http://currents.plos.org/influenza Wed, 16 Dec 2015 13:44:17 +0000 hourly 1 https://wordpress.org/?v=4.5.3 http://currents.plos.org/influenza/article/the-early-diversification-of-influenza-ah1n1pdm/#comment-2454 Wed, 16 Dec 2015 13:44:17 +0000 http://currents.plos.org/influenza/?post_type=article&p=4515#comment-2454 Hello,
Where can I find the supplemental material?

]]> http://currents.plos.org/influenza/article/climate-change-and-influenza-the-likelihood-of-early-and-severe-influenza-seasons-following-warmer-than-average-winters/#comment-1811 Wed, 30 Jan 2013 02:20:50 +0000 http://currents.plos.org/influenza/?post_type=article&p=6955#comment-1811 This is great work you all did!!

]]> http://currents.plos.org/influenza/article/preliminary-estimates-of-mortality-and-35hpbywfdwl4n-8/#comment-101 Wed, 28 Apr 2010 13:53:13 +0000 http://currents.plos.org/influenza/article/preliminary-estimates-of-mortality-and-35hpbywfdwl4n-8/#comment-101 Fundamental Error — You have made a fundamental methodological error that discredits your analysis.You have taken the ratio of the case counts from the international data and applied it to the US population as if it was an age-specific rate. This would be valid if (and only if) the cumulative age-structure of the international data was similar to the US population.Obviously it is not.The CDC data you cite (but didn’t use in the analysis) shows that 44% of US pH1N1 mortality was in people over the age of 50 compared to 27.6% in the international data. Median age of death in Canada and Australia was in the low 50’s. The US must be comparable. The international data you used had a median mortality of age 37.Different population, different results.

]]> http://currents.plos.org/influenza/article/preliminary-estimates-of-mortality-and-35hpbywfdwl4n-8/#comment-103 Wed, 28 Apr 2010 13:53:09 +0000 http://currents.plos.org/influenza/article/preliminary-estimates-of-mortality-and-35hpbywfdwl4n-8/#comment-103 Thanks for the note. We have carefully studied the age distribution of deaths from different sources before making years of life lost (YLL) calculations. We chose the international data because the sample size was large and there was a detailed age breakdown, but we also conducted sensitivity analyses with US data, which confirmed our results, as explained below. We conducted sensitivity analyses with the age distribution of laboratory confirmed deaths published by the CDC in mid-October 2009 and more recently in January 2010, with respectively an estimated mean of 42 and 44 yrs. Using these distributions, the YLL estimates are within (-2% to +15%) of our initial estimates using the more detailed but older Eurosurveillance data. Hence we are still in the same ballpark estimates and our conclusions remain unchanged. Our most conservative YLL estimates for the 2009 pandemic still cover a range spanning from a typical A/H3N2 season to the 1968 pandemic. It is important to keep in mind that most of the uncertainty in YLL estimates come from different assumptions about the overall number of deaths attributable to the pandemic (in particular whether we consider P&I excess deaths, vs all cause excess deaths), rather than the specific dataset we use for the age distribution of deaths.

]]> http://currents.plos.org/influenza/article/preliminary-estimates-of-mortality-and-35hpbywfdwl4n-8/#comment-107 Wed, 31 Mar 2010 06:58:19 +0000 http://currents.plos.org/influenza/article/preliminary-estimates-of-mortality-and-35hpbywfdwl4n-8/#comment-107 Thanks, this is a fair question. Our estimates for the 1968 and 1957 pandemics have little uncertainty because detailed mortality statistics are available for these years (the US started computing mortality statistics in the early 20th Century and by 1957 these statistics were quite detailed).In contrast, we have to rely on preliminary mortality estimates for the 2009 pandemic derived from statistical models, because mortality data are available with a lag of 2-3 years. Once the final mortality data become available for year 2009 (likely sometime in 2011-2012), the uncertainty in pandemic burden estimates will become very small and similar to that for past pandemics.

]]> http://currents.plos.org/influenza/article/preliminary-estimates-of-mortality-and-35hpbywfdwl4n-8/#comment-105 Wed, 31 Mar 2010 06:58:19 +0000 http://currents.plos.org/influenza/article/preliminary-estimates-of-mortality-and-35hpbywfdwl4n-8/#comment-105 range — the “range” of 334000-1973000 YLL , especially the upper bound, looks rather wide. Is it a 90% subjective confidence interval ?Why is it so uncertain with our modern surveillance system as compared withancient 1957 and 1968 data , where the width of the range is given a 0 ?

]]> http://currents.plos.org/influenza/article/preliminary-estimates-of-mortality-and-35hpbywfdwl4n-8/#comment-111 Wed, 31 Mar 2010 06:52:53 +0000 http://currents.plos.org/influenza/article/preliminary-estimates-of-mortality-and-35hpbywfdwl4n-8/#comment-111 Thanks, this is a good point. We have not integrated pre-existing conditions in estimates of YLL for past pandemics, but we could certainly do so. Do you know by any chance of any life expectancy estimates stratified by age and underlying conditions in the US?

