, 328) excess deaths of all ages in Hong Kong, mainly among the elderly. The point estimates of the risk of death on a per-infection basis increased substantially with age, from below 1 per 100,000 infections in children to 1,099 per 100,000 infections in those 6069 years of age. Substantial variation in the age-specific infection fatality risk complicates comparison of the severity of different influenza strains.