Pandemic potential of a strain of influenza A (H1N1): early findings.
Pandemic potential of a strain of influenza A (H1N1): early findings.
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DOI：
10.1126/science.1176062
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发表时间：
2009-06-19
期刊：
影响因子：
--
通讯作者：
WHO Rapid Pandemic Assessment Collaboration
中科院分区：
文献类型：
--
作者：
Fraser C;Donnelly CA;Cauchemez S;Hanage WP;Van Kerkhove MD;Hollingsworth TD;Griffin J;Baggaley RF;Jenkins HE;Lyons EJ;Jombart T;Hinsley WR;Grassly NC;Balloux F;Ghani AC;Ferguson NM;Rambaut A;Pybus OG;Lopez-Gatell H;Alpuche-Aranda CM;Chapela IB;Zavala EP;Guevara DM;Checchi F;Garcia E;Hugonnet S;Roth C;WHO Rapid Pandemic Assessment Collaboration
一种新的甲型H1N1流感病毒在全球迅速传播。在数据有限的情况下，很难判断其大流行潜力，但对于提供适当的卫生应对措施至关重要。通过分析墨西哥的疫情、国际传播的早期数据和病毒基因多样性，我们对传染性和严重性做出了早期评估。我们的估计表明，截至4月下旬，墨西哥已有23,000人(6,000至32,000人)感染，根据当时报告的确诊和疑似死亡病例，估计病死率(CFR)为0.4%(范围：0.3至1.8%)。在韦拉克鲁斯La Gloria小社区的一次社区暴发中，没有死亡归因于感染，使CFR上限为95%，CFR为0.6%。因此，尽管仍然存在很大的不确定性，但临床严重程度似乎低于1918年流感大流行，但与1957年大流行相当。在拉格洛里亚，儿童的临床发病率是成人的两倍(<；15岁：61%；≥15岁：29%)。三种不同的流行病学分析给出的基本繁殖数(R0)估计在1.4到1.6的范围内，而遗传分析给出的中心估计为1.2。这一数值范围与墨西哥至4月下旬发生的14至73代人传人保持一致。因此，传播率大大高于季节性流感，并与以前流感大流行中较低的R0估计值相当。
A novel influenza A (H1N1) virus has spread rapidly across the globe. Judging its pandemic potential is difficult with limited data, but nevertheless essential to inform appropriate health responses. By analyzing the outbreak in Mexico, early data on international spread, and viral genetic diversity, we make an early assessment of transmissibility and severity. Our estimates suggest that 23,000 (range 6000 to 32,000) individuals had been infected in Mexico by late April, giving an estimated case fatality ratio (CFR) of 0.4% (range: 0.3 to 1.8%) based on confirmed and suspected deaths reported to that time. In a community outbreak in the small community of La Gloria, Veracruz, no deaths were attributed to infection, giving an upper 95% bound on CFR of 0.6%. Thus, although substantial uncertainty remains, clinical severity appears less than that seen in the 1918 influenza pandemic but comparable with that seen in the 1957 pandemic. Clinical attack rates in children in La Gloria were twice that in adults (<15 years of age: 61%; ≥15 years: 29%). Three different epidemiological analyses gave basic reproduction number (R0) estimates in the range of 1.4 to 1.6, whereas a genetic analysis gave a central estimate of 1.2. This range of values is consistent with 14 to 73 generations of human-to-human transmission having occurred in Mexico to late April. Transmissibility is therefore substantially higher than that of seasonal flu, and comparable with lower estimates of R0 obtained from previous influenza pandemics.
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影响因子：
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作者：
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发表时间：
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