ArticlePloS one2015
Transmission of the First Influenza A(H1N1)pdm09 Pandemic Wave in Australia Was Driven by Undetected Infections: Pandemic Response Implications.
Article in PloS one, 2015. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers.
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
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Who cites it
4 citing papers in PubMed.
- Estimation of under-reporting influenza cases in Hong Kong based on bayesian hierarchical framework.Infectious Disease Modelling · 2025Article
- Influenza and COVID-19 co-infection and vaccine effectiveness against severe cases: a mathematical modeling study.Frontiers in cellular and infection microbiology · 2024Article
- Assessing the spatial variability of raising public risk awareness for the intervention performance of COVID-19 voluntary screening: A spatial simulation approach.Applied geography (Sevenoaks, England) · 2022Article
- Comparison of methods to Estimate Basic Reproduction Number (Journal of research in medical sciences : the official journal of Isfahan University of Medical Sciences · 2019Article
Corrections and comments
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Authors and funding
3 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundDuring the first wave of influenza A(H1N1)pdm09 in Victoria, Australia the rapid increase in notified cases and the high proportion with relatively mild symptoms suggested that community transmission was established before cases were identified. This lead to the hypothesis that those with low-level infections were the main drivers of the pandemic.
methodsA deterministic susceptible-infected-recovered model was constructed to describe the first pandemic wave in a population structured by disease severity levels of asymptomatic, low-level symptoms, moderate symptoms and severe symptoms requiring hospitalisation. The model incorporated mixing, infectivity and duration of infectiousness parameters to calculate subgroup-specific reproduction numbers for each severity level.
resultsWith stratum-specific effective reproduction numbers of 1.82 and 1.32 respectively, those with low-level symptoms, and those with asymptomatic infections were responsible for most of the transmission. The effective reproduction numbers for infections resulting in moderate symptoms and hospitalisation were less than one. Sensitivity analyses confirmed the importance of parameters relating to asymptomatic individuals and those with low-level symptoms.
conclusionsTransmission of influenza A(H1N1)pdm09 was largely driven by those invisible to the health system. This has implications for control measures--such as distribution of antivirals to cases and contacts and quarantine/isolation--that rely on detection of infected cases. Pandemic plans need to incorporate milder scenarios, with a graded approach to implementation of control measures.
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