ArticleClinical infectious diseases : an official publication of the Infectious Diseases Society of America2017
Epidemiology and Relative Severity of Influenza Subtypes in Singapore in the Post-Pandemic Period from 2009 to 2010.
Article in Clinical infectious diseases : an official publication of the Infectious Diseases Society of America, 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 14 papers.
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14 citing papers in PubMed.
- Increasing Influenza and Pneumococcal Vaccination Uptake in Seniors Using Point-of-Care Informational Interventions in Primary Care in Singapore: A Pragmatic, Cluster-Randomized Crossover Trial.American journal of public health · 2019Trial
- Metastatic lymph nodes and prognosis assessed by the number of retrieved lymph nodes in gastric cancer.World journal of gastrointestinal surgery · 2022Article
- Observational
- Long-Term Chili Monoculture Alters Environmental Variables Affecting the Dominant Microbial Community in Rhizosphere Soil.Frontiers in microbiology · 2021Article
- Viral Load Dynamics in Sputum and Nasopharyngeal Swab in Patients with COVID-19.Journal of dental research · 2020Observational
- Viral load dynamics and disease severity in patients infected with SARS-CoV-2 in Zhejiang province, China, January-March 2020: retrospective cohort study.BMJ (Clinical research ed.) · 2020Article
- State-level estimates of excess hospitalizations and deaths associated with influenza.Influenza and other respiratory viruses · 2020Article
- Illness Severity in Hospitalized Influenza Patients by Virus Type and Subtype, Spain, 2010-2017.Emerging infectious diseases · 2020Article
- Public activities preceding the onset of acute respiratory infection syndromes in adults in England - implications for the use of social distancing to control pandemic respiratory infections.Wellcome open research · 2020Article
- Post-pandemic influenza A/H1N1pdm09 is associated with more severe outcomes than A/H3N2 and other respiratory viruses in adult hospitalisations.Epidemiology and infection · 2019Article
- Multiple Influenza Virus Infections in 4 Consecutive Epidemiological Seasons: A Retrospective Study in Children and Adolescents.Open forum infectious diseases · 2019Article
- Evidence for Cross-Protection Against Subsequent Febrile Respiratory Illness Episodes From Prior Infections by Different Viruses Among Singapore Military Recruits 2009-2014.The Journal of infectious diseases · 2019Article
- Investigating the Legacy of the 1918 Influenza Pandemic in Age-Related Seroepidemiology and Immune Responses to Subsequent Influenza A(H1N1) Viruses Through a Structural Equation Model.American journal of epidemiology · 2018Article
- Validation of a Natural Language Processing Algorithm for Detecting Infectious Disease Symptoms in Primary Care Electronic Medical Records in Singapore.JMIR medical informatics · 2018Article
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15 authors.
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No grant is acknowledged in the PubMed record.
Abstract
backgroundAfter 2009, pandemic influenza A(H1N1) [A(H1N1)pdm09] cocirculated with A(H3N2) and B in Singapore.
methodsA cohort of 760 participants contributed demographic data and up to 4 blood samples each from October 2009 to September 2010. We compared epidemiology of the 3 subtypes and investigated evidence for heterotypic immunity through multivariable logistic regression using a generalized estimating equation. To examine age-related differences in severity between subtypes, we used LOESS (locally weighted smoothing) plots of hospitalization to infection ratios and explored birth cohort effects referencing the pandemic years (1957; 1968).
resultsHaving more household members aged 5-19 years and frequent public transport use increased risk of infection, while preexisting antibodies against the same subtype (odds ratio [OR], 0.61; P = .002) and previous influenza infection against heterotypic infections (OR, 0.32; P = .045) were protective. A(H1N1)pdm09 severity peaked in those born around 1957, while A(H3N2) severity was least in the youngest individuals and increased until it surpassed A(H1N1)pdm09 in those born in 1952 or earlier. Further analysis showed that severity of A(H1N1)pdm09 was less than that for A(H3N2) in those born in 1956 or earlier (P = .021) and vice versa for those born in 1968 or later (P < .001), with no difference in those born between 1957 and 1967 (P = .632).
conclusionsOur findings suggest that childhood exposures had long-term impact on immune responses consistent with the theory of antigenic sin. This, plus observations on short-term cross-protection, have implications for vaccination and influenza epidemic and pandemic mitigation strategies.
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