Abstract
In the United Kingdom, the influenza A(H1N1) 2009 pandemic had a distinct two-wave pattern of general practice consultations for influenza-like illness (ILI). We describe the epidemiology of the influenza pandemic in Wales between April and December 2009 using integrated data from a number of independent sources: GP surveillance, community virology surveillance, hospital admissions and deaths, and media enquiries monitoring. The first wave peaked in late July at 100 consultations per 100,000 general practice population and attracted intensive media coverage. The positivity rate for the A(H1N1)2009 influenza did not exceed 25% and only 44 hospitalisations and one death were recorded. By contrast, the second wave peaked in late October and although characterised by lower ILI consultation rates (65 consultations per 100,000 general practice population) and low profile media activity, was associated with much higher positivity rates for pandemic influenza A(H1N1)2009 (60%) and substantially more hospital admissions (n=379) and deaths (n=26). The large number of ILI-related consultations during the first wave in Wales probably reflected the intensive media activity rather than influenza virus circulating in the community. Data from community surveillance schemes may therefore have considerably overestimated the true incidence of influenza. This has implications for the future interpretation of ILI surveillance data and their use in policy making, and underlines the importance of using integrated epidemiological, virological and hospital surveillance data to monitor influenza activity.
Highlights
The media are major sources of health information
We examined data on influenza-like illness (ILI) consultation rates generated by NHS Direct Wales, two independent general practitioner (GP) surveillance systems (GP sentinel surveillance of infection and rapid automated GP surveillance) in conjunction with laboratory data, hospital admissions and deaths in order to define the epidemic period of influenza and the distribution of other circulating viruses
The GP sentinel surveillance scheme detected an increase in ILI consultations that exceeded the threshold for normal seasonal activity by mid-July 2009 (Figure 1)
Summary
The media are major sources of health information. They can generate awareness of health issues and play key roles in health behaviour change [1]. Studies suggest that media reports are the main source of most parents’ information about health problems [2]. The media can influence the behaviour of healthcare professionals, for example by increasing awareness and reporting of communicable diseases especially during outbreaks [3,4]. In mid-April 2009, a new strain of influenza A(H1N1) was identified in the United States (US). The same strain was identified in Mexico and Canada and later elsewhere. By late April the virus, named novel influenza A/H1N1, had spread worldwide [5]. On 11 June 2009, after confirming community transmission of influenza A(H1N1)2009 virus in two of its regions, the World Health Organization (WHO) declared an influenza pandemic [7]
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