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首页> 外文期刊>BMC Public Health >Assessing secondary attack rates among household contacts at the beginning of the influenza A (H1N1) pandemic in Ontario, Canada, April-June 2009: A prospective, observational study
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Assessing secondary attack rates among household contacts at the beginning of the influenza A (H1N1) pandemic in Ontario, Canada, April-June 2009: A prospective, observational study

机译：2009年4月至6月在加拿大安大略省评估甲型H1N1流感大流行开始时家庭接触者的二次发作率：一项前瞻性观察性研究

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Background Understanding transmission dynamics of the pandemic influenza A (H1N1) virus in various exposure settings and determining whether transmissibility differed from seasonal influenza viruses was a priority for decision making on mitigation strategies at the beginning of the pandemic. The objective of this study was to estimate household secondary attack rates for pandemic influenza in a susceptible population where control measures had yet to be implemented. Methods All Ontario local health units were invited to participate; seven health units volunteered. For all laboratory-confirmed cases reported between April 24 and June 18, 2009, participating health units performed contact tracing to detect secondary cases among household contacts. In total, 87 cases and 266 household contacts were included in this study. Secondary cases were defined as any household member with new onset of acute respiratory illness (fever or two or more respiratory symptoms) or influenza-like illness (fever plus one additional respiratory symptom). Attack rates were estimated using both case definitions. Results Secondary attack rates were estimated at 10.3% (95% CI 6.8-14.7) for secondary cases with influenza-like illness and 20.2% (95% CI 15.4-25.6) for secondary cases with acute respiratory illness. For both case definitions, attack rates were significantly higher in children under 16 years than adults (25.4% and 42.4% compared to 7.6% and 17.2%). The median time between symptom onset in the primary case and the secondary case was estimated at 3.0 days. Conclusions Secondary attack rates for pandemic influenza A (H1N1) were comparable to seasonal influenza estimates suggesting similarities in transmission. High secondary attack rates in children provide additional support for increased susceptibility to infection.
机译：背景技术了解大流行性甲型流感（H1N1）病毒在各种暴露环境下的传播动态并确定其可传播性是否与季节性流感病毒不同是决定大流行开始时的缓解策略的重点。这项研究的目的是在尚未采取控制措施的易感人群中，估计大流行性流感的家庭继发发作率。方法邀请安大略省所有地方卫生单位参加;七个卫生部门自愿参加。对于2009年4月24日至6月18日之间报告的所有实验室确诊病例，参与的卫生部门进行了接触者追踪，以发现家庭接触者中的继发病例。本研究总共包括87例病例和266个家庭接触者。继发病例定义为新发急性呼吸道疾病（发烧或两种或更多种呼吸道症状）或流感样疾病（发烧加一种其他呼吸道症状）的家庭成员。使用两种病例定义都可以估算出发病率。结果流感样疾病继发病例的次发发作率估计为10.3％（95％CI 6.8-14.7），急性呼吸道疾病继发病例的20.2％（95％CI 15.4-25.6）。在这两种情况下，16岁以下儿童的发作率均显着高于成人（25.4％和42.4％，而7.6％和17.2％）。在原发病例和继发病例之间，症状发作之间的中位时间估计为3.0天。结论大流行性甲型流感（H1N1）的继发攻击率与季节性流感估计值相当，表明传播相似。儿童较高的继发性发作率为增加感染易感性提供了额外的支持。

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