The early transmission dynamics of H1N1pdm influenza in the United Kingdom

Ghani, Azra C and Baguelin, Marc and Griffin, Jamie T and Flasche, Stefan and Pebody, Richard and Van Hoek, Albert Jan and Cauchemez, Simon and Hall, Ian M and Donnelly, Christl A and Robertson, Chris and White, Michael T and Barrass, Iain and Fraser, Christophe and Bermingham, Alison and Truscott, James and Ellis, Joanna and Jenkins, Helen E and Kafatos, George and Garske, Tini and Harris, Ross and McMenamin, Jim and Hawkins, Colin and Phin, Nick and Charlett, André and Zambon, Maria and Edmunds, W. John and Catchpole, Mike and Leach, Steve and White, Peter J and Ferguson, Neil M and Cooper, Ben S (2010) The early transmission dynamics of H1N1pdm influenza in the United Kingdom. PLoS Currents. ISSN 2157-3999

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    Abstract

    We analyzed data on all laboratory-confirmed cases of H1N1pdm influenza in the UK to 10th June 2009 to estimate epidemiological characteristics. We estimated a mean incubation period of 2.05 days and serial interval of 2.5 days with infectivity peaking close to onset of symptoms. Transmission was initially sporadic but increased from mid-May in England and from early June in Scotland. We estimated 37% of transmission occurred in schools, 24% in households, 28% through travel abroad and the remainder in the wider community. Children under 16 were more susceptible to infection in the household (adjusted OR 5.80, 95% CI 2.99-11.82). Treatment with oseltamivir plus widespread use of prophylaxis significantly reduced transmission (estimated reduction 16%). Households not receiving oseltamivir within 3 days of symptom onset in the index case had significantly increased secondary attack rates (adjusted OR 3.42, 95% CI 1.51-8.55).