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Analysis - Age and sex morbidity and mortality from avian influenza A(H7N9) virus

sharon sanders

sharon sanders

Editor-in-Chief & President
Monday, 16 September 2013

Age and sex morbidity and mortality from avian influenza A(H7N9) virus


<table class="tr-caption-container" style="float: right; margin-left: 1em; text-align: right;" cellpadding="0" cellspacing="0"><tbody> <tr><td style="text-align: center;"></td></tr> <tr><td class="tr-caption" style="text-align: center;">Click to enlarge. The majority of cases of H7N9 that occurred
worldwide earlier in 2013. Taken from Virology Down Under's
H7N9 page.</td></tr> </tbody></table> In a study co-written by yours truly using a lot of data collected for Virology Down Under, Dr Joseph Dudley and I have just described, in the Journal of Clinical Virology, the age-specific and sex-specific morbidity and mortality from the avian influenza A(H7N9) virus outbreak earlier in the year.

 We sought to highlight differences between H7N9 and another zoonotic influenza A virus, H5N1. The distribution of age and sex is notably different between cases of each viruses, even in relatively close countries (Saudi Arabia vs Egypt). Such differences and patterns may be instructive for identifying specific risk factors for an outbreak and also serve to highlight that there are differences between outbreaks which, on the surface, might be expected to have very similar courses.

Intriguingly, there were marked similarities between H7N9 and Middle East respiratory syndrome coronavirus age and sex case distribution.

 We also published the term created here on VDU, the Proportion of Fatal Cases. A percentage defined as the number of currently known fatalities divided by the number of total lab-confirmed cases including fatalities, regardless of whether they are inpatients (hospitalized) or outpatients. It was created to avoid the need for a gauge of recovered cases (released from hospital) which is linked with use of the term Case Fatality Ratio.
Posted by Ian M Mackay
 
Re: Analysis - Age and sex morbidity and mortality from avian influenza A(H7N9) virus

Age-Specific and Sex-Specific Morbidity and Mortality from Avian Influenza A(H7N9)



  • <sup>a</sup> Science Applications International Corporation, Rockville MD 20852 USA
  • <sup>b</sup> Queensland Paediatric Infectious Diseases Laboratory, Queensland Children's Medical Research Institute, The University of Queensland, Brisbane, Queensland, Australia
<hr id="authorabs00051" class="artHeader">Abstract

We used data on age and sex for 136 laboratory confirmed human A(H7N9) cases reported as of 11 August 2013 to compare age-specific and sex-specific patterns of morbidity and mortality from the avian influenza A(H7N9) virus with those of the avian influenza A(H5N1) virus. Human A(H7N9) cases exhibit high degrees of age and sex bias: mortality is heavily biased towards males >50 years, no deaths have been reported among individuals <25 years old, and relatively few cases documented among children or adolescents. The proportion of fatal cases (PFC) for human A(H7N9) cases as of 11 August 2013 was 32%, compared to a cumulative PFC for A(H5N1) of 83% in Indonesia and 36% in Egypt. Approximately 75% of cases of all A(H7N9) cases occurred among individuals >45 years old. Morbidity and mortality from A(H7N9) are lowest among individuals between 10-29 years, the age group which exhibits the highest cumulative morbidity and case fatality rates from A(H5N1). Although individuals <20 years old comprise nearly 50% of all human A(H5N1) cases, only 7% of all reported A(H7N9) cases and no deaths have been reported among individuals in this age group. Only 4% of A(H7N9) cases occurred among children < 5 years old, and only one case from the 10-20 year age group. Age- and sex-related differences in morbidity and mortality from emerging zoonotic diseases can provide insights into ecological, economic, and cultural factors that may contribute to the emergence and proliferation of novel zoonotic diseases in human populations.


http://www.sciencedirect.com/science/article/pii/S1386653213003958
 
Re: Analysis - Age and sex morbidity and mortality from avian influenza A(H7N9) virus

Monday, September 16, 2013

J. Clinical Virology: H7N9 - Age & Sex Specific Morbidity & Mortality



Distribution of H7N9 Cases In China ? Credit CDW

# 7777


Flublogia?s resident virologist,Dr. Ian Mackay (author of the Virology Down Under blog & Associate Professor University of Queensland) has co-authored a study which has just been published in the Journal of Clinical Virology, that looks at the age & sex mortality & morbidity figures from the first wave of H7N9 that occurred in China last spring.

