The epidemiology and clinical impact of pandemic influenza
The epidemiology and clinical impact of pandemic influenza
复制标题
DOI：
10.1016/s0264-410x(03)00069-0
复制
发表时间：
2003-05-01
期刊：
影响因子：
5.5
通讯作者：
Hampson, AW
中科院分区：
文献类型：
--
作者：
Nguyen-Van-Tam, JS;Hampson, AW
无法预测下一次流感大流行将于何时发生；然而，距离上一次大流行已有近35年的时间，可以肯定的是，大流行之间的最长间隔是39年。下一种大流行病毒很可能出现在东南亚，过去三种大流行病毒中的两种也是如此。由于旅游和城市化的增加，全球传播可能在6个月或更短的时间内完成。年龄段死亡率通常的大流行间模式很可能会暂时偏离年轻人的高死亡率。这种转变将在多大程度上发生尚不清楚，因为这种转变在1918-1919年是极端的，但在随后的大流行中不那么严重。然而，这可能对卫生保健、紧急服务和军事人员等基本工作人员的保护产生重要影响。老年人受影响的程度将取决于以前接触过类似的流感病毒。不可能预测当新的大流行病毒出现时可能出现的超额死亡率的增加。然而，虽然1918-1919年经历的死亡规模可能不太可能，但1997年感染A/H5N1病毒的人的死亡率很高，因此不能假设未来的大流行将像1957-1958年或1968-1969年那样温和。可能会有不止一波的感染，大多数国家的卫生服务机构将很难提供疫苗或管理临床发病率为25%-30%的人口，同时对初级和二级卫生保健服务的需求也随之增加。(C)2003爱思唯尔科学有限公司。保留所有权利。
It is impossible to predict when the next pandemic of influenza will occur; however, it is almost 35 years since the last pandemic, and the longest inter-pandemic interval recorded with certainty is 39 years. The next pandemic virus is likely to emerge in southeast Asia, as have two of the last three pandemic viruses. Complete global spread is likely to occur in 6 months or less, due to increased travel and urbanisation. It is likely that the usual inter-pandemic pattern of age-specific mortality will deviate temporarily towards higher mortality in younger adults. The extent to which this will happen is unclear, as the shift was extreme in 1918-1919 but less so in subsequent pandemics. Nevertheless, this may have important implications for the protection of essential workers such as health care, emergency service and military personnel. The extent to which elderly persons will be affected will depend upon previous exposure to similar influenza viruses. It is impossible to predict the likely increase in excess mortality that will occur when a new pandemic virus emerges. However, whilst mortality on the scale experienced in 1918-1919 is probably unlikely, there was a high level of mortality among those infected with the A/H5N1 virus in 1997, so it cannot be assumed that a future pandemic will be as mild as those in 1957-1958 or 1968-1969. There is likely to be more than on,e wave of infection and health services in most countries will be hard pressed to provide vaccines or to manage populations with clinical attack rates of; 25-30% and concomitant increases in demand for both primary and secondary health care services. (C) 2003 Elsevier Science Ltd. All rights reserved.