Assessment of baseline age-specific antibody prevalence and incidence of infection to novel influenza A/HINI 2009

被引:89
作者
Hardelid, P. [2 ]
Andrews, N. J. [2 ]
Hoschler, K. [3 ]
Stanford, E. [4 ]
Baguelin, M. [1 ]
Waight, P. A. [1 ]
Zambon, M. [3 ]
Miller, E. [1 ]
机构
[1] Hlth Protect Agcy, Immunisat Hepatitis & Blood Safety Dept, Ctr Infect, London, England
[2] Hlth Protect Agcy, Stat Unit, Ctr Infect, London, England
[3] Hlth Protect Agcy, Virus Reference Dept, Ctr Infect, Resp Virus Unit, London, England
[4] Manchester Royal Infirm, Hlth Protect Agcy, Vaccine Evaluat Seroepidemiol Unit, Manchester M13 9WL, Lancs, England
关键词
MONOCLONAL-ANTIBODIES; PROTECTIVE IMMUNITY; VIRUSES; RESPONSES; ENGLAND;
D O I
10.3310/hta14550-03
中图分类号
R19 [保健组织与事业(卫生事业管理)];
学科分类号
摘要
Objectives: The objectives of the HINI 2009 serological surveillance project were twofold: to document (1) the prevalence of cross-reactive antibodies to HINI 2009 by age group in the population of England prior to arrival of the pandemic strain virus in the UK and (2) the age-specific incidence of infection by month as the pandemic progressed by measuring increases in the proportion of individuals with antibodies to HINI 2009 by age. Methods: Residual aliquots of samples submitted to 16 microbiology laboratories in eight regions in England in defined age groups in 2008 and stored by the Health Protection Agency serological surveillance programme were used to document age-stratified prevalence of antibodies to HINI 2009 prior to the arrival of the pandemic in the UK. Functional antibodies to the HINI 2009 virus were measured by haemagglutination inhibition (HI) and microneutralisation (MN) assays. For timely measurement of monthly incidence of infection with HINI 2009 between August 2009 and April 2010, the microbiology serum collections were supplemented by collection of residual sera from chemical pathology laboratories in England. Monthly seroincidence samples were tested by HI only, apart from the final sera collected post pandemic in 2010, which were also tested by MN. Incidence during the pandemic was estimated from changes in prevalence between time points and also by a likelihood-based method. Setting: Eight regions of England. Participants: Serum samples from patients accessing health care in England from whom blood samples were taken for unrelated microbiological or chemical pathology testing. Interventions: None. Main outcome measures: Baseline age-specific prevalence of functional antibodies to the HI NI 2009 virus prior to the arrival of the pandemic; changes in antibody prevalence during the period August 2009 to April 2010. Results: Pre-existing cross-reactive antibodies to HINI 2009 were detected in the baseline sera and increased with age, particularly in those born before 1950. The prediction of immunological protection derived from the baseline serological analysis was consistent with the lower clinical attack rates in older age groups. The high levels of susceptibility in children < 15 years, together with their mixing within school, resulted in the highest attack rates in this age group. Serological analysis by region confirms that there were geographical differences in timing of major pandemic waves. London had a big first wave among the 5- to 14-year age group, with the rest of the country reducing the gap after the second wave. Cumulative incidence in London remained higher throughout the pandemic in each age group. By the end of the second wave it is estimated that as many as 70% of school-aged children in London had been infected. Taken together, these observations are consistent with observations from previous pandemics in 1918, 1957 and 1968 that the major impact of influenza pandemics is on younger age groups, with a pattern of morbidity and mortality distinct from seasonal influenza epidemics. Conclusions: Serological analysis of appropriately structured, age-stratified and geographically representative samples can provide an immense amount of information to set in context other measures of pandemic impact in a population, and provide the most accurate measures of population exposure. National scale seroepidemiology studies require cross-agency coordination, multidisciplinary working, and considerable scientific resource.
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页码:115 / +
页数:68
相关论文
共 43 条
  • [1] The European Sero-Epidemiology Network: standardizing the enzyme immunoassay results for measles, mumps and rubella
    Andrews, N
    Pebody, RG
    Berbers, G
    Blondeau, C
    Crovari, P
    Davidkin, I
    Farrington, P
    Fievet-Groyne, F
    Gabutti, G
    Gerike, E
    Giordano, C
    Hesketh, L
    Marzec, T
    Morgan-Capner, P
    Osborne, K
    Pleisner, AM
    Raux, M
    Tischer, A
    Ruden, U
    Valle, M
    Miller, E
    [J]. EPIDEMIOLOGY AND INFECTION, 2000, 125 (01) : 127 - 141
  • [2] [Anonymous], EURO SURVEILL
  • [3] Vaccination against pandemic influenza A/H1N1v in England: A real-time economic evaluation
    Baguelin, Marc
    Van Hoek, Albert Jan
    Jit, Mark
    Flasche, Stefan
    White, Peter J.
    Edmunds, W. John
    [J]. VACCINE, 2010, 28 (12) : 2370 - 2384
  • [4] Like-with-like comparisons?
    Bird, Sheila M.
    [J]. LANCET, 2010, 376 (9742) : 684 - 684
  • [5] Time lines of infection and disease in human influenza: A review of volunteer challenge studies
    Carrat, Fabrice
    Vergu, Elisabeta
    Ferguson, Neil M.
    Lemaitre, Magali
    Cauchemez, Simon
    Leach, Steve
    Valleron, Alain-Jacques
    [J]. AMERICAN JOURNAL OF EPIDEMIOLOGY, 2008, 167 (07) : 775 - 785
  • [6] Broad Cross-Protection against H5N1 Avian Influenza Virus Infection by Means of Monoclonal Antibodies that Map to Conserved Viral Epitopes
    Chen, Yixin
    Qin, Kun
    Wu, Wai Lan
    Li, Guoqiang
    Zhang, Jun
    Du, Hailian
    Ng, Mun Hon
    Shih, J. Wai-Kuo
    Peiris, J. S. Malik
    Guan, Yi
    Chen, Honglin
    Xia, Ningshao
    [J]. JOURNAL OF INFECTIOUS DISEASES, 2009, 199 (01) : 49 - 58
  • [7] Comparative Epidemiology of Pandemic and Seasonal Influenza A in Households.
    Cowling, Benjamin J.
    Chan, Kwok Hung
    Fang, Vicky J.
    Lau, Lincoln L. H.
    So, Hau Chi
    Fung, Rita O. P.
    Ma, Edward S. K.
    Kwong, Alfred S. K.
    Chan, Chi-Wai
    Tsui, Wendy W. S.
    Ngai, Ho-Yin
    Chu, Daniel W. S.
    Lee, Paco W. Y.
    Chiu, Ming-Chee
    Leung, Gabriel M.
    Peiris, Joseph S. M.
    [J]. NEW ENGLAND JOURNAL OF MEDICINE, 2010, 362 (23) : 2175 - 2184
  • [8] Department of Health (DH), CHIEF MED OFF UPD
  • [9] *DH, 2009, CHIEF MED OFF UPD
  • [10] *FLU WATCH, FLU WATCH PAND STUD