They point out, that like the MERS-CoV in the Middle East, the morbidity & mortality of avian H7N9 has been heavily skewed towards older (>50) males ? in stark contrast to the pattern we?ve seen with the H5N1 virus, which has demonstrated a marked proclivity for younger victims.


Ian (who is about to embark on a short vacation), has posted a preview of this paper on his own blog. Follow the link below to read:

Age and sex morbidity and mortality from avian influenza A(H7N9) virus


Click to enlarge. The majority of cases of H7N9 that occurred
worldwide earlier in 2013. Taken from Virology Down Under's
H7N9 page.
In a study co-written by yours truly using a lot of data collected for Virology Down Under, Dr Joseph Dudley and I have just described, in the Journal of Clinical Virology, the age-specific and sex-specific morbidity and mortality from the avian influenza A(H7N9) virus outbreak earlier in the year.
(Continue . . . )
​
Posted by Michael Coston at <a class="timestamp-link" href="http://afludiary.blogspot.com/2013/09/j-clinical-virology-h7n9-age-sex.html" rel="bookmark" title="permanent link"><abbr class="published" itemprop="datePublished" title="2013-09-16T09:53:00-04:00">9:53 AM</abbr>
 
Re: Analysis - Age and sex morbidity and mortality from avian influenza A(H7N9) virus

Since this part of the paper does not seem to be public. Our list was used for part of the paper's analysis here:


#1 - Man, 87, father of cases #74 & #75 , onset date February 19, died March 4 - Shanghai Death+

#2 - Man, 27, onset date February 19, died March 10 - possible pork contact - Shanghai Death

#3 - Woman, 35, onset date March 15, Chuzhou City, Anhui Province Death++

#4 - Woman, 45, onset date March 19, hospitalized March 27 - poultry culler - Jiangning district of Nanjing, Jiangsu province

#5 - Woman, 48, onset date March 19, hospitalized March 30 - Shuyang county of Suqian City, Jiangsu province

#6 - Man, 83, onset date March 20 - hospitalized March 29 - Wujiang district of Suzhou, Jiangsu province Death

#7 - Woman, 32, onset date March 21 - hospitalized March 28 - Binhu district of Wuxi City, Jiangsu province Death Note

#8 - Man, 38, onset date March 10, hospitalized March 18, died March 27 - reported to be a cook - Taicang, Zhejiang province Death

#9 - Man, 67, onset date March 25, hospitalized March 25, died April 2? Hangzhou, Zhejiang province

#10 - Man, 64, onset date hospitalized March 29, Zhejiang province Death

#11 - Man, 48, onset date March 28, engaged in chickens and ducks transportation work - Shanghai Death

#12 - Woman, 67, onset date March 22, hospitalized on March 25 in critical condition - Shanghai Death Note.

#13 - Woman, 52, onset date March 27, died on April 3 - Shanghai Death (note: wife of case #47) +++

#14 - Child, 4, onset date March 31, mild case. Shanghai

#15 - Woman, 61, onset date March 20, from a retirement home - in critical condition Qinhuai District, Nanjing, Jiangsu province

#16 - Man, 79, onset date March 21, from a retirement home. Qinhuai District in Nanjing, Jiangsu province, in critical condition

#17 - Man, 73/74, farmer, onset date March 28, hospitalized March 31, died April 11 Shanghai Death note Added note.

#18 - Man, 65/66, retiree, onset date March 29, hospitalized April 2, in treatment - discharged April 18 Shanghai note Added note.

