Incidence, Seasonality and Mortality Associated with Influenza Pneumonia in Thailand: 2005–2008

Data on the incidence, seasonality and mortality associated with influenza in subtropical low and middle income countries are limited. Prospective data from multiple years are needed to develop vaccine policy and treatment guidelines, and improve pandemic preparedness. During January 2005 through De...

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Vydané v:	PloS one Ročník 4; číslo 11; s. e7776
Hlavní autori:	Simmerman, James Mark, Chittaganpitch, Malinee, Levy, Jens, Chantra, Somrak, Maloney, Susan, Uyeki, Timothy, Areerat, Peera, Thamthitiwat, Somsak, Olsen, Sonja J., Fry, Alicia, Ungchusak, Kumnuan, Baggett, Henry C., Chunsuttiwat, Supamit
Médium:	Journal Article
Jazyk:	English
Vydavateľské údaje:	United States Public Library of Science 11.11.2009 Public Library of Science (PLoS)
Predmet:	Adolescent Adult Adults Age Age Factors Aged Annual variations Cell culture Child Child, Preschool Children Collaboration Disease control Disease prevention DNA polymerases Fatalities Geriatrics Health surveillance Hospitalization Humans Immunization Incidence Infant Infections Infectious Diseases/Respiratory Infections Influenza Influenza A Influenza A virus Influenza B Influenza vaccines Influenza, Human - diagnosis Influenza, Human - epidemiology Influenza, Human - mortality Middle Aged Mortality Older people Pandemics Patients Pneumonia Pneumonia - diagnosis Pneumonia - epidemiology Pneumonia - mortality Polymerase chain reaction Population Prospective Studies Provinces Public health Public Health and Epidemiology/Global Health Public Health and Epidemiology/Infectious Diseases Respiratory syncytial virus Risk factors RNA-directed DNA polymerase Seasonal variability Seasonal variations Seasons Thailand Vaccination Vaccines Viral infections Viruses Thailand Atlanta Georgia Georgia United States > US
ISSN:	1932-6203, 1932-6203
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Shrnutí:	Data on the incidence, seasonality and mortality associated with influenza in subtropical low and middle income countries are limited. Prospective data from multiple years are needed to develop vaccine policy and treatment guidelines, and improve pandemic preparedness. During January 2005 through December 2008, we used an active, population-based surveillance system to prospectively identify hospitalized pneumonia cases with influenza confirmed by reverse transcriptase-polymerase chain reaction or cell culture in 20 hospitals in two provinces in Thailand. Age-specific incidence was calculated and extrapolated to estimate national annual influenza pneumonia hospital admissions and in-hospital deaths. Influenza was identified in 1,346 (10.4%) of pneumonia patients of all ages, and 10 influenza pneumonia patients died while in the hospital. 702 (52%) influenza pneumonia patients were less than 15 years of age. The average annual incidence of influenza pneumonia was greatest in children less than 5 years of age (236 per 100,000) and in those age 75 or older (375 per 100,000). During 2005, 2006 and 2008 influenza A virus detection among pneumonia cases peaked during June through October. In 2007 a sharp increase was observed during the months of January through April. Influenza B virus infections did not demonstrate a consistent seasonal pattern. Influenza pneumonia incidence was high in 2005, a year when influenza A(H3N2) subtype virus strains predominated, low in 2006 when A(H1N1) viruses were more common, moderate in 2007 when H3N2 and influenza B co-predominated, and high again in 2008 when influenza B viruses were most common. During 2005-2008, influenza pneumonia resulted in an estimated annual average 36,413 hospital admissions and 322 in-hospital pneumonia deaths in Thailand. Influenza virus infection is an important cause of hospitalized pneumonia in Thailand. Young children and the elderly are most affected and in-hospital deaths are more common than previously appreciated. Influenza occurs year-round and tends to follow a bimodal seasonal pattern with substantial variability. The disease burden varies significantly from year to year. Our findings support a recent Thailand Ministry of Public Health (MOPH) decision to extend annual influenza vaccination to older adults and suggest that children should also be targeted for routine vaccination.
Bibliografia:	ObjectType-Article-1 SourceType-Scholarly Journals-1 ObjectType-Feature-2 content type line 14 ObjectType-Article-2 ObjectType-Feature-1 content type line 23 Conceived and designed the experiments: JS. Performed the experiments: JS MC SC PA ST HB. Analyzed the data: JS JL SJO AF HB. Contributed reagents/materials/analysis tools: MC KU SC. Wrote the paper: JS JL SM TU AF HB. Program director: SM. Contributed to drafting the manuscript: SM AF. Contributed expert guidance to study, assisted with approach to data analysis: TU SJO AF. Contributed to manuscript: TU SJO. Epidemiology Program Director: KU. Senior Advisor to the Ministry of Health, oversee MOPH-US CDC Collaboration: SC.
ISSN:	1932-6203 1932-6203
DOI:	10.1371/journal.pone.0007776