Soyemi Kenneth, Medina-Marino Andrew, Sinkowitz-Cochran Ronda, Schneider Amy, Njai Rashid, McDonald Marian, Glover Maleeka, Garcia Jocelyn, Aiello Allison E
Office of Health Protection, Division of Infectious Diseases, Illinois Department of Public Health, Chicago, Illinois, United States of America.
Office of Health Protection, Division of Infectious Diseases, Illinois Department of Public Health, Chicago, Illinois, United States of America; Epidemic Intelligence Service, Office of Surveillance, Epidemiology, and Laboratory Services, Centers for Disease Control and Prevention, Atlanta, Georgia, United States of America.
PLoS One. 2014 Apr 28;9(4):e84380. doi: 10.1371/journal.pone.0084380. eCollection 2014.
During late April 2009, the first cases of 2009 pandemic influenza A (H1N1) (pH1N1) in Illinois were reported. On-going, sustained local transmission resulted in an estimated 500,000 infected persons. We conducted a mixed method analysis using both quantitative (surveillance) and qualitative (interview) data; surveillance data was used to analyze demographic distribution of hospitalized cases and follow-up interview data was used to assess health seeking behavior. Invitations to participate in a telephone interview were sent to 120 randomly selected Illinois residents that were hospitalized during April-December 2009. During April-December 2009, 2,824 pH1N1 hospitalizations occurred in Illinois hospitals; median age (interquartile range) at admission was 24 (range: 6-49) years. Hospitalization rates/100,000 persons for blacks and Hispanics, regardless of age or sex were 2-3 times greater than for whites (blacks, 36/100,000 (95% Confidence Interval ([95% CI], 33-39)); Hispanics, 35/100,000 [95%CI,32-37] (; whites, 13/100,000[95%CI, 12-14); p<0.001). Mortality rates were higher for blacks (0.9/100,000; p<0.09) and Hispanics (1/100,000; p<0.04) when compared with the mortality rates for whites (0.6/100,000). Of 33 interview respondents, 31 (94%) stated that they had heard of pH1N1 before being hospitalized, and 24 (73%) did not believed they were at risk for pH1N1. On average, respondents reported experiencing symptoms for 2 days (range: 1-7) before seeking medical care. When asked how to prevent pH1N1 infection in the future, the most common responses were getting vaccinated and practicing hand hygiene. Blacks and Hispanics in Illinois experienced disproportionate pH1N1 hospitalization and mortality rates. Public health education and outreach efforts in preparation for future influenza pandemics should include prevention messaging focused on perception of risk, and ensure community wide access to prevention messages and practices.
2009年4月下旬，伊利诺伊州报告了首例2009年甲型H1N1大流行性流感（pH1N1）病例。持续的本地传播导致估计有50万人感染。我们采用定量（监测）和定性（访谈）数据进行了混合方法分析；监测数据用于分析住院病例的人口分布，后续访谈数据用于评估就医行为。我们向2009年4月至12月期间住院的120名随机挑选的伊利诺伊州居民发出了参加电话访谈的邀请。2009年4月至12月期间，伊利诺伊州医院共发生2824例pH1N1住院病例；入院时的年龄中位数（四分位间距）为24岁（范围：6 - 49岁）。无论年龄或性别，黑人和西班牙裔的住院率/10万人比白人高2至3倍（黑人，36/10万（95%置信区间[95%CI]，33 - 39）；西班牙裔，35/10万[95%CI，32 - 37]；白人，13/10万[95%CI，12 - 14]；p<0.001）。与白人的死亡率（0.6/10万）相比，黑人（0.9/10万；p<0.09）和西班牙裔（1/10万；p<0.04）的死亡率更高。在33名接受访谈的受访者中，31名（94%）表示在住院前就听说过pH1N1，24名（73%）认为自己没有感染pH1N1的风险。受访者平均报告在就医前出现症状2天（范围：1 - 7天）。当被问及未来如何预防pH1N1感染时，最常见的回答是接种疫苗和勤洗手。伊利诺伊州的黑人和西班牙裔在pH1N1住院率和死亡率方面不成比例。为未来流感大流行做准备的公共卫生教育和宣传工作应包括针对风险认知的预防信息，并确保社区广泛获取预防信息和措施。
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