Children have an important role in transmission of influenza A H1N1

January 01, 0001

Children have an important role in transmission of influenza A H1N1

In this cross-sectional serological survey, the researchers from the UK obtained 1403 serum samples taken in 2008 (before the first wave of H1N1 infection) and 1954 serum samples taken in August and September, 2009 (after the first wave of infection) as part of the annual collection for the Health Protection Agency seroepidemiology programme from patients accessing health care in England. Antibody titres were measured by use of haemagglutination inhibition and microneutralisation assays.

In the baseline serum samples from 2008, haemagglutination inhibition and microneutralisation antibody titres increased significantly with age. The proportion of samples with haemagglutination inhibition titre 1:32 or more ranged from 1.8% in children aged 0-4 years to 31.3% in adults aged 80 years or older. In London and the West Midlands, the difference in the proportion of samples with haemagglutination inhibition titre equal to or above 1:32 between baseline and September, 2009, was 21.3% for children younger than 5 years of age, 42.0% for 5- 14-year-olds, and 20.6% for 15-24-year-olds, with no difference between baseline and September in older age groups. In other regions, only children younger than 15 years showed a significant increase from baseline (6.3%).

The researchers concluded: "Around one child in every three was infected with 2009 pandemic H1N1 in the first wave of infection in regions with a high incidence, ten times more than estimated from clinical surveillance. Pre- existing antibody in older age groups protects against infection. Children have an important role in transmission of influenza and would be a key target group for vaccination both for their protection and for the protection of others through herd immunity."

This will require a rethink from the vaccination against seasonal flu approach.

For the full abstract, click here.

The Lancet published online 21 January 2010
© 2010 Elsevier Limited
Incidence of 2009 pandemic influenza A H1N1 infection in England: a cross-sectional serological study. Prof Elizabeth Miller, Katja Hoschler, Pia Hardelid et al. Correspondence to Elizabeth Miller: [email protected]

Category: B. Blood/Immune Mechanisms. Keywords: incidence, 2009, pandemic, influenza, influenza A H1N1, infection, cross sectional serological study, journal watch.
Synopsis edited by Dr Stephen Wilkinson, Melbourne, Australia. Posted on Global Family Doctor 2 April 2010

Pearls are an independent product of the Cochrane primary care group and are meant for educational use and not to guide clinical care.