Use of national pneumonia surveillance to describe influenza A(H7N9) virus epidemiology, China, 2004-2013

Nijuan Xiang; Fiona Havers; Tao Chen; Ying Song; Wenxiao Tu; Leilei Li; Yang Cao; Bo Liu; Lei Zhou; Ling Meng; Zhiheng Hong; Rui Wang; Yan Niu; Jianyi Yao; Kaiju Liao; Lianmei Jin; Yanping Zhang; Qun Li; Marc-Alain Widdowson; Zijian Feng

doi:10.3201/eid1911.130865

Use of national pneumonia surveillance to describe influenza A(H7N9) virus epidemiology, China, 2004-2013

Nijuan Xiang, Fiona Havers, Tao Chen, Ying Song, Wenxiao Tu, Leilei Li, Yang Cao, Bo Liu, Lei Zhou, Ling Meng, Zhiheng Hong, Rui Wang, Yan Niu, Jianyi Yao, Kaiju Liao, Lianmei Jin, Yanping Zhang, Qun Li, Marc-Alain Widdowson, Zijian Feng

Institute of Tropical Medicine

Research output: Contribution to journal › A1: Web of Science-article › peer-review

Abstract

In mainland China, most avian influenza A(H7N9) cases in the spring of 2013 were reported through the pneumonia of unknown etiology (PUE) surveillance system. To understand the role of possible underreporting and surveillance bias in assessing the epidemiology of subtype H7N9 cases and the effect of live-poultry market closures, we examined all PUE cases reported from 2004 through May 3, 2013. Historically, the PUE system was underused, reporting was inconsistent, and PUE reporting was biased toward A(H7N9)-affected provinces, with sparse data from unaffected provinces; however, we found no evidence that the older ages of persons with A(H7N9) resulted from surveillance bias. The absolute number and the proportion of PUE cases confirmed to be A(H7N9) declined after live-poultry market closures (p<0.001), indicating that market closures might have positively affected outbreak control. In China, PUE surveillance needs to be improved.

Original language	English
Journal	Emerging Infectious Diseases
Volume	19
Issue number	11
Pages (from-to)	1784-1790
Number of pages	7
ISSN	1080-6040
DOIs	https://doi.org/10.3201/eid1911.130865
Publication status	Published - 2013

Keywords

Adolescent
Adult
Aged
Animals
Child
Child, Preschool
China/epidemiology
Disease Outbreaks
Female
Humans
Infant
Influenza A Virus, H7N9 Subtype
Influenza, Human/epidemiology
Male
Middle Aged
Pneumonia/epidemiology
Public Health Surveillance
Young Adult

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10.3201/eid1911.130865

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Xiang, N., Havers, F., Chen, T., Song, Y., Tu, W., Li, L., Cao, Y., Liu, B., Zhou, L., Meng, L., Hong, Z., Wang, R., Niu, Y., Yao, J., Liao, K., Jin, L., Zhang, Y., Li, Q., Widdowson, M.-A., & Feng, Z. (2013). Use of national pneumonia surveillance to describe influenza A(H7N9) virus epidemiology, China, 2004-2013. Emerging Infectious Diseases, 19(11), 1784-1790. https://doi.org/10.3201/eid1911.130865

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title = "Use of national pneumonia surveillance to describe influenza A(H7N9) virus epidemiology, China, 2004-2013",

abstract = "In mainland China, most avian influenza A(H7N9) cases in the spring of 2013 were reported through the pneumonia of unknown etiology (PUE) surveillance system. To understand the role of possible underreporting and surveillance bias in assessing the epidemiology of subtype H7N9 cases and the effect of live-poultry market closures, we examined all PUE cases reported from 2004 through May 3, 2013. Historically, the PUE system was underused, reporting was inconsistent, and PUE reporting was biased toward A(H7N9)-affected provinces, with sparse data from unaffected provinces; however, we found no evidence that the older ages of persons with A(H7N9) resulted from surveillance bias. The absolute number and the proportion of PUE cases confirmed to be A(H7N9) declined after live-poultry market closures (p<0.001), indicating that market closures might have positively affected outbreak control. In China, PUE surveillance needs to be improved. ",

keywords = "Adolescent, Adult, Aged, Animals, Child, Child, Preschool, China/epidemiology, Disease Outbreaks, Female, Humans, Infant, Influenza A Virus, H7N9 Subtype, Influenza, Human/epidemiology, Male, Middle Aged, Pneumonia/epidemiology, Public Health Surveillance, Young Adult",

