Skip to main content Accessibility help
×
Home

The pandemic potential of avian influenza A(H7N9) virus: a review

  • W. D. TANNER (a1), D. J. A. TOTH (a1) (a2) and A. V. GUNDLAPALLI (a1) (a2)

Summary

In March 2013 the first cases of human avian influenza A(H7N9) were reported to the World Health Organization. Since that time, over 650 cases have been reported. Infections are associated with considerable morbidity and mortality, particularly within certain demographic groups. This rapid increase in cases over a brief time period is alarming and has raised concerns about the pandemic potential of the H7N9 virus. Three major factors influence the pandemic potential of an influenza virus: (1) its ability to cause human disease, (2) the immunity of the population to the virus, and (3) the transmission potential of the virus. This paper reviews what is currently known about each of these factors with respect to avian influenza A(H7N9). Currently, sustained human-to-human transmission of H7N9 has not been reported; however, population immunity to the virus is considered very low, and the virus has significant ability to cause human disease. Several statistical and geographical modelling studies have estimated and predicted the spread of the H7N9 virus in humans and avian species, and some have identified potential risk factors associated with disease transmission. Additionally, assessment tools have been developed to evaluate the pandemic potential of H7N9 and other influenza viruses. These tools could also hypothetically be used to monitor changes in the pandemic potential of a particular virus over time.

  • View HTML
    • Send article to Kindle

      To send this article to your Kindle, first ensure no-reply@cambridge.org is added to your Approved Personal Document E-mail List under your Personal Document Settings on the Manage Your Content and Devices page of your Amazon account. Then enter the ‘name’ part of your Kindle email address below. Find out more about sending to your Kindle. Find out more about sending to your Kindle.

      Note you can select to send to either the @free.kindle.com or @kindle.com variations. ‘@free.kindle.com’ emails are free but can only be sent to your device when it is connected to wi-fi. ‘@kindle.com’ emails can be delivered even when you are not connected to wi-fi, but note that service fees apply.

      Find out more about the Kindle Personal Document Service.

      The pandemic potential of avian influenza A(H7N9) virus: a review
      Available formats
      ×

      Send article to Dropbox

      To send this article to your Dropbox account, please select one or more formats and confirm that you agree to abide by our usage policies. If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your <service> account. Find out more about sending content to Dropbox.

      The pandemic potential of avian influenza A(H7N9) virus: a review
      Available formats
      ×

      Send article to Google Drive

      To send this article to your Google Drive account, please select one or more formats and confirm that you agree to abide by our usage policies. If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your <service> account. Find out more about sending content to Google Drive.

      The pandemic potential of avian influenza A(H7N9) virus: a review
      Available formats
      ×

Copyright

Corresponding author

* Author for correspondence: A. V. Gundlapalli, MD, PhD, MS, Immunology 5B114D SOM, University of Utah School of Medicine, Salt Lake City, UT 84132, USA. (Email: Adi.Gundlapalli@hsc.utah.edu)

References

Hide All
1. Gautret, P, et al. Emerging viral respiratory tract infections-environmental risk factors and transmission. Lancet Infectious Diseases 2014; 14: 11131122.
2. Chowell, G, et al. Transmission potential of influenza A/H7N9, February to May 2013, China. BMC Medicine 2013; 11: 214.
3. Hong Kong Centre for Health Protection Avian influenza report volume 11 number 19 (http://www.chp.gov.hk/files/pdf/2015_avian_influenza_report_vol11_wk19.pdf). Accessed 12 May 2015.
4. Beigel, JH, et al. Avian influenza A (H5N1) infection in humans. New England Journal of Medicine 2005; 353: 13741385.
5. Husain, M. Avian influenza A (H7N9) virus infection in humans: epidemiology, evolution, and pathogenesis. Infection, Genetics and Evolution 2014; 28: 304312.
6. Li, Q, et al. Epidemiology of human infections with avian influenza A(H7N9) virus in China. New England Journal of Medicine 2014; 370: 520532.
7. Kaplan, BS, Webby, RJ. The avian and mammalian host range of highly pathogenic avian H5N1 influenza. Virus Research 2013; 178: 311.
8. Yuan, R, et al. Pathogenicity and transmission of H5N1 avian influenza viruses in different birds. Veterinary Microbiology 2014; 168: 5059.
9. US Department of Agriculture. Guidelines for avian influenza viruses. 4 November 2011 (http://www.selectagents.gov/resources/Guidelines_for_Avian_Influenza_Viruses_2011-11-4.pdf). Accessed 15 January 2015.
10. Belser, JA, et al. Pathogenesis, transmissibility, and ocular tropism of a highly pathogenic avian influenza A (H7N3) virus associated with human conjunctivitis. Journal of Virology 2013; 87: 57465754.
11. Chan, MC, et al. Tropism and innate host responses of a novel avian influenza A H7N9 virus: an analysis of ex-vivo and in-vitro cultures of the human respiratory tract. Lancet Respiratory Medicine 2013; 1: 534542.
12. Webster, RG, Govorkova, EA. Continuing challenges in influenza. Annals of the New York Academy of Sciences 2014; 1323: 115139.
13. Hurt, AC, et al. Assessing the development of oseltamivir and zanamivir resistance in A(H5N1) influenza viruses using a ferret model. Antiviral Research 2010; 87: 361366.
14. Bertran, K, et al. Pathogenesis and transmissibility of highly (H7N1) and low (H7N9) pathogenic avian influenza virus infection in red-legged partridge (Alectoris rufa). Veterinary Research 2011; 42: 24.
15. Brown, JD, Poulson, R, Stallknecht, DE. Wild bird surveillance for avian influenza virus. Methods in Molecular Biology 2014; 1161: 6981.
16. Fournie, G, et al. Identifying live bird markets with the potential to act as reservoirs of avian influenza A (H5N1) virus: a survey in northern Viet Nam and Cambodia. PLoS ONE 2012; 7: e37986.
17. Pérez-Ramírez, E, et al. Detection of low pathogenic avian influenza viruses in wild birds in Castilla-La Mancha (south central Spain). Veterinary Microbiology 2010; 146: 200208.
18. Yang, Y, et al. Household transmissibility of avian influenza A (H7N9) virus, China, February to May 2013 and October 2013 to March 2014. Eurosurveillance 2015; 20: pii=21056.
19. Kucharski, A, et al. Distinguishing between reservoir exposure and human-to-human transmission for emerging pathogens using case onset data. PLoS Currents 2014; 6: pii.
20. Kucharski, AJ, Edmunds, WJ. Characterizing the transmission potential of zoonotic infections from minor outbreaks. PLoS Computational Biology 2015; 11: e1004154.
21. Aditama, TY, et al. Avian influenza H5N1 transmission in households, Indonesia. PLoS ONE 2012; 7: e29971.
22. Ahmed, MS, et al. Cross-reactive immunity against influenza viruses in children and adults following 2009 pandemic H1N1 infection. Antiviral Research 2015; 114 106112.
23. Bai, T, Zhou, J, Shu, Y. Serologic study for influenza A (H7N9) among high-risk groups in China. New England Journal of Medicine 2013; 368: 23392340.
24. Xiong, C, et al. Serological study of antibodies to influenza A viruses among general population in Wuhan city China. Journal of Clinical Virology 2014; 61: 178179.
25. Lazarus, R, Lim, PL. Avian influenza: recent epidemiology, travel-related risk, and management. Current Infectious Disease Reports 2014; 17: 19.
26. World Health Organization. Cumulative number of confirmed human cases for avian influenza A(H5N1) reported to WHO, 2003–2015 (http://www.who.int/influenza/human_animal_interface/EN_GIP_20150106CumulativeNumberH5N1cases.pdf?ua=1). Accessed 14 January 2015.
27. World Health Organization. Summary of status of development and availability of avian influenza A(H7N9) candidate vaccine viruses and potency testing reagents (http://www.who.int/influenza/vaccines/virus/candidates_reagents/summary_a_h7n9_cvv_20150317.pdf?ua=1). Accessed 19 May 2015.
28. US Food and Drug Administration. FDA approves first adjuvanted vaccine for prevention of H5N1 avian influenza. 2013 (http://www.fda.gov/NewsEvents/Newsroom/PressAnnouncements/ucm376444.htm). Accessed 16 January, 2015.
29. Centers for Disease Control and Prevention. Interim risk assessment and biosafety level recommendations for working with influenza A(H7N9) viruses (http://www.cdc.gov/flu/avianflu/h7n9/risk-assessment.htm). Accessed 10 January 2015.
30. Hong Kong Centre for Health Protection. Avian influenza report (http://www.chp.gov.hk/en/epidemiology/134/332/617.html). Accessed 21 May 2015.
31. World Health Organization WHO risk assessment as of 2 October 2014 (http://www.who.int/influenza/human_animal_interface/influenza_h7n9/riskassessment_h7n9_2Oct14.pdf). Accessed 7 January 2015.
32. Hong Kong Centre for Health Protection. Avian influenza report volume 11 number 7 (http://www.chp.gov.hk/files/pdf/2015_avian_influenza_report_vol11_wk07.pdf). Accessed 20 February 2015.
33. Hong Kong Centre for Health Protection. Avian influenza report volume 11 number 1 (http://www.chp.gov.hk/files/pdf/2015_avian_influenza_report_vol11_wk01.pdf). Accessed 20 February 2015.
34. Lam, TT, et al. Dissemination, divergence and establishment of H7N9 influenza viruses in China. Nature 2015; 522: 102105.
35. Liu, Y, et al. The third