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Epidemiologic and virologic assessment of the 2009 influenza A (H1N1) pandemic on selected temperate countries in the Southern Hemisphere: Argentina, Australia, Chile, New Zealand and South Africa
Authors:Van Kerkhove Maria D  Mounts Anthony W  Mall Sabine  Vandemaele Katelijn A H  Chamberland Mary  dos Santos Thais  Fitzner Julia  Widdowson Marc-Alain  Michalove Jennifer  Bresee Joseph  Olsen Sonja J  Quick Linda  Baumeister Elsa  Carlino Luis O  Savy Vilma  Uez Osvaldo  Owen Rhonda  Ghani Fatima  Paterson Bev  Forde Andrea  Fasce Rodrigo  Torres Graciela  Andrade Winston  Bustos Patricia  Mora Judith  Gonzalez Claudia  Olea Andrea  Sotomayor Viviana  Najera De Ferrari Manuel  Burgos Alejandra  Hunt Darren  Huang Q Sue  Jennings Lance C  Macfarlane Malcolm  Lopez Liza D  McArthur Colin  Cohen Cheryl  Archer Brett
Affiliation:World Health Organization, Imperial College London, UK. m.vankerkhove@imperial.ac.uk
Abstract:Please cite this paper as: Van Kerkhove et al. (2011) Epidemiologic and virologic assessment of the 2009 influenza A (H1N1) pandemic on selected temperate countries in the Southern Hemisphere: Argentina, Australia, Chile, New Zealand and South Africa. Influenza and Other Respiratory Viruses 5(6), e487–e498. Introduction and Setting Our analysis compares the most comprehensive epidemiologic and virologic surveillance data compiled to date for laboratory‐confirmed H1N1pdm patients between 1 April 2009 ‐ 31 January 2010 from five temperate countries in the Southern Hemisphere–Argentina, Australia, Chile, New Zealand, and South Africa. Objective We evaluate transmission dynamics, indicators of severity, and describe the co‐circulation of H1N1pdm with seasonal influenza viruses. Results In the five countries, H1N1pdm became the predominant influenza strain within weeks of initial detection. South Africa was unique, first experiencing a seasonal H3N2 wave, followed by a distinct H1N1pdm wave. Compared with the 2007 and 2008 influenza seasons, the peak of influenza‐like illness (ILI) activity in four of the five countries was 3‐6 times higher with peak ILI consultation rates ranging from 35/1,000 consultations/week in Australia to 275/100,000 population/week in New Zealand. Transmission was similar in all countries with the reproductive rate ranging from 1.2–1.6. The median age of patients in all countries increased with increasing severity of disease, 4–14% of all hospitalized cases required critical care, and 26–68% of fatal patients were reported to have ≥1 chronic medical condition. Compared with seasonal influenza, there was a notable downward shift in age among severe cases with the highest population‐based hospitalization rates among children <5 years old. National population‐based mortality rates ranged from 0.8–1.5/100,000. Conclusions The difficulty experienced in tracking the progress of the pandemic globally, estimating its severity early on, and comparing information across countries argues for improved routine surveillance and standardization of investigative approaches and data reporting methods.
Keywords:H1N1  influenza circulation  pandemic  severity  Southern Hemisphere  transmission
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