#19 - Man, 58/59, retiree, onset on March 25, hospitalized on March 30 (possibly from Anhui province and a visitor to Pudong)Shanghai Added note. Death Note

#20 - Man, 67 - onset on March 29. Hospitalized on March 30 - in treatment - Shanghai

#21 - Man, 55, onset date March 28, hospitalized April 1 in stable condition - poultry worker - Anhui province

#22 - Age 64, onset date: April 1. Hospitalized on April 7. - Shanghai Death

#23 - Man, 85, onset date March 28, hospitalized April 8 in critical condition, retirement home, Nanjing Shimonosek Jiangsu province

#24 - Woman, 25, pregnant, onset date: March 30. - Hospitalized In critical condition. Recovered and delivered health baby. Note. Zhenjiang City area, Jiangsu province

#25 - Woman, 51, onset date March 13, hospitalized, Huzhou City, Zhejiang Province

#26 - Man, 79, onset date March 29, hospitalized in critical condition, Hangzhou, Zhejiang Province

#27 - Man, 62, onset date April 1, hospitalized April 5, retired Shanghai

#28 - Man, 77, onset date April 3, hospitalized April 7, retired Shanghai Death Note.

#29 - Man, 65, hospitalized - a farmer Hangzhou, Zhejiang Province

#30 - Man, 70, onset date March 29, Wuxi Huishan, Jiangsu province

#31 - Man, 74, onset date April 2, Jiangyin City, Wuxi City, Jiangsu province

#32 - Woman, 76, onset date April 1, hospitalized April 5, Shanghai

#33 - Woman, 81, hospitalized April 4, farmer , Shanghai

#34 - Man, 31, chef, Yangzhou City, Jiangsu province

#35 - Man, 56, teacher, Suzhou Industrial Park, Jiangsu province

#36 - Man, 74, onset date March 31, hospitalized April 5, died April 11 retiree, Shanghai Death

#37 - Woman, 83, onset date April 2, hospitalized April 7, Shanghai Death Note.

#38 - Man, 68, onset date April 4, hospitalized April 9, Shanghai

#39 - Man, 53, onset date April 3, hospitalized April 10, Shanghai

#40 - Man, 86, onset date April 3, hospitalized April 6, Shanghai Death Note

#41 - Man, 66, onset date April 8, hospitalized April 9, Hangzhou, Zhejiang province

#42 - Man, 74, onset date April 6, hospitalized April 11, Hangzhou, Zhejiang province

#43 - Woman, 54, onset date April 6, hospitalization April 12, Huzhou, Zhejiang province

#44 - Child, 7, hospitalized April 11 Shunyi District Beijing

#45 - Woman, 77, Nanjing former Baixia District, Jiangsu province Death note

#46 - Man, 72, Changshu, Jiangsu province

#47 - Man, 56, onset date April 1, hospitalized April 4; his wife was confirmed positive and died on April 3 (case #13 above), Shanghai +++ Death Note.

#48 - Man , 65, onset date April 3, hospitalized April 9. Zhejiang Province

#49 - Man , 38, onset date April 6, hospitalized April 11. Zhejiang Province

#50 - Man, 34, onset date April 6, hospitalized April 9, chef, Weishi County, Kaifeng City Bridge, Henan province

#51 - Man, 65, onset date April 8, hospitalized April 9, farmer, Zhoukou City Chuanhui, Henan province

#52 - Woman, 64, farmer Huzhou, Onset date April 6, in serious condition. Zhejiang Province

#53 - Woman, 62, Huzhou, Onset date March 29, in serious condition. Zhejiang Province Death Note

#54 - Man, 75, Nanjing, Onset date April 9, in serious condition. Zhejiang Province

#55 - Man, 79, Hanghzou, Onset date April 9, in serious condition. Zhejiang Province

#56 - Man, 50, Qixia District, Jiangsu province

#57 - Man, 26, Yancheng City Pavilion Lakes Discharged on April 26 2013. Jiangsu province

#58 - Man, 73, onset April 5, hospitalized April 8, Shanghai

#59 - Man, 54, onset April 8, hospitalized April 12, Shanghai

#60 - Man, 78, onset April 5, hospitalized April 7, Shanghai

#61 - Child, 4, PCR positive in routine screening of contacts/neighbors of case #44 - asymptomatic Beijing++++

#62 - Man, 60, diagnosed April 15, hospitalized in Suzhou from Kunshan City, Jiangsu province Death Note.

#63 - Woman, 68, onset April 3, Huzhou, Zhejiang Province

#64 - Man, 60, hospitalized April 10/11, Tianchang, Anhui province

#65 - Man, 56, Nanjing Qinhuai District, hospitalized in serious condition. Jiangsu province

#66 - Woman, 21, Kunshan City, hospitalized in serious condition. Jiangsu province

#67 - Man, 72, Suzhou, hospitalized in serious condition. Jiangsu province

#68 - Man, 56, onset date April 12, hospitalized, Hangzhou Zhejiang Province

#69 - Man, 57, onset date April 10, hospitalized Hangzhou Zhejiang Province

#70 - Woman, 58, onset date April 11, hospitalized Hangzhou Zhejiang Province

#71 - Woman, 72, onset date April 10, hospitalized HangzhouZhejiang Province

#72 - Man, 62, onset date April 10, hospitalized Hangzhou Zhejiang Province

#73 - Man, 47, onset April 10, hospitalized April 15, Shanghai

#74 - Man, 69, son of case #1, brother of case #75 - hospitalized February 19-24, recovered Shanghai

#75 - Man, 55, son of case #1, brother of case #74 - hospitalized February 19-24, Shanghai Death

#76 - Child, 2, Onset March 17 - recovered, Shanghai treated in Hunan Province Note.

#77 - No details. Retrospective cases discovered by testing samples. Shanghai 1 Death

#78 - No details. 1 of 4 retrospective cases identified on April 16. 2 cases of these 4 are the sons of case #1 and are id as cases 74 & 75 above. Shanghai

#79 - Man, 89, ex-Jiangsu (?). onset date: April 12. Hospitalized on April 16. Date of confirmation April 17. Shanghai Death

#80 - Woman, 37, farmer, onset on April 11, Hangzhou, Zhejiang Province

#81 - Man, 74, retired, onset on April 8, Hangzhou, Zhejiang Province

#82 - Man, 86, retired, onset on April 13, Hangzhou, Zhejiang Province Death Note.

#83 - Male, 41, cadres, onset on April 14, Huzhou, Zhejiang Province

#84 - Male, 38, poultry worker, Guancheng District Nancao, Henan province

#85 - Woman, 26, Xuanwu District, Nanjing, Jiangsu province

#86 - Woman, 80, Onset date April 8. Hospitalized on April 16. In stable condition. Shanghai

#87 - Woman, 54, onset date April 13. In serious condition. Jaxing, Zhejiang Province

#88 - Man, 69, onset date April 11. In serious condition. Hangzhou, Zhejiang Province Death Note.

#89 - Man, 54, Hospitalized in critical condition. Xuanwu District, Nanjing, Jiangsu province

#90 - Man, 43, onset on April 12, in serious condition. Hangzhou, Zhejiang Province

#91 - Man, 48, onset on April 11, in serious condition. Hangzhou, Zhejiang Province

#92 - Woman, 66, onset on April 10, in serious condition. Huzhou, Zhejiang Province

#93 - Man, 43, Hospitalized in Nanjing, in critical condition. Xuanwu District, Nanjing, Jiangsu province

#94 - Man, 56, onset date April 11. Hospitalized. Hangzhou, Zhejiang Province

#95 - Woman, 35, workers, onset on April 14, hospitalized. Hangzhou, Zhejiang Province

#96 - Man, 37, driver, onset on March 30, hospitalized. Hangzhou, Zhejiang Province

#97 - Woman, 75, Onset date on April 13, hospitalized. Shanghai

#98 - Woman, 68, onset on April 12, Hangzhou, in hospital for treatment. Hangzhou, Zhejiang Province

#99 - Man, 76, onset on April 8, the morning of April 21, due to further deterioration, Jiaxing, Zhejiang Province Death

#100 - Woman, 81, onset on April 12, in hospital for treatment. Huzhou, Zhejiang Province

#101 - Man, 58, onset on April 16, in hospital for treatment. Hangzhou, Zhejiang Province

#102 - Woman, 79, onset on April 13, in hospital for treatment. Hangzhou, Zhejiang Province

#103 - Man, 68, Jiangsu, retiree. onset on April 13, hospitalized on April 16, transferred to Shanghai on April 19 for treatment from Jiangsu province

#104 - Woman, 54, onset on 16 April, in hospital for treatment (possibly mild case). Hangzhou, Zhejiang Province

#105 - Man, 32, onset on April 14, in a Huzhou hospital for treatment (possibly mild case). Huzhou, Zhejiang Province

#106 - Man, 36. Confirmed by Chinese CDC on April 23 2013. Shandong Province

#107 - Man, 84, retired, Onset on April 15, in hospital for treatment. Hangzhou Zhejiang Province

#108 - Man, 62, farmer, onset at April 15 , in hospital for treatment. Hangzhou Zhejiang Province

#109 - Man, 91, onset on April 14, Tianchang, Chuzhou City, in hospital for treatment. Anhui province Death Note.

#110 - Man, 53, onset April 12, citizen of Taiwan & hospitalized there April 16, infected in Suzhou, was working in Jiangsu province and infected there

#111 - Man, 69, onset date April 17, Nanchang Center, Jiangxi province

#112 - Man, 56, onset date April 17, Zhongyuan district, Zhengzhou city, Henan province Death Note.

#113 - Woman, 60, farmer, onset April 17, Huzhou, Zhejiang province

#114 - Woman, 50, farmer, onset April 18, Shaoxing, Zhejiang province

#115 - Man, 38, farmer, onset date April 17, Huzhou, Zhejiang province

#116 - Man, 65, onset April 18, hospitalized April 23, Longyan City, Fujian province

#117 - Man, 49, onset date April 17, Lishui Jiangsu province

#118 - Man, 36, onset date April 19, Xuzhou Xinyi City Jiangsu province

#119 - Man, 60, father of case #7 - onset date March 8, hospitalized March 11, Died May 4 Binhu District Jiangsu province Death Note

#120 - Woman, 76, onset date April 17, Nanchang County Jiangxi province

#121 - Woman, 64, onset date April 14 Shaoyang City, Hunan province Death Note.

#122 - Man, 54, "pork trafficking" onset date April 15, Yichun City, Tonggu County Jiangxi province Death Note.

#123 - Man, 80, farmer, onset date April 21, Nanchang County Jiangxi province

#124 - Woman, 31, onset date April 23, Nanchang County Jiangxi province

#125 - Man, 38, onset on April 18. Currently the patient is hospitalized, seriously ill. Hangzhou Zhejiang province

#126 - Man, 80, Fuzhou, Yang Fuqing City. Hospitalized on April 27 at Fuqing City Hospital. Fujian province

#127 - Child, 4, onset date April 27, Zaozhuang City in Central City, Shandong Province

#128 - Man,58, onset date April 21, hospitalized April 28 Cangshan District, Fuzhou, Fujian province

#129 - Man, 69, farmer, onset April 23, hospitalized April 27,Wugang, Shaoyang, Hunan province

#130 - Man, 69. Onset on April 29. Currently hospitalized. Fuzhou, Fuqing City. Fujian province

#131 - Child (male), 9, Onset on April 26. Currently recovered and discharged after mild illness. Cangshan District, Fuzhou. Fujian province

#132 - Woman, 79, farmer, onset May 3, hospitalized May 6, Nanchang County Jiangxi province

#133 - Boy, 6, onset date May 21, no reported contact with poultry, condition good - Beijing

#134 - Boy, 15, onset date April 25, hospitalized on April 26. He recovered and was discharged on May 2, 2013 - Jiangsu province

#135 - Woman, 61, onset date July 10, first hospitalized on July 13, transferred to a Beijing hospital on July 18, in critical condition - Hebei Province Death

#136 - Woman, 51, date onset July 27, hospitalized on August 3, confirmed by China CDC on August 10, live poultry exposure, Huizhou City - Guangdong Province
 
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