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Risk Factors and Attack Rates of Seasonal Influenza Infection: Results of the Southern Hemisphere Influenza and Vaccine Effectiveness Research and Surveillance (SHIVERS) Seroepidemiologic Cohort Study

2018; Oxford University Press; Volume: 219; Issue: 3 Linguagem: Inglês

10.1093/infdis/jiy443

1537-6613

Q. Sue Huang, Don Bandaranayake, Tim Wood, E. Claire Newbern, Ruth Seeds, Jacqui Ralston, Ben Waite, Ange Bissielo, Namrata Prasad, Angela Todd, Lauren Jelley, Wendy Gunn, Anne McNicholas, Thomas Metz, Shirley Lawrence, E. Collis, Amanda Retter, Sook‐San Wong, Richard J. Webby, Judy Bocacao, J Haubrock, Graham Mackereth, Nikki Turner, Barbara McArdle, John L. Cameron, Edwin Reynolds, Michael G. Baker, Cameron Grant, Colin McArthur, Sally Roberts, Adrian Trenholme, Conroy Wong, Susan Taylor, Paul G. Thomas, Jazmin Duque, Diane Gross, Mark G. Thompson, Marc‐Alain Widdowson, Kathryn Haven, Bhamita Chand, Pamela Muponisi, Debbie Aley, Claire Sherring, M. J. F. Rea, Judith Barry, Tracey Bushell, Julianne Brewer, Catherine McClymont, Shona Chamberlin, Reniza Ongcoy, Kirstin Davey, Emilina Jasmat, Maree Dickson, Annette Western, Olive Lai, Sheila Fowlie, Faasoa Aupa’au, Louise Robertson, Pam Kawakami, Susan P. Walker, Robyn Madge, Amanda des Barres, Helen Qiao, Fifi Tse, Mahtab Zibaei, Tirzah Korrapadu, Louise Optland, Cecilia Dela Cruz,

Viral Infections and Vectors

Understanding the attack rate of influenza infection and the proportion who become ill by risk group is key to implementing prevention measures. While population-based studies of antihemagglutinin antibody responses have been described previously, studies examining both antihemagglutinin and antineuraminidase antibodies are lacking. In 2015, we conducted a seroepidemiologic cohort study of individuals randomly selected from a population in New Zealand. We tested paired sera for hemagglutination inhibition (HAI) or neuraminidase inhibition (NAI) titers for seroconversion. We followed participants weekly and performed influenza polymerase chain reaction (PCR) for those reporting influenza-like illness (ILI). Influenza infection (either HAI or NAI seroconversion) was found in 321 (35% [95% confidence interval, 32%–38%]) of 911 unvaccinated participants, of whom 100 (31%) seroconverted to NAI alone. Young children and Pacific peoples experienced the highest influenza infection attack rates, but overall only a quarter of all infected reported influenza PCR–confirmed ILI, and one-quarter of these sought medical attention. Seroconversion to NAI alone was higher among children aged <5 years vs those aged ≥5 years (14% vs 4%; P < .001) and among those with influenza B vs A(H3N2) virus infections (7% vs 0.3%; P < .001). Measurement of antineuraminidase antibodies in addition to antihemagglutinin antibodies may be important in capturing the true influenza infection rates.