The first wave of pandemic influenza (H1N1) 2009 in Germany: From initiation to acceleration
The first wave of pandemic influenza (H1N1) 2009 in Germany: From initiation to acceleration
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DOI：
10.1186/1471-2334-10-155
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发表时间：
2010-06-07
影响因子：
3.7
通讯作者：
Haas, Walter
中科院分区：
文献类型：
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作者：
Poggensee, Gabriele;Gilsdorf, Andreas;Haas, Walter
背景：德国2009年首例输入性大流行性流感(H1N1)病例于2009年4月确诊。然而，第一波具有可衡量的疾病负担的浪潮直到2009年10月才开始。为了了解德国大流行的过程，对大流行的基本流行病学和临床特征进行了分析。方法：分析基于病例的、强制性的德国传染病监测系统的数据。结果：可以确定两个具有不同流行病学特征的时间段：23,789例(44.1%)发生在发病初期(18-41周)，30,179例(55.9%)发生在加速期(42-45周)。在IP期间，恰逢学校暑假，61.1%的病例与旅行有关，1例死亡。严格的遏制措施一直持续到第32周。在急性胰腺炎期间，大多数病例(94.3%)为本地病例，报告死亡12例。主要受影响的年龄组从15岁到19岁转变为10岁到14岁(中位数19岁对15岁；P<；0.001)。有潜在疾病的病例比例从4.7%上升到6.9%(p<；0.001)。无论时间长短，这些病例都更有可能住院(OR=3.6[95%CI：3.1；4.3])并发展为肺炎(OR=8.1[95%CI：6.1；10.7])。此外，儿童(0~2岁)(OR=2.8[95%CI：1.5；5.2])和流感样疾病患者(ILI，OR=1.4[95%CI：1.0；2.1])与其他年龄段和无ILI的个人相比，患肺炎的风险更高。结论：2009年夏秋两季的流行病学差异可能受到学校暑假和遏制措施的影响。疾病的传播不会导致危险群体或严重程度的变化。我们的结果表明，对基于病例的信息的分析可以为未来的公共卫生措施提供建议。
Background: The first imported case of pandemic influenza (H1N1) 2009 in Germany was confirmed in April 2009. However, the first wave with measurable burden of disease started only in October 2009. The basic epidemiological and clinical characteristics of the pandemic were analysed in order to understand the course of the pandemic in Germany.Methods: The analysis was based on data from the case-based, mandatory German surveillance system for infectious diseases. Cases notified between 27 April and 11 November 2009 and fulfilling the case definition were included in the study.Results: Two time periods with distinct epidemiologic characteristics could be determined: 23,789 cases (44.1%) occurred during the initiation period (IP, week 18 to 41), and 30,179 (55.9%) during the acceleration period (AP, week 42 to 45). During IP, coinciding with school summer holidays, 61.1% of cases were travel-related and one death occurred. Strict containment efforts were performed until week 32. During AP the majority of cases (94.3%) was autochthonous, 12 deaths were reported. The main affected age group shifted from 15 to 19 years in IP to 10 to 14 years in AP ( median age 19 versus 15 years; p < 0.001). The proportion of cases with underlying medical conditions increased from 4.7% to 6.9% ( p < 0.001). Irrespective of the period, these cases were more likely to be hospitalised (OR = 3.6 [95% CI: 3.1; 4.3]) and to develop pneumonia (OR = 8.1 [95% CI: 6.1; 10.7]). Furthermore, young children (0 to 2 years) (OR = 2.8 [95% CI: 1.5; 5.2]) and persons with influenza-like illness (ILI, OR = 1.4 [95% CI: 1.0; 2.1]) had a higher risk to develop pneumonia compared to other age groups and individuals without ILI.Conclusion: The epidemiological differences we could show between summer and autumn 2009 might have been influenced by the school summer holidays and containment efforts. The spread of disease did not result in change of risk groups or severity. Our results show that analyses of case-based information can advise future public health measures.