Pandemic Potential of a Strain of Influenza A (H1N1): Early Findings

被引：1457

作者：

Fraser, Christophe ^{[1
]}

Donnelly, Christl A. ^{[1
]}

Cauchemez, Simon ^{[1
]}

Hanage, William P. ^{[1
]}

Van Kerkhove, Maria D. ^{[1
]}

Hollingsworth, T. Deirdre ^{[1
]}

Griffin, Jamie ^{[1
]}

Baggaley, Rebecca F. ^{[1
]}

Jenkins, Helen E. ^{[1
]}

Lyons, Emily J. ^{[1
]}

Jombart, Thibaut ^{[1
]}

Hinsley, Wes R. ^{[1
]}

Grassly, Nicholas C. ^{[1
]}

Balloux, Francois ^{[1
]}

Ghani, Azra C. ^{[1
]}

Ferguson, Neil M. ^{[1
]}

Rambaut, Andrew ^{[2
]}

Pybus, Oliver G. ^{[3
]}

Lopez-Gatell, Hugo ^{[4
]}

Alpuche-Aranda, Celia M. ^{[5
]}

Bojorquez Chapela, Ietza ^{[4
]}

Palacios Zavala, Ethel ^{[4
]}

Espejo Guevara, Dulce Ma. ^{[6
]}

Checchi, Francesco ^{[7
]}

Garcia, Erika ^{[7
]}

Hugonnet, Stephane ^{[7
]}

Roth, Cathy ^{[7
]}

机构：

[1] Univ London Imperial Coll Sci Technol & Med, Fac Med, Dept Infect Dis Epidemiol, MRC Ctr Outbreak Anal & Modelling, London W2 1PG, England

[2] Univ Edinburgh, Ashworth Labs, Inst Evolutionary Biol, Edinburgh EH9 3JT, Midlothian, Scotland

[3] Univ Oxford, Dept Zool, Oxford OX1 3PS, England

[4] FCO De P Miranda, Directorate Gen Epidemiol, Mexico City 01480, DF, Mexico

[5] Natl Inst Epidemiol Diagnosis & Reference, Mexico City 11340, DF, Mexico

[6] Secretaria Salud Serv Salud Veracruz Soconusco 36, Xalapa, Veracruz, Mexico

[7] WHO, Geneva, Switzerland

来源：

SCIENCE | 2009年 / 324卷 / 5934期

基金：

英国生物技术与生命科学研究理事会; 英国医学研究理事会; 英国惠康基金;

关键词：

TRANSMISSIBILITY; STRATEGIES; MORTALITY; IMPACT;

D O I：

10.1126/science.1176062

中图分类号：

O [数理科学和化学]; P [天文学、地球科学]; Q [生物科学]; N [自然科学总论];

学科分类号：

070301 [无机化学]; 070403 [天体物理学]; 070507 [自然资源与国土空间规划学]; 090105 [作物生产系统与生态工程];

摘要：

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 (R-0) 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.

引用

页码：1557 / 1561

页数：5

共 22 条

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Emergence of a Novel Swine-Origin Influenza A (H1N1) Virus in Humans Novel Swine-Origin Influenza A (H1N1) Virus Investigation Team [J].