دورية أكاديمية

Population-level susceptibility, severity and spread of pandemic influenza: design of, and initial results from, a pre-pandemic and hibernating pandemic phase study using cross-sectional data from the Health Survey for England (HSE)

التفاصيل البيبلوغرافية
العنوان: Population-level susceptibility, severity and spread of pandemic influenza: design of, and initial results from, a pre-pandemic and hibernating pandemic phase study using cross-sectional data from the Health Survey for England (HSE)
المؤلفون: Ellen B Fragaszy, Mark Quinlivan, Judith Breuer, Rachel Craig, Stephanie Hutchings, Michael Kidd, Jennifer Mindell, Andrew C Hayward
المصدر: Public Health Research, Vol 3, Iss 6 (2015)
بيانات النشر: NIHR Journals Library, 2015.
سنة النشر: 2015
المجموعة: LCC:Public aspects of medicine
مصطلحات موضوعية: influenza, human, pandemics, health surveys, data collection, public health, surveillance, serology, epidemiology, Public aspects of medicine, RA1-1270
الوصف: Background: Assessing severity and spread of a novel influenza strain at the start of a pandemic is critical for informing a targeted and proportional response. It requires community-level studies to estimate the burden of infection and disease. Rapidly initiating such studies in a pandemic is difficult. The study aims to establish an efficient system allowing real-time assessment of population susceptibility, spread of infection and clinical attack rates in the event of a pandemic. Methods: We developed and appended additional survey questions and specimen collection to the Health Survey for England (HSE) – a large, annual, rolling nationally representative general population survey recruiting throughout the year – to enable rapid population-based surveys of influenza infection and disease during a pandemic. Using these surveys we can assess the spread of the virus geographically, by age and through time. The data generated can also provide denominators for national estimates of case fatality and hospitalisation rates. Phase 1: we compared retrospectively collected HSE illness rates during the first two infection waves of the 2009 pandemic with the Flu Watch study (a prospective community cohort). Monthly and seasonal age-specific rates of illness and proportion vaccinated were compared. Phase 2: we piloted blood specimen and data collection alongside the 2012–13 HSE. We are developing laboratory methods and protocols for real-time serological assays of a novel pandemic influenza virus using these specimens, and automated programmes for analysing and reporting illness and infection rates. Phase 3: during inter-pandemic years, the study enters a holding phase, where it is included in the yearly HSE ethics application and planning procedures, allowing rapid triggering in a pandemic. Phase 4: once retriggered, the study will utilise the methods developed in phase 2 to monitor the severity and spread of the pandemic in real time. Results: Phase 1: the rates of reported illness during the first two waves in the HSE underestimated the community burden as measured by Flu Watch, but the patterns of illness by age and time were broadly comparable. The extent of underestimation was greatest for HSE participants interviewed later in the year compared with those interviewed closer to the pandemic. Vaccine uptake in the HSE study was comparable to independent national estimates and the Flu Watch study. Phases 2 and 3: illness data and serological samples from 2018 participants were collected in the 2012–13 HSE and transferred to the University College London Hospital. In the 2013 HSE and onwards, this project was included in the annual HSE ethics and planning rounds. Conclusions: The HSE’s underestimation of illness rates during the first two waves of the pandemic is probably due to recall bias and the limitation of being able to report only one illness when multiple illnesses per season can occur. Changes to the illness questions (reporting only recent illnesses) should help minimise these issues. Additional prospective follow-up could improve measurement of disease incidence. The representative nature of the HSE allows accurate measurements of vaccine uptake. Study registration: This study is registered as ISRCTN80214280. Funding: This project was funded by the NIHR Public Health Research programme and will be published in full in Public Health Research; Vol. 3, No. 6. See the NIHR Journals Library website for further project information.
نوع الوثيقة: article
وصف الملف: electronic resource
اللغة: English
تدمد: 2050-4381
2050-439X
العلاقة: https://doaj.org/toc/2050-4381Test; https://doaj.org/toc/2050-439XTest
DOI: 10.3310/phr03060
الوصول الحر: https://doaj.org/article/72e4c7a88c004a4fae11790955813b32Test
رقم الانضمام: edsdoj.72e4c7a88c004a4fae11790955813b32
قاعدة البيانات: Directory of Open Access Journals
الوصف
تدمد:20504381
2050439X
DOI:10.3310/phr03060