Abstract
BackgroundThe world has recently experienced the first influenza pandemic of the 21st century that lasted 14 months from June 2009 to August 2010. This study aimed to compare the timing, geographic spread and community impact during the winter wave of influenza pandemic A (H1N1) 2009 to historical influenza seasons in countries of the WHO European region.MethodsWe assessed the timing of pandemic by comparing the median peak of influenza activity in countries of the region during the last seven influenza seasons. The peaks of influenza activity were selected by two independent researchers using predefined rules. The geographic spread was assessed by correlating the peak week of influenza activity in included countries against the longitude and latitude of the central point in each country. To assess the community impact of pandemic influenza, we constructed linear regression models to compare the total and age-specific influenza-like-illness (ILI) or acute respiratory infection (ARI) rates reported by the countries in the pandemic season to those observed in the previous six influenza seasons.ResultsWe found that the influenza activity reached its peak during the pandemic, on average, 10.5 weeks (95% CI 6.4-14.2) earlier than during the previous 6 seasons in the Region, and there was a west to east spread of pandemic A(H1N1) influenza virus in the western part of the Region. A regression analysis showed that the total ILI or ARI rates were not higher than historical rates in 19 of the 28 countries. However, in countries with age-specific data, there were significantly higher consultation rates in the 0-4 and/or 5-14 age groups in 11 of the 20 countries.ConclusionsUsing routine influenza surveillance data, we found that pandemic influenza had several differential features compared to historical seasons in the region. It arrived earlier, caused significantly higher number of outpatient consultations in children in most countries and followed west to east spread that was previously observed during some influenza seasons with dominant A (H3N2) ifluenza viruses. The results of this study help to understand the epidemiology of 2009 influenza pandemic and can be used for pandemic preparedness planning.
Highlights
The world has recently experienced the first influenza pandemic of the 21st century that lasted 14 months from June 2009 to August 2010
While pandemic A(H1N1) 2009 influenza virus infections caused a wide spectrum of illness, it did have a significant effect on particular subpopulations such as pregnant women, persons with underlying conditions, and young adults who were at higher risk of developing severe disease [2,3]
Timing and duration of pandemic in the WHO European region During the 2009-2010 pandemic influenza season, the median influenza activity peak in the Region was observed during the week 47. (Figure 3) There was a perfect synchronization of influenza activity peak across age groups during the pandemic 2009-2010 influenza season
Summary
The world has recently experienced the first influenza pandemic of the 21st century that lasted 14 months from June 2009 to August 2010. This study aimed to compare the timing, geographic spread and community impact during the winter wave of influenza pandemic A (H1N1) 2009 to historical influenza seasons in countries of the WHO European region. The world has recently experienced the first influenza pandemic of the 21st century that officially lasted 14 months from June 2009 to August 2010 [1]. Where outpatient illness is concerned, there is lack of data comparing the pandemic with previous seasonal influenza outbreaks. This paper aims to compare the timing, geographical spread and the community effect of 2009 influenza pandemic as compared to previous seasonal influenza outbreaks in WHO European Region. Influenza surveillance in the countries of the region is coordinated by the WHO European Influenza Network, EuroFlu [4] administered by the WHO Regional office for Europe
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