FOR DEBATE: Age, influenza pandemics and disease dynamics

The world is currently confronting the first influenza pandemic of the 21st century [caused by a novel pandemic influenza A (H1N1) virus]. Earlier pandemics have been characterized by age distributions that are distinct from those observed with seasonal influenza epidemics, with higher attack rates...

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Bibliographic Details
Published inEpidemiology and infection Vol. 138; no. 11; pp. 1542 - 1549
Main Authors GREER, A. L., TUITE, A., FISMAN, D. N.
Format Journal Article
LanguageEnglish
Published Cambridge Cambridge University Press 01.11.2010
Subjects
Biological and medical sciences
Epidemics
Epidemiology
Fundamental and applied biological sciences. Psychology
H1N1 subtype influenza A virus
Indigenous populations
Infections
Influenza
Influenza A virus
Microbiology
Mortality
Pandemics
Vaccination
Viruses
Infection
Epidemiology
Viral disease
Influenza
Age
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Summary:The world is currently confronting the first influenza pandemic of the 21st century [caused by a novel pandemic influenza A (H1N1) virus]. Earlier pandemics have been characterized by age distributions that are distinct from those observed with seasonal influenza epidemics, with higher attack rates (and correspondingly increased proportionate or relative mortality) in younger individuals. While the genesis of protection against infection in older individuals during a pandemic is uncertain, differential vulnerability to infection by age has important implications for disease dynamics and control, and for choice of optimal vaccination strategies. Age-related vulnerability to infection may explain differences between school-and community-derived estimates of the reproductive number (R) for a newly emerged pandemic strain, and may also help explain the failure of a newly emerged influenza A (H1N1) virus strain to cause a pandemic in 1977. Age-related factors may also help explain variability in attack rates, and the size and impact of influenza epidemics across jurisdictions and between populations. In Canada, such effects have been observed in the apparently increased severity of outbreaks on Indigenous peoples' reserves. The implications of these patterns for vaccine allocation necessitate targeted research to understand age-related vulnerabilities early in an influenza pandemic.
ISSN:0950-2688
1469-4409