author = "Nijuan Xiang and Fiona Havers and Tao Chen and Ying Song and Wenxiao Tu and Leilei Li and Yang Cao and Bo Liu and Lei Zhou and Ling Meng and Zhiheng Hong and Rui Wang and Yan Niu and Jianyi Yao and Kaiju Liao and Lianmei Jin and Yanping Zhang and Qun Li and Marc-Alain Widdowson and Zijian Feng",

year = "2013",

doi = "10.3201/eid1911.130865",

language = "English",

volume = "19",

pages = "1784--1790",

journal = "Emerging Infectious Diseases",

issn = "1080-6040",

publisher = "Centers for Disease Control and Prevention (CDC)",

number = "11",

}

Xiang, N, Havers, F, Chen, T, Song, Y, Tu, W, Li, L, Cao, Y, Liu, B, Zhou, L, Meng, L, Hong, Z, Wang, R, Niu, Y, Yao, J, Liao, K, Jin, L, Zhang, Y, Li, Q, Widdowson, M-A & Feng, Z 2013, 'Use of national pneumonia surveillance to describe influenza A(H7N9) virus epidemiology, China, 2004-2013', Emerging Infectious Diseases, vol. 19, no. 11, pp. 1784-1790. https://doi.org/10.3201/eid1911.130865

TY - JOUR

T1 - Use of national pneumonia surveillance to describe influenza A(H7N9) virus epidemiology, China, 2004-2013

AU - Xiang, Nijuan

AU - Havers, Fiona

AU - Chen, Tao

AU - Song, Ying

AU - Tu, Wenxiao

AU - Li, Leilei

AU - Cao, Yang

AU - Liu, Bo

AU - Zhou, Lei

AU - Meng, Ling

AU - Hong, Zhiheng

AU - Wang, Rui

AU - Niu, Yan

AU - Yao, Jianyi

AU - Liao, Kaiju

AU - Jin, Lianmei

AU - Zhang, Yanping

AU - Li, Qun

AU - Widdowson, Marc-Alain

AU - Feng, Zijian

PY - 2013

Y1 - 2013

N2 - In mainland China, most avian influenza A(H7N9) cases in the spring of 2013 were reported through the pneumonia of unknown etiology (PUE) surveillance system. To understand the role of possible underreporting and surveillance bias in assessing the epidemiology of subtype H7N9 cases and the effect of live-poultry market closures, we examined all PUE cases reported from 2004 through May 3, 2013. Historically, the PUE system was underused, reporting was inconsistent, and PUE reporting was biased toward A(H7N9)-affected provinces, with sparse data from unaffected provinces; however, we found no evidence that the older ages of persons with A(H7N9) resulted from surveillance bias. The absolute number and the proportion of PUE cases confirmed to be A(H7N9) declined after live-poultry market closures (p<0.001), indicating that market closures might have positively affected outbreak control. In China, PUE surveillance needs to be improved.

AB - In mainland China, most avian influenza A(H7N9) cases in the spring of 2013 were reported through the pneumonia of unknown etiology (PUE) surveillance system. To understand the role of possible underreporting and surveillance bias in assessing the epidemiology of subtype H7N9 cases and the effect of live-poultry market closures, we examined all PUE cases reported from 2004 through May 3, 2013. Historically, the PUE system was underused, reporting was inconsistent, and PUE reporting was biased toward A(H7N9)-affected provinces, with sparse data from unaffected provinces; however, we found no evidence that the older ages of persons with A(H7N9) resulted from surveillance bias. The absolute number and the proportion of PUE cases confirmed to be A(H7N9) declined after live-poultry market closures (p<0.001), indicating that market closures might have positively affected outbreak control. In China, PUE surveillance needs to be improved.

KW - Adolescent

KW - Adult

KW - Aged

KW - Animals

KW - Child

KW - Child, Preschool

KW - China/epidemiology

KW - Disease Outbreaks

KW - Female

KW - Humans

KW - Infant

KW - Influenza A Virus, H7N9 Subtype

KW - Influenza, Human/epidemiology

KW - Male

KW - Middle Aged

KW - Pneumonia/epidemiology

KW - Public Health Surveillance

KW - Young Adult

U2 - 10.3201/eid1911.130865

DO - 10.3201/eid1911.130865

M3 - A1: Web of Science-article

C2 - 24206646

SN - 1080-6040

VL - 19

SP - 1784

EP - 1790

JO - Emerging Infectious Diseases

JF - Emerging Infectious Diseases

IS - 11

ER -

Use of national pneumonia surveillance to describe influenza A(H7N9) virus epidemiology, China, 2004-2013

Abstract

Keywords

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