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arXiv 1706.03348q-bio.PE
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2002-2017年德国甲型流感流行期间不同年龄组的相对作用

On the relative role of different age groups during influenza A epidemics in Germany, 2002-2017

Edward Goldstein

摘要:

背景资料:关于不同年龄组,特别是学龄儿童和年轻人在传播流感流行方面的作用的信息有限。研究方法:对于传染病暴发,由于易感性和/或接触率的增加,某些亚群可能在暴发的上升过程中发挥不成比例的作用。这样的亚群可以通过考虑亚群中的病例在流行高峰之前(Bp)发生的所有病例中所占的比例以及流行高峰之后(Ap)的相应比例来确定,以计算亚群的相对风险,RR=Bp/Ap。我们使用2002-2017年德国报告的甲型流感病例数据估计了几个年龄组的RR。结果如下:14- 17岁的儿童在数据中的15次甲型流感流行中有7次的RR估计值最高,包括2009年的大流行,以及2016/17,2008/09和2006/07的大流行季节。10- 13岁儿童在3次流行期间的RR估计值最高,包括2014/15和2004/05大季节。在两次流行期间,包括2012/13年的大季节,6- 9岁儿童的RR估计值最高。2- 5岁的儿童在2015/16年中季的RR估计值最高; 18- 24岁的成人在2005/06年小季的RR估计值最高; 2 - 5 - 34岁的成人在2002/03年大季的RR估计值最高。结论:我们的研究结果支持了所有学龄儿童,特别是年龄最大的儿童在社区传播流感流行中的突出作用。我们注意到,在美国最近的流感季节,年龄较大的学龄儿童的全国疫苗接种覆盖率低于年龄较小的学龄儿童,而英格兰的流感疫苗接种计划尚未在中学生中逐步实施。

英文摘要:

Background: There is limited information about the role of different age groups, particularly subgroups of school-age children and younger adults in propagating influenza epidemics. Methods: For a communicable disease outbreak, some subpopulations may play a disproportionate role during the ascent of the outbreak due to increased susceptibility and/or contact rates. Such subpopulations can be identified by considering the proportion that cases in a subpopulation represent among all cases in the population occurring before the epidemic peak (Bp), the corresponding proportion after the epidemic peak (Ap), to calculate the relative risk for a subpopulation, RR=Bp/Ap. We estimated RR for several age groups using data on reported influenza A cases in Germany between 2002-2017. Results: Children aged 14-17y had the highest RR estimates for 7 out of 15 influenza A epidemics in the data, including the 2009 pandemic, and the large 2016/17, 2008/09, and 2006/07 seasons. Children aged 10-13y had the highest RR estimates during 3 epidemics, including the large 2014/15 and 2004/05 seasons. Children aged 6-9y had the highest RR estimates during two epidemics, including the large 2012/13 season. Children aged 2-5y had the highest RR estimate during the moderate 2015/16 season; adults aged 18-24y had the highest RR estimate during the small 2005/06 season; adults aged 25-34y had the highest RR estimate during the large, 2002/03 season. Conclusions: Our results support the prominent role of all school-age children, particularly the oldest ones, in propagating influenza epidemics in the community. We note that national vaccination coverage levels among older school-age children were lower than among younger school-age children during the recent influenza seasons in the US, and influenza vaccination program in England has not been phased in yet for secondary school students.

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