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Title: Different transmission patterns in the early stages of the influenza A(H1N1)v pandemic: a comparative analysis of 12 European countries
Authors: Flasche, Stefan
HENS, Niel 
Boëlle, Pierre-Yves
Mossong, Joël
van Ballegooijen, W.Marijn
Nunes, Baltazar
Rizzo, Caterina
Popovici, Florin
Santa-Olalla, Patricia
Hrubá, Frantisca
Parmakova, Kremena
Baguelin, Marc
van Hoek, Albert Jan
Desenclos, Jean-Marc
Bernillon, Pascale
Larrauri Cámara, Amparro
Wallinga, Jaco
Asikainen, Tommi
White, Peter J.
Edmunds, W. John
Issue Date: 2011
Source: Epidemics, 3 (2), p. 125-133
Abstract: Following the emergence of a novel strain of influenza A(H1N1) in Mexico and the United States in April 2009, its epidemiology in Europe during the summer was limited to sporadic and localised outbreaks. Only the United Kingdom experienced widespread transmission declining with school holidays in late July. Using statistical modelling where applicable we explored the following causes that could explain this surprising difference in transmission dynamics: extinction by chance, differences in the susceptibility profile, age distribution of the imported cases, differences in contact patterns, mitigation strategies, school holidays and weather patterns. No single factor was able to explain the differences sufficiently. Hence an additive mixed model was used to model the country-specific weekly estimates of the effective reproductive number using the extinction probability, school holidays and weather patterns as explanatory variables. The average extinction probability, its trend and the trend in absolute humidity were found to be significantly negatively correlated with the effective reproduction number — although they could only explain about 3% of the variability in the model. By comparing the initial epidemiology of influenza A (H1N1) across different European countries, our analysis was able to uncover a possible role for the timing of importations (extinction probability), mixing patterns and the absolute humidity as underlying factors. However, much uncertainty remains. With better information on the role of these epidemiological factors, the control of influenza could be improved.
Keywords: Swine-origin influenza A H1N1 virus; Pandemics; Europe; Seasonality; Statistical models; Absolute humidity
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ISSN: 1755-4365
e-ISSN: 1878-0067
DOI: 10.1016/j.epidem.2011.03.005
ISI #: 000300706300009
Category: A1
Type: Journal Contribution
Validations: ecoom 2013
Appears in Collections:Research publications

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