Mortality from pandemic A/H1N1 2009 influenza in England: public health surveillance study.
Mortality from pandemic A/H1N1 2009 influenza in England: public health surveillance study.
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DOI：
10.1136/bmj.b5213
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发表时间：
2009-12-10
期刊：
影响因子：
--
通讯作者：
Yardley IE
中科院分区：
文献类型：
--
作者：
Donaldson LJ;Rutter PD;Ellis BM;Greaves FE;Mytton OT;Pebody RG;Yardley IE
目的建立截至2009年11月8日的2009年甲型H1N1流感大流行死亡率。对英格兰所有报告的与甲型H1N1流感大流行有关的死亡病例进行设计调查。建立在急诊医院和初级保健中建立的强制性报告制度。研究对象为患者负责的医生。主要结果衡量流感死亡人数，结合流感病例中期估计数来计算特定年龄的病死率。基础条件、病程和抗病毒治疗。结果根据官方对甲型H1N1大流行发病率的中期估计，总体估计病死率为每10万 中26例(范围为11-66)。5-14岁儿童最低(11(范围3-36)/100 000)，≥65岁儿童最高(980(300-3 200)/100 000)。在确认死因为甲型H1N1大流行的138人中，中位年龄为39岁(四分位数范围为17-57岁)。在英格兰，三分之二的死亡患者(92%，67%)现在有资格接受第一阶段的疫苗接种。50人(36%)没有或只有轻微的既往疾病。大多数患者(108名，78%)曾开过抗病毒药物的处方，但其中82名(76%)在患病后48小时内没有接受治疗。结论从统计学上看，此次流感大流行的死亡率高于20世纪的流感大流行。然而，人口影响低于以前的大流行并不是公共卫生不采取行动的理由。我们的数据支持优先接种高危人群的疫苗。我们观察到在大多数致命病例中延迟使用抗病毒药物，这表明有机会通过提供及时的抗病毒治疗来减少死亡，尽管缺乏对照组限制了从这一观察中推断的能力。鉴于相当大一部分死亡发生在以前健康的人身上，因此有理由扩大疫苗接种方案，并继续广泛提供早期抗病毒治疗。
Objective To establish mortality from pandemic A/H1N1 2009 influenza up to 8 November 2009. Design Investigation of all reported deaths related to pandemic A/H1N1 in England. Setting Mandatory reporting systems established in acute hospitals and primary care. Participants Physicians responsible for the patient. Main outcome measures Numbers of deaths from influenza combined with mid-range estimates of numbers of cases of influenza to calculate age specific case fatality rates. Underlying conditions, time course of illness, and antiviral treatment. Results With the official mid-range estimate for incidence of pandemic A/H1N1, the overall estimated case fatality rate was 26 (range 11-66) per 100 000. It was lowest for children aged 5-14 (11 (range 3-36) per 100 000) and highest for those aged ≥65 (980 (range 300-3200) per 100 000). In the 138 people in whom the confirmed cause of death was pandemic A/H1N1, the median age was 39 (interquartile range 17-57). Two thirds of patients who died (92, 67%) would now be eligible for the first phase of vaccination in England. Fifty (36%) had no, or only mild, pre-existing illness. Most patients (108, 78%) had been prescribed antiviral drugs, but of these, 82 (76%) did not receive them within the first 48 hours of illness. Conclusions Viewed statistically, mortality in this pandemic compares favourably with 20th century influenza pandemics. A lower population impact than previous pandemics, however, is not a justification for public health inaction. Our data support the priority vaccination of high risk groups. We observed delayed antiviral use in most fatal cases, which suggests an opportunity to reduce deaths by making timely antiviral treatment available, although the lack of a control group limits the ability to extrapolate from this observation. Given that a substantial minority of deaths occur in previously healthy people, there is a case for extending the vaccination programme and for continuing to make early antiviral treatment widely available.
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影响因子：
168.9
作者：
Jamieson, Denise J.;Honein, Margaret A.;Olsen, Sonja J.
通讯作者：
Olsen, Sonja J.
影响因子：
120.7
作者：
Dominguez-Cherit, Guillermo;Lapinsky, Stephen E.;Fowler, Robert A.
通讯作者：
Fowler, Robert A.
影响因子：
--
作者：
Garske, Tini;Legrand, Judith;Ghani, Azra C.
通讯作者：
Ghani, Azra C.
影响因子：
158.5
作者：
Jain, Seema;Kamimoto, Laurie;Finelli, Lyn
通讯作者：
Finelli, Lyn
DOI：
10.1093/oxfordjournals.pubmed.a024463
发表时间：
1996-03-01
期刊：
JOURNAL OF PUBLIC HEALTH MEDICINE
影响因子：
--
作者：
Maudsley, G;Williams, EMI
通讯作者：
Williams, EMI