Sero-prevalence and incidence of A/H1N1 2009 influenza infection in Scotland in winter 2009-2010.

<h4>Background</h4>Sero-prevalence is a valuable indicator of prevalence and incidence of A/H1N1 2009 infection. However, raw sero-prevalence data must be corrected for background levels of cross-reactivity (i.e. imperfect test specificity) and the effects of immunisation programmes.<...

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Main Authors: Nigel J McLeish, Peter Simmonds, Chris Robertson, Ian Handel, Mark McGilchrist, Brajendra K Singh, Shona Kerr, Margo E Chase-Topping, Katy Sinka, Mark Bronsvoort, David J Porteous, William Carman, James McMenamin, Andrew Leigh-Brown, Mark E J Woolhouse
Format: Article
Language:English
Published: Public Library of Science (PLoS) 2011-01-01
Series:PLoS ONE
Online Access:https://journals.plos.org/plosone/article/file?id=10.1371/journal.pone.0020358&type=printable
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author Nigel J McLeish
Peter Simmonds
Chris Robertson
Ian Handel
Mark McGilchrist
Brajendra K Singh
Shona Kerr
Margo E Chase-Topping
Katy Sinka
Mark Bronsvoort
David J Porteous
William Carman
James McMenamin
Andrew Leigh-Brown
Mark E J Woolhouse
author_facet Nigel J McLeish
Peter Simmonds
Chris Robertson
Ian Handel
Mark McGilchrist
Brajendra K Singh
Shona Kerr
Margo E Chase-Topping
Katy Sinka
Mark Bronsvoort
David J Porteous
William Carman
James McMenamin
Andrew Leigh-Brown
Mark E J Woolhouse
author_sort Nigel J McLeish
collection DOAJ
description <h4>Background</h4>Sero-prevalence is a valuable indicator of prevalence and incidence of A/H1N1 2009 infection. However, raw sero-prevalence data must be corrected for background levels of cross-reactivity (i.e. imperfect test specificity) and the effects of immunisation programmes.<h4>Methods and findings</h4>We obtained serum samples from a representative sample of 1563 adults resident in Scotland between late October 2009 and April 2010. Based on a microneutralisation assay, we estimate that 44% (95% confidence intervals (CIs): 40-47%) of the adult population of Scotland were sero-positive for A/H1N1 2009 influenza by 1 March 2010. Correcting for background cross-reactivity and for recorded vaccination rates by time and age group, we estimated that 34% (27-42%) were naturally infected with A/H1N1 2009 by 1 March 2010. The central estimate increases to >40% if we allow for imperfect test sensitivity. Over half of these infections are estimated to have occurred during the study period and the incidence of infection in late October 2009 was estimated at 4.3 new infections per 1000 people per day (1.2 to 7.2), falling close to zero by April 2010. The central estimate increases to over 5.0 per 1000 if we allow for imperfect test specificity. The rate of infection was higher for younger adults than older adults. Raw sero-prevalences were significantly higher in more deprived areas (likelihood ratio trend statistic = 4.92,1 df, P = 0.03) but there was no evidence of any difference in vaccination rates.<h4>Conclusions</h4>We estimate that almost half the adult population of Scotland were sero-positive for A/H1N1 2009 influenza by early 2010 and that the majority of these individuals (except in the oldest age classes) sero-converted as a result of natural infection with A/H1N1 2009. Public health planning should consider the possibility of higher rates of infection with A/H1N1 2009 influenza in more deprived areas.
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spelling doaj-art-ffa8f9f9e47d42e2a7ff8dec98adb2832025-08-20T03:46:54ZengPublic Library of Science (PLoS)PLoS ONE1932-62032011-01-0166e2035810.1371/journal.pone.0020358Sero-prevalence and incidence of A/H1N1 2009 influenza infection in Scotland in winter 2009-2010.Nigel J McLeishPeter SimmondsChris RobertsonIan HandelMark McGilchristBrajendra K SinghShona KerrMargo E Chase-ToppingKaty SinkaMark BronsvoortDavid J PorteousWilliam CarmanJames McMenaminAndrew Leigh-BrownMark E J Woolhouse<h4>Background</h4>Sero-prevalence is a valuable indicator of prevalence and incidence of A/H1N1 2009 infection. However, raw sero-prevalence data must be corrected for background levels of cross-reactivity (i.e. imperfect test specificity) and the effects of immunisation programmes.<h4>Methods and findings</h4>We obtained serum samples from a representative sample of 1563 adults resident in Scotland between late October 2009 and April 2010. Based on a microneutralisation assay, we estimate that 44% (95% confidence intervals (CIs): 40-47%) of the adult population of Scotland were sero-positive for A/H1N1 2009 influenza by 1 March 2010. Correcting for background cross-reactivity and for recorded vaccination rates by time and age group, we estimated that 34% (27-42%) were naturally infected with A/H1N1 2009 by 1 March 2010. The central estimate increases to >40% if we allow for imperfect test sensitivity. Over half of these infections are estimated to have occurred during the study period and the incidence of infection in late October 2009 was estimated at 4.3 new infections per 1000 people per day (1.2 to 7.2), falling close to zero by April 2010. The central estimate increases to over 5.0 per 1000 if we allow for imperfect test specificity. The rate of infection was higher for younger adults than older adults. Raw sero-prevalences were significantly higher in more deprived areas (likelihood ratio trend statistic = 4.92,1 df, P = 0.03) but there was no evidence of any difference in vaccination rates.<h4>Conclusions</h4>We estimate that almost half the adult population of Scotland were sero-positive for A/H1N1 2009 influenza by early 2010 and that the majority of these individuals (except in the oldest age classes) sero-converted as a result of natural infection with A/H1N1 2009. Public health planning should consider the possibility of higher rates of infection with A/H1N1 2009 influenza in more deprived areas.https://journals.plos.org/plosone/article/file?id=10.1371/journal.pone.0020358&type=printable
spellingShingle Nigel J McLeish
Peter Simmonds
Chris Robertson
Ian Handel
Mark McGilchrist
Brajendra K Singh
Shona Kerr
Margo E Chase-Topping
Katy Sinka
Mark Bronsvoort
David J Porteous
William Carman
James McMenamin
Andrew Leigh-Brown
Mark E J Woolhouse
Sero-prevalence and incidence of A/H1N1 2009 influenza infection in Scotland in winter 2009-2010.
PLoS ONE
title Sero-prevalence and incidence of A/H1N1 2009 influenza infection in Scotland in winter 2009-2010.
title_full Sero-prevalence and incidence of A/H1N1 2009 influenza infection in Scotland in winter 2009-2010.
title_fullStr Sero-prevalence and incidence of A/H1N1 2009 influenza infection in Scotland in winter 2009-2010.
title_full_unstemmed Sero-prevalence and incidence of A/H1N1 2009 influenza infection in Scotland in winter 2009-2010.
title_short Sero-prevalence and incidence of A/H1N1 2009 influenza infection in Scotland in winter 2009-2010.
title_sort sero prevalence and incidence of a h1n1 2009 influenza infection in scotland in winter 2009 2010
url https://journals.plos.org/plosone/article/file?id=10.1371/journal.pone.0020358&type=printable
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