Department of Epidemiology and Population Health, London School of Hygiene andTropical Medicine, UK.
Am J Epidemiol. 2010 Feb 15;171(4):465-78. doi: 10.1093/aje/kwp394. Epub 2009 Dec 10.
The transmissibility of the strain of influenza virus which caused the 1968 influenza pandemic is poorly understood. Increases in outbreak size between the first and second waves suggest that it may even have increased between successive waves. The authors estimated basic and effective reproduction numbers for both waves of the 1968 influenza pandemic. Epidemic curves and overall attack rates for the 1968 pandemic, based on clinical and serologic data, were retrieved from published literature. The basic and effective reproduction numbers were estimated from 46 and 17 data sets for the first and second waves, respectively, based on the growth rate and/or final size of the epidemic. Estimates of the basic reproduction number (R(0)) were in the range of 1.06-2.06 for the first wave and, assuming cross-protection, 1.21-3.58 in the second. Within each wave, there was little geographic variation in transmissibility. In the 10 settings for which data were available for both waves, R(0) was estimated to be higher during the second wave than during the first. This might partly explain the larger outbreaks in the second wave as compared with the first. This potential for change in viral behavior may have consequences for future pandemic mitigation strategies.
导致 1968 年流感大流行的流感病毒株的传染性了解甚少。第一波和第二波之间暴发规模的增加表明,它甚至可能在连续波之间增加。作者估计了 1968 年流感大流行的两波的基本和有效繁殖数。根据临床和血清学数据,从已发表的文献中检索到了 1968 年大流行的流行曲线和总体攻击率。基于流行的增长率和/或最终规模,从第一波和第二波的 46 和 17 个数据集分别估计了基本和有效繁殖数。第一波的基本繁殖数(R(0))估计在 1.06-2.06 之间,假设存在交叉保护,第二波为 1.21-3.58。在每个波中,传染性的地理差异很小。在两波都有数据的 10 个设置中,第二波的 R(0)估计高于第一波。这可能部分解释了第二波与第一波相比暴发规模更大。病毒行为变化的这种可能性可能会对未来的大流行缓解策略产生影响。