Victorian Public Health Training Scheme, School of Public Health and Preventive Medicine, Monash University. [corrected]
Aust N Z J Public Health. 2010 Jun;34(3):228-31. doi: 10.1111/j.1753-6405.2010.00518.x.
To determine the community seropositivity of pandemic (H1N1) 2009 influenza in order to estimate immunity and the community attack rate.
Selected clusters of participants (n=706) in the 'Victorian Health Monitor' (VHM), from whom blood samples were taken between August and October 2009, were tested opportunistically for antibodies to pandemic (H1N1) 2009 influenza virus. A titre of > or = 1:40 was chosen as the cut-off for recording seropositivity. The proportion (95% CI) of seropositive participants, aged 18 to <65 years of age, were computed for groups of census collection districts (CDs) across metropolitan Melbourne.
The observed pandemic (H1N1) 2009 seropositivity rates for all CDs tested in metropolitan Melbourne was 16.0% (95% CI:12.9-19.1%); in northern Melbourne subset was 14.4% (95% CI:12.4-16.3%); and in eastern subset was 16.2% (95% CI:9.7-22.6%). The pre-pandemic (H1N1) 2009 positivity rate was estimated at 6%.
Given this study's estimate of 16.0% seropositivity in adults in metropolitan Melbourne, and given the WHO laboratory's estimate of 6% pre-pandemic positivity, the estimated adult community attack rate was 10% for metropolitan Melbourne.
This community attack rate is lower than anticipated and suggests that levels of immunity to Pandemic (H1N1) 2009 might be lower than anticipated. Although limited by a low response rate of 34%, this study suggests low adult seropositivity, which may be useful for public health professionals when encouraging the community to get vaccinated.
确定大流行性(H1N1)2009 流感的社区血清阳性率,以估计免疫力和社区发病率。
从 2009 年 8 月至 10 月间抽取的“维多利亚健康监测”(VHM)中选择参与者的聚类样本(n=706),对其进行大流行性(H1N1)2009 流感病毒抗体的机会性检测。选择>或=1:40 的滴度作为记录血清阳性的截止值。计算了年龄在 18 至<65 岁之间的、来自整个墨尔本大都市不同人口普查收集区(CD)的血清阳性参与者的比例(95%置信区间)。
在整个墨尔本大都市测试的所有 CD 中,观察到的大流行性(H1N1)2009 血清阳性率为 16.0%(95%置信区间:12.9-19.1%);在墨尔本北部亚组为 14.4%(95%置信区间:12.4-16.3%);在东部亚组为 16.2%(95%置信区间:9.7-22.6%)。大流行前(H1N1)2009 阳性率估计为 6%。
鉴于本研究估计在墨尔本大都市成年人中的血清阳性率为 16.0%,并且鉴于世界卫生组织实验室估计的大流行前阳性率为 6%,则墨尔本大都市的估计成人社区发病率为 10%。
该社区发病率低于预期,表明对大流行性(H1N1)2009 的免疫力可能低于预期。尽管由于低应答率(34%)而受到限制,但本研究表明成人血清阳性率较低,这可能对公共卫生专业人员在鼓励社区接种疫苗时有用。