]]> http://currents.plos.org/influenza/article/preliminary-estimates-of-mortality-and-35hpbywfdwl4n-8/#comment-109 Wed, 31 Mar 2010 06:52:53 +0000 http://currents.plos.org/influenza/article/preliminary-estimates-of-mortality-and-35hpbywfdwl4n-8/#comment-109 Adjusting YLL for pre-existing condition-specific life expectancy — When more data are available, it may be useful to attempt to re-calculate the Years of Lost Life based on estimates of actual pre-pandemic life expectancies of those who died, rather than basing YLL on average age-based life expectancies.Analyzing U.S. pandemic deaths through August 8, 2009, the U.S. CDC reported[1]:“As of August 8, 2009, CDC had received reports of 477 deaths associated with 2009 pandemic influenza A (H1N1) in the United States, including 36 deaths among children aged <18 years. To characterize these cases, CDC analyzed data from April to August 2009. The results of that analysis indicated that, of 36 children who died, seven (19%) were aged <5 years, and 24 (67%) had one or more of the high-risk medical conditions. Twenty-two (92%) of the 24 children with high-risk medical conditions had neurodevelopmental conditions.” Table 1 of the CDC’s analysis lists underlying conditions for 32 of those 36 unfortunate children. The conditions include: one child with cerebral palsy, spina bifida, paraplegia, and hydrocephalus; one with Krabbe disease, and one requiring “constant care since near drowning at age 21 mos; spastic quadriplegia; static encephalopathy; seizure disorder; restrictive lung disease; scoliosis; [and] moderate to severe developmental delay.”[1] Centers for Disease Control (CDC). Surveillance for Pediatric Deaths Associated with 2009 Pandemic Influenza A (H1N1) Virus Infection — United States, April–August 2009. MMWR Morb Mortal Wkly Rep. 2009 September 4, 2009 / 58(34);941-947, online at: http://www.cdc.gov/mmwr/preview/mmwrhtml/mm5834a1.htm

]]> http://currents.plos.org/influenza/article/top-hits-for-h1n1pdm-identified-by-1ipgcdmpd4knt-4/#comment-119 Wed, 28 Oct 2009 12:59:47 +0000 http://currents.plos.org/influenza/article/top-hits-for-h1n1pdm-identified-by-1ipgcdmpd4knt-4/#comment-119 wow,you are great!Thank you! — wow,you are great!Thank you!

]]> http://currents.plos.org/influenza/article/fitness-of-pandemic-h1n1-and-seasonal-2e4ii3cnzi06d-2/#comment-47 Sat, 05 Sep 2009 13:14:41 +0000 http://currents.plos.org/influenza/article/fitness-of-pandemic-h1n1-and-seasonal-2e4ii3cnzi06d-2/#comment-47 H5N1/H1N1 virus co-infection - Egypt (02): ex S.Arabia, NOT (Wednesday, September 2, 2009)"Jason L Garner, Senior Molecular Biologist, Global Influenza Surveillance: "A University of Maryland/NIH study, using ferret animal models, suggests that co-infections of A(H1N1) with seasonal flu viruses do not produce chimeric or reassortant viruses. Said another way, the A(H1N1) outcompetes seasonal viruses, possibly demonstrating the pandemic strain is not under biological pressure and is perhaps more efficiently communicable.However, with regard to the H5N1-A(H1N1) co-infections reported recently, there is no data to suggest these latest findings could apply to H5N1 co-infections. In light of the [lack of efficient transmission] characteristic that HPAI H5N1 has been shown to be a "dead-end" infection in humans, it could possibly be out-competed by a more robust strain such as A(H1N1) rather than being a player in a recombination event. [Or not!?!]."]]> Thanks guys for the “down to earth” approach, much appreciated. On the subject of viral evolution (or not) via co-infection, I agree with Jason Garner it would be very helpful to have controlled lab study data to gain insight into what’s probably happening in areas where naive politics creates obstacles for medicine and science. An example is Indonesia, where both H1N1/2009 and H5N1 are cross-species co-circulating…Cheers Then — Jonathon Singleton, Perth, Western Australia Excerpt from “PRO/AH/EDR> H5N1/H1N1 virus co-infection – Egypt (02): ex S.Arabia, NOT (Wednesday, September 2, 2009)”Jason L Garner, Senior Molecular Biologist, Global Influenza Surveillance: “A University of Maryland/NIH study, using ferret animal models, suggests that co-infections of A(H1N1) with seasonal flu viruses do not produce chimeric or reassortant viruses. Said another way, the A(H1N1) outcompetes seasonal viruses, possibly demonstrating the pandemic strain is not under biological pressure and is perhaps more efficiently communicable.However, with regard to the H5N1-A(H1N1) co-infections reported recently, there is no data to suggest these latest findings could apply to H5N1 co-infections. In light of the [lack of efficient transmission] characteristic that HPAI H5N1 has been shown to be a “dead-end” infection in humans, it could possibly be out-competed by a more robust strain such as A(H1N1) rather than being a player in a recombination event. [Or not!?!].”

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