Estimating the disease burden of 2009 pandemic influenza A(H1N1) from surveillance and household surveys in Greece.

<h4>Background</h4>The aim of this study was to assess the disease burden of the 2009 pandemic influenza A(H1N1) in Greece.<h4>Methodology/principal findings</h4>Data on influenza-like illness (ILI), collected through cross-sectional nationwide telephone surveys of 1,000 hous...

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Autores principales:	Vana Sypsa, Stefanos Bonovas, Sotirios Tsiodras, Agoritsa Baka, Panos Efstathiou, Meni Malliori, Takis Panagiotopoulos, Ilias Nikolakopoulos, Angelos Hatzakis
Formato:	article
Lenguaje:	EN
Publicado:	Public Library of Science (PLoS) 2011
Materias:	Medicine R Science Q
Acceso en línea:	https://doaj.org/article/3d30ffba39fe4a67921effd573f34634
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spelling	oai:doaj.org-article:3d30ffba39fe4a67921effd573f346342021-11-18T06:52:22ZEstimating the disease burden of 2009 pandemic influenza A(H1N1) from surveillance and household surveys in Greece.1932-620310.1371/journal.pone.0020593https://doaj.org/article/3d30ffba39fe4a67921effd573f346342011-01-01T00:00:00Zhttps://www.ncbi.nlm.nih.gov/pmc/articles/pmid/21694769/?tool=EBIhttps://doaj.org/toc/1932-6203<h4>Background</h4>The aim of this study was to assess the disease burden of the 2009 pandemic influenza A(H1N1) in Greece.<h4>Methodology/principal findings</h4>Data on influenza-like illness (ILI), collected through cross-sectional nationwide telephone surveys of 1,000 households in Greece repeated for 25 consecutive weeks, were combined with data from H1N1 virologic surveillance to estimate the incidence and the clinical attack rate (CAR) of influenza A(H1N1). Alternative definitions of ILI (cough or sore throat and fever>38°C [ILI-38] or fever 37.1-38°C [ILI-37]) were used to estimate the number of symptomatic infections. The infection attack rate (IAR) was approximated using estimates from published studies on the frequency of fever in infected individuals. Data on H1N1 morbidity and mortality were used to estimate ICU admission and case fatality (CFR) rates. The epidemic peaked on week 48/2009 with approximately 750-1,500 new cases/100,000 population per week, depending on ILI-38 or ILI-37 case definition, respectively. By week 6/2010, 7.1%-15.6% of the population in Greece was estimated to be symptomatically infected with H1N1. Children 5-19 years represented the most affected population group (CAR:27%-54%), whereas individuals older than 64 years were the least affected (CAR:0.6%-2.2%). The IAR (95% CI) of influenza A(H1N1) was estimated to be 19.7% (13.3%, 26.1%). Per 1,000 symptomatic cases, based on ILI-38 case definition, 416 attended health services, 108 visited hospital emergency departments and 15 were admitted to hospitals. ICU admission rate and CFR were 37 and 17.5 per 100,000 symptomatic cases or 13.4 and 6.3 per 100,000 infections, respectively.<h4>Conclusions/significance</h4>Influenza A(H1N1) infected one fifth and caused symptomatic infection in up to 15% of the Greek population. Although individuals older than 65 years were the least affected age group in terms of attack rate, they had 55 and 185 times higher risk of ICU admission and CFR, respectively.Vana SypsaStefanos BonovasSotirios TsiodrasAgoritsa BakaPanos EfstathiouMeni MallioriTakis PanagiotopoulosIlias NikolakopoulosAngelos HatzakisPublic Library of Science (PLoS)articleMedicineRScienceQENPLoS ONE, Vol 6, Iss 6, p e20593 (2011)
institution	DOAJ
collection	DOAJ
language	EN
topic	Medicine R Science Q
spellingShingle	Medicine R Science Q Vana Sypsa Stefanos Bonovas Sotirios Tsiodras Agoritsa Baka Panos Efstathiou Meni Malliori Takis Panagiotopoulos Ilias Nikolakopoulos Angelos Hatzakis Estimating the disease burden of 2009 pandemic influenza A(H1N1) from surveillance and household surveys in Greece.
description	<h4>Background</h4>The aim of this study was to assess the disease burden of the 2009 pandemic influenza A(H1N1) in Greece.<h4>Methodology/principal findings</h4>Data on influenza-like illness (ILI), collected through cross-sectional nationwide telephone surveys of 1,000 households in Greece repeated for 25 consecutive weeks, were combined with data from H1N1 virologic surveillance to estimate the incidence and the clinical attack rate (CAR) of influenza A(H1N1). Alternative definitions of ILI (cough or sore throat and fever>38°C [ILI-38] or fever 37.1-38°C [ILI-37]) were used to estimate the number of symptomatic infections. The infection attack rate (IAR) was approximated using estimates from published studies on the frequency of fever in infected individuals. Data on H1N1 morbidity and mortality were used to estimate ICU admission and case fatality (CFR) rates. The epidemic peaked on week 48/2009 with approximately 750-1,500 new cases/100,000 population per week, depending on ILI-38 or ILI-37 case definition, respectively. By week 6/2010, 7.1%-15.6% of the population in Greece was estimated to be symptomatically infected with H1N1. Children 5-19 years represented the most affected population group (CAR:27%-54%), whereas individuals older than 64 years were the least affected (CAR:0.6%-2.2%). The IAR (95% CI) of influenza A(H1N1) was estimated to be 19.7% (13.3%, 26.1%). Per 1,000 symptomatic cases, based on ILI-38 case definition, 416 attended health services, 108 visited hospital emergency departments and 15 were admitted to hospitals. ICU admission rate and CFR were 37 and 17.5 per 100,000 symptomatic cases or 13.4 and 6.3 per 100,000 infections, respectively.<h4>Conclusions/significance</h4>Influenza A(H1N1) infected one fifth and caused symptomatic infection in up to 15% of the Greek population. Although individuals older than 65 years were the least affected age group in terms of attack rate, they had 55 and 185 times higher risk of ICU admission and CFR, respectively.
format	article
author	Vana Sypsa Stefanos Bonovas Sotirios Tsiodras Agoritsa Baka Panos Efstathiou Meni Malliori Takis Panagiotopoulos Ilias Nikolakopoulos Angelos Hatzakis
author_facet	Vana Sypsa Stefanos Bonovas Sotirios Tsiodras Agoritsa Baka Panos Efstathiou Meni Malliori Takis Panagiotopoulos Ilias Nikolakopoulos Angelos Hatzakis
author_sort	Vana Sypsa
title	Estimating the disease burden of 2009 pandemic influenza A(H1N1) from surveillance and household surveys in Greece.
title_short	Estimating the disease burden of 2009 pandemic influenza A(H1N1) from surveillance and household surveys in Greece.
title_full	Estimating the disease burden of 2009 pandemic influenza A(H1N1) from surveillance and household surveys in Greece.
title_fullStr	Estimating the disease burden of 2009 pandemic influenza A(H1N1) from surveillance and household surveys in Greece.
title_full_unstemmed	Estimating the disease burden of 2009 pandemic influenza A(H1N1) from surveillance and household surveys in Greece.
title_sort	estimating the disease burden of 2009 pandemic influenza a(h1n1) from surveillance and household surveys in greece.
publisher	Public Library of Science (PLoS)
publishDate	2011
url	https://doaj.org/article/3d30ffba39fe4a67921effd573f34634
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Estimating the disease burden of 2009 pandemic influenza A(H1N1) from surveillance and household surveys in Greece.

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