Seasonal patterns in human A (H5N1) virus infection: analysis of global cases.
Seasonal patterns in human A (H5N1) virus infection: analysis of global cases.
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DOI：
10.1371/journal.pone.0106171
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发表时间：
2014
期刊：
影响因子：
3.7
通讯作者：
Khazeni N
中科院分区：
文献类型：
--
作者：
Mathur MB;Patel RB;Gould M;Uyeki TM;Bhattacharya J;Xiao Y;Gillaspie Y;Chae C;Khazeni N
人感染高致病性禽流感（HPAI）A（H5 N1）的病例死亡率高。尽管有大量关于流感流行季节性模式的数据，但尚不清楚全球人类高致病性禽流感H5 N1病例是否存在类似模式。这些知识可以通过在高峰期增加预防和控制活动来帮助减少禽传人。我们对迄今为止已发表的人类高致病性禽流感H5 N1病例进行了系统检索，收集了月份、年份、国家、季节、半球和气候数据。我们使用负二项回归来预测病例发病率随季节的变化。为了研究半球作为潜在的调节剂，我们使用AIC和似然比检验来比较季节模型和嵌套模型，包括主效应或与半球的相互作用。最后，我们根据柯本-盖格气候分类，直观地评估了各气候组之间季节模式的复制。我们确定了617例人间病例（611例有完整的季节性数据），发生在东南亚、非洲和中东的15个国家。病例发生率在冬季（n = 285，p = 0.03）比夏季（n = 64）高得多，冬季高峰发生在不同的气候组。 半球与季节之间无显著交互作用。在不同的气候条件下，人类感染高致病性禽流感H5 N1病毒在冬季显著增加。这与寒冷和干燥条件下家禽暴发和高致病性禽流感H5 N1病毒传播的增加是一致的。在家禽中优先开展预防和控制活动，并将公共卫生信息的重点放在减少冬季家禽暴露方面，可能有助于在资源有限的环境中减少高致病性禽流感H5 N1病毒的人畜共患传播。
Human cases of highly pathogenic avian influenza (HPAI) A (H5N1) have high mortality. Despite abundant data on seasonal patterns in influenza epidemics, it is unknown whether similar patterns exist for human HPAI H5N1 cases worldwide. Such knowledge could help decrease avian-to-human transmission through increased prevention and control activities during peak periods. We performed a systematic search of published human HPAI H5N1 cases to date, collecting month, year, country, season, hemisphere, and climate data. We used negative binomial regression to predict changes in case incidence as a function of season. To investigate hemisphere as a potential moderator, we used AIC and the likelihood-ratio test to compare the season-only model to nested models including a main effect or interaction with hemisphere. Finally, we visually assessed replication of seasonal patterns across climate groups based on the Köppen-Geiger climate classification. We identified 617 human cases (611 with complete seasonal data) occurring in 15 countries in Southeast Asia, Africa, and the Middle East. Case occurrence was much higher in winter (n = 285, p = 0.03) than summer (n = 64), and the winter peak occurred across diverse climate groups. There was no significant interaction between hemisphere and season. Across diverse climates, HPAI H5N1 virus infection in humans increases significantly in winter. This is consistent with increased poultry outbreaks and HPAI H5N1 virus transmission during cold and dry conditions. Prioritizing prevention and control activities among poultry and focusing public health messaging to reduce poultry exposures during winter months may help to reduce zoonotic transmission of HPAI H5N1 virus in resource-limited settings.
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