tetano
Editor, Senior Moderator
Clinical Infectious Diseases
Serial Intervals and the Temporal Distribution of Secondary Infections within Households of 2009 Pandemic Influenza A (H1N1): Implications for Influenza Control Recommendations
1. Christl A Donnelly1,
2. Lyn Finelli5,
3. Simon Cauchemez1,
4. Sonja J. Olsen3,
5. Saumil Doshi2,4,
6. Michael L. Jackson2,4,
7. Erin D. Kennedy4,5,
8. Laurie Kamimoto5,
9. Tiffany L. Marchbanks6,8,
10. Oliver W. Morgan3,
11. Minal Patel4,7,
12. David L Swerdlow2,
13. Neil M. Ferguson1, and
14. the pH1N1 Household Investigations Working Group
+ Author Affiliations
1.
1Medical Research Council Centre for Outbreak Analysis and Modelling, Department of Infectious Disease Epidemiology, Imperial College London, London, United Kingdom
2.
2National Center for Immunization and Respiratory Diseases
3.
3Division of Emerging Infections and Surveillance Services
4.
4Epidemic Intelligence Service, Office of Workforce and Career Development
5.
5Epidemiology and Prevention Branch, Influenza Division
6.
6CDC/CSTE Applied Epidemiology Fellowship Program
7.
7Enteric Diseases Epidemiology Branch, Division of Bacterial and Mycotic Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia
8.
8Division of Infectious Disease Epidemiology, Pennsylvania Department of Health, Harrisburg
1. Correspondence: Prof Christl A. Donnelly, MRC Centre for Outbreak Analysis and Modelling, Dept of Infectious Disease Epidemiology, Imperial College London, St Mary's Campus, Norfolk Place, London W2 1PG, United Kingdom (c.donnelly@imperial.ac.uk).
Abstract
A critical issue during the 2009 influenza A (H1N1) pandemic was determining the appropriate duration of time individuals with influenza-like illness (ILI) should remain isolated to reduce onward transmission while limiting societal disruption. Ideally this is based on knowledge of the relative infectiousness of ill individuals at each point during the course of the infection. Data on 261 clinically apparent pH1N1 infector-infectee pairs in households, from 7 epidemiological studies conducted in the United States early in 2009, were analyzed to estimate the distribution of times from symptom onset in an infector to symptom onset in the household contacts they infect (mean, 2.9 days, not correcting for tertiary transmission). Only 5% of transmission events were estimated to take place >3 days after the onset of clinical symptoms among those ill with pH1N1 virus. These results will inform future recommendations on duration of isolation of individuals with ILI.
http://cid.oxfordjournals.org/content/52/suppl_1/S123.full
Serial Intervals and the Temporal Distribution of Secondary Infections within Households of 2009 Pandemic Influenza A (H1N1): Implications for Influenza Control Recommendations
1. Christl A Donnelly1,
2. Lyn Finelli5,
3. Simon Cauchemez1,
4. Sonja J. Olsen3,
5. Saumil Doshi2,4,
6. Michael L. Jackson2,4,
7. Erin D. Kennedy4,5,
8. Laurie Kamimoto5,
9. Tiffany L. Marchbanks6,8,
10. Oliver W. Morgan3,
11. Minal Patel4,7,
12. David L Swerdlow2,
13. Neil M. Ferguson1, and
14. the pH1N1 Household Investigations Working Group
+ Author Affiliations
1.
1Medical Research Council Centre for Outbreak Analysis and Modelling, Department of Infectious Disease Epidemiology, Imperial College London, London, United Kingdom
2.
2National Center for Immunization and Respiratory Diseases
3.
3Division of Emerging Infections and Surveillance Services
4.
4Epidemic Intelligence Service, Office of Workforce and Career Development
5.
5Epidemiology and Prevention Branch, Influenza Division
6.
6CDC/CSTE Applied Epidemiology Fellowship Program
7.
7Enteric Diseases Epidemiology Branch, Division of Bacterial and Mycotic Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia
8.
8Division of Infectious Disease Epidemiology, Pennsylvania Department of Health, Harrisburg
1. Correspondence: Prof Christl A. Donnelly, MRC Centre for Outbreak Analysis and Modelling, Dept of Infectious Disease Epidemiology, Imperial College London, St Mary's Campus, Norfolk Place, London W2 1PG, United Kingdom (c.donnelly@imperial.ac.uk).
Abstract
A critical issue during the 2009 influenza A (H1N1) pandemic was determining the appropriate duration of time individuals with influenza-like illness (ILI) should remain isolated to reduce onward transmission while limiting societal disruption. Ideally this is based on knowledge of the relative infectiousness of ill individuals at each point during the course of the infection. Data on 261 clinically apparent pH1N1 infector-infectee pairs in households, from 7 epidemiological studies conducted in the United States early in 2009, were analyzed to estimate the distribution of times from symptom onset in an infector to symptom onset in the household contacts they infect (mean, 2.9 days, not correcting for tertiary transmission). Only 5% of transmission events were estimated to take place >3 days after the onset of clinical symptoms among those ill with pH1N1 virus. These results will inform future recommendations on duration of isolation of individuals with ILI.
http://cid.oxfordjournals.org/content/52/suppl_1/S123.full