Oseltamivir for treatment and prevention of pandemic influenza A/H1N1 virus infection in households, Milwaukee, 2009.
Oseltamivir for treatment and prevention of pandemic influenza A/H1N1 virus infection in households, Milwaukee, 2009.
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DOI：
10.1186/1471-2334-10-211
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发表时间：
2010-07-20
影响因子：
3.7
通讯作者：
Lipsitch M
中科院分区：
文献类型：
--
作者：
Goldstein E;Cowling BJ;O'Hagan JJ;Danon L;Fang VJ;Hagy A;Miller JC;Reshef D;Robins J;Biedrzycki P;Lipsitch M
在流感大流行期间，很大一部分传播被认为发生在家庭中。我们使用密尔沃基市卫生局 (MHD) 收集的个人及其接触者流感进展数据来研究大流行性甲型 H1N1 流感病毒在威斯康星州密尔沃基 362 个家庭中的传播情况，以及奥司他韦治疗和化学预防的效果。 135 个家庭拥有所有家庭成员的症状和奥司他韦使用情况的时间信息。使用以家庭为分析单位的单变量和多变量逻辑回归来估计奥司他韦治疗和其他因素对家庭继发率的影响。使用单变量和多变量逻辑回归，以个体家庭接触者为分析单位，估计奥司他韦治疗和其他因素对个体继发发病率的影响，并使用广义估计方程方法来拟合模型，以允许在家庭内进行聚类。发病当天或第二天（早期治疗）的奥司他韦指数治疗与家庭中一次或多次继发感染的几率降低 42%（OR：0.58，95% CI：0.19，1.73）有关，并使个人接触者继发感染的几率降低 50%（OR：0.5，95% CI：0.17，1.46）。由于早期使用奥司他韦指数的家庭样本较少，置信区间较宽 - 在 29 个此类家庭中，有 5 个家庭发生了二次发作。年轻的家庭接触者感染的风险较高（OR：2.79，95% CI：1.50-5.20）。早期奥司他韦治疗可能有益于预防 H1N1pdm 流感传播；这可能与未来流感大流行的控制措施有关。需要更大规模的随机试验来从统计学上证实这一发现。
During an influenza pandemic, a substantial proportion of transmission is thought to occur in households. We used data on influenza progression in individuals and their contacts collected by the City of Milwaukee Health Department (MHD) to study the transmission of pandemic influenza A/H1N1 virus in 362 households in Milwaukee, WI, and the effects of oseltamivir treatment and chemoprophylaxis. 135 households had chronological information on symptoms and oseltamivir usage for all household members. The effect of oseltamivir treatment and other factors on the household secondary attack rate was estimated using univariate and multivariate logistic regression with households as the unit of analysis. The effect of oseltamivir treatment and other factors on the individual secondary attack rate was estimated using univariate and multivariate logistic regression with individual household contacts as the unit of analysis, and a generalized estimating equations approach was used to fit the model to allow for clustering within households. Oseltamivir index treatment on onset day or the following day (early treatment) was associated with a 42% reduction (OR: 0.58, 95% CI: 0.19, 1.73) in the odds of one or more secondary infections in a household and a 50% reduction (OR: 0.5, 95% CI: 0.17, 1.46) in the odds of a secondary infection in individual contacts. The confidence bounds are wide due to a small sample of households with early oseltamivir index usage - in 29 such households, 5 had a secondary attack. Younger household contacts were at higher risk of infection (OR: 2.79, 95% CI: 1.50-5.20). Early oseltamivir treatment may be beneficial in preventing H1N1pdm influenza transmission; this may have relevance to future control measures for influenza pandemics. Larger randomized trials are needed to confirm this finding statistically.
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DOI：
10.1056/nejmoa0905498
发表时间：
2009-12-31
期刊：
The New England journal of medicine
影响因子：
--
作者：
Cauchemez S;Donnelly CA;Reed C;Ghani AC;Fraser C;Kent CK;Finelli L;Ferguson NM
通讯作者：
Ferguson NM
影响因子：
11.8
作者：
McGeer, Allison;Green, Karen A.;Low, Donald E.
通讯作者：
Low, Donald E.
影响因子：
5.4
作者：
Hernán, MA;Hernández-Díaz, S;Robins, JM
通讯作者：
Robins, JM
影响因子：
2.7
作者：
LIANG, KY;ZEGER, SL
通讯作者：
ZEGER, SL
DOI：
10.1097/ede.0b013e31819d1092
发表时间：
2009-05
期刊：
Epidemiology (Cambridge, Mass.)
影响因子：
--
作者：
Cowling BJ;Fang VJ;Riley S;Malik Peiris JS;Leung GM
通讯作者：
Leung GM