Household transmission of 2009 pandemic influenza A (H1N1) virus in the United States.
Household transmission of 2009 pandemic influenza A (H1N1) virus in the United States.
复制标题
DOI：
10.1056/nejmoa0905498
复制
发表时间：
2009-12-31
期刊：
影响因子：
--
通讯作者：
Ferguson NM
中科院分区：
文献类型：
--
作者：
Cauchemez S;Donnelly CA;Reed C;Ghani AC;Fraser C;Kent CK;Finelli L;Ferguson NM
截至2009年6月11日，美国共报告了17，855例可能或确诊的2009年甲型H1N1流感病例。传播的风险因素在很大程度上仍然没有确定。我们描述的风险因素和家庭内的病毒传播。美国可能和确诊的2009年H1N1病毒感染病例使用标准化病例表报告给疾病控制和预防中心。我们调查了216个家庭的感染传播情况，包括216名指示病人及其600名家庭接触者，其中指示病人是第一例病人，所有家庭成员都有关于症状和年龄的完整信息。在600名家庭接触者中，有78人（13%）患上了急性呼吸道疾病。在156个家庭（占216个家庭的72%）中，没有一个家庭接触者出现急性呼吸道疾病;在46个家庭（21%）中，一个接触者出现疾病;在14个家庭（6%）中，一个以上接触者出现疾病。在与家人有接触的人士中，患上急性呼吸道疾病的比例随家庭规模的增加而下降，由二人家庭的28%下降至六人家庭的9%。18岁或以下的家庭接触者的易感性是19至50岁的两倍（相对易感性，1.96;贝叶斯95%可信区间，1.05至3.78; P = 0.005），50岁以上的家庭接触者比19至50岁的人易感性低（相对易感性，0.17; 95%可信区间，0.02 ~ 0.92; P = 0.03）。自发性不随年龄而变化。病例患者出现症状与该患者感染的家庭接触者出现症状之间的平均时间为2.6天（95%可信区间为2.2至3.5天）。2009年H1N1流感病毒在家庭中的传播率低于以往大流行中的传播率。大多数传播发生在病人症状出现之前或之后不久。
As of June 11, 2009, a total of 17,855 probable or confirmed cases of 2009 pandemic influenza A (H1N1) had been reported in the United States. Risk factors for transmission remain largely uncharacterized. We characterize the risk factors and describe the transmission of the virus within households. Probable and confirmed cases of infection with the 2009 H1N1 virus in the United States were reported to the Centers for Disease Control and Prevention with the use of a standardized case form. We investigated transmission of infection in 216 households — including 216 index patients and their 600 household contacts — in which the index patient was the first case patient and complete information on symptoms and age was available for all household members. An acute respiratory illness developed in 78 of 600 household contacts (13%). In 156 households (72% of the 216 households), an acute respiratory illness developed in none of the household contacts; in 46 households (21%), illness developed in one contact; and in 14 households (6%), illness developed in more than one contact. The proportion of household contacts in whom acute respiratory illness developed decreased with the size of the household, from 28% in two-member households to 9% in six-member households. Household contacts 18 years of age or younger were twice as susceptible as those 19 to 50 years of age (relative susceptibility, 1.96; Bayesian 95% credible interval, 1.05 to 3.78; P = 0.005), and household contacts older than 50 years of age were less susceptible than those who were 19 to 50 years of age (relative susceptibility, 0.17; 95% credible interval, 0.02 to 0.92; P = 0.03). Infectivity did not vary with age. The mean time between the onset of symptoms in a case patient and the onset of symptoms in the household contacts infected by that patient was 2.6 days (95% credible interval, 2.2 to 3.5). The transmissibility of the 2009 H1N1 influenza virus in households is lower than that seen in past pandemics. Most transmissions occur soon before or after the onset of symptoms in a case patient.