Differing Symptom Patterns in Early Pandemic vs Seasonal Influenza Infections

Tang, Julian W.; Tambyah, Paul A.; Lai, Florence Yuk Lin; Lee, Hong Kai; Lee, Chun Kiat; Loh, Tze Ping; Chiu, Lily; Koay, Evelyn Siew-Chuan

doi:10.1001/archinternmed.2010.108

Cited by 42 publications

(49 citation statements)

References 25 publications

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“…This finding was similar to Cuba, where pandemic (H1N1) 2009 and influenza A/H3N2 co‐circulated, peaking in early October 9 . Co‐circulation of pandemic (H1N1) 2009 and seasonal influenza A was also reported in tropical regions of Asia and Africa 11 , 12 , 13 . In the United States, although pandemic (H1N1) 2009 peaked during October, there was minimal seasonal influenza activity 14 .…”

Section: Discussionsupporting

confidence: 73%

Pandemic H1N1 influenza surveillance in Haiti, July–December 2009

Fitter

Freeman²,

Buteau³

et al. 2012

Influenza Resp Viruses

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Please cite this paper as: Fitter et al. (2012) Pandemic H1N1 influenza surveillance in Haiti, July–December 2009. Influenza and Other Respiratory Viruses DOI: 10.1111/irv.12060.From June 2009 through December 2009, Haiti conducted sentinel surveillance for influenza. 499 samples were collected and tested using real‐time RT‐PCR. 197 (39.5%) were positive for influenza, including 95 (48%) pandemic (H1N1) 2009, 57 (29%) seasonal influenza A and 45 (23%) influenza B. The median age of pandemic (H1N1) 2009 cases was 21.7; two‐thirds of pandemic (H1N1) 2009 cases were in patients aged 6 years – 35 years. Pandemic activity peaked in September and co‐circulated with other influenza subtypes. The age distribution and seasonality of pandemic (H1N1) 2009 in Haiti were similar to other countries in the Caribbean region.

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Section: Discussionsupporting

confidence: 73%

Pandemic H1N1 influenza surveillance in Haiti, July–December 2009

Fitter

Freeman²,

Buteau³

et al. 2012

Influenza Resp Viruses

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“…The presenting symptoms of influenza may vary depending on the type of influenza responsible. In Singapore, H1N1 and seasonal influenza had different symptom profiles, with fever and runny nose being more common among seasonal influenza cases31 and the prevalence of specific symptoms among H1N1 cases also varied between studies,32–34 so further exploration is warranted.…”

Section: Discussionmentioning

confidence: 99%

Self-diagnosis of influenza during a pandemic: a cross-sectional survey

Jutel

Baker

et al. 2011

BMJ Open

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BackgroundSelf-diagnosis of influenza is an important component of pandemic control and management as it may support self-management practices and reduce visits to healthcare facilities, thus helping contain viral spread. However, little is known about the accuracy of self-diagnosis of influenza, particularly during pandemics.MethodsWe used cross-sectional survey data to correlate self-diagnosis of influenza with serological evidence of 2009 pandemic influenza A(H1N1) infection (haemagglutination inhibition titres of ≥1:40) and to determine what symptoms were more likely to be present in accurate self-diagnosis. The sera and risk factor data were collected for the national A(H1N1) seroprevalence survey from November 2009 to March 2010, 3 months after the first pandemic wave in New Zealand (NZ).ResultsThe samples consisted of 318 children, 413 adults and 423 healthcare workers. The likelihood of being seropositive was no different in those who believed they had influenza from those who believed they did not have influenza in all groups. Among adults, 23.3% (95% CI 11.9% to 34.7%) of those who reported having had influenza were seropositive for H1N1, but among those reporting no influenza, 21.3% (95% CI 13% to 29.7%) were also seropositive. Those meeting NZ surveillance or Ministry of Health influenza case definitions were more likely to believe they had the flu (surveillance data adult sample OR 27.1, 95% CI 13.6 to 53.6), but these symptom profiles were not associated with a higher likelihood of H1N1 seropositivity (surveillance data adult sample OR 0.93, 95% CI 0.5 to 1.7).ConclusionsSelf-diagnosis does not accurately predict influenza seropositivity. The symptoms promoted by many public health campaigns are linked with self-diagnosis of influenza but not with seropositivity. These findings raise challenges for public health initiatives that depend on accurate self-diagnosis by members of the public and appropriate self-management action.

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“…Although clinical characteristics of pandemic (H1N1) 2009 have been well documented ( 1 , 2 ), fewer specific virologic comparisons with seasonal influenza have been studied in hospitalized patients ( 3 ). Studies of other influenza virus infections in humans suggest that host immune responses play a major role in determining clinical outcomes ( 4 , 5 ).…”

mentioning

confidence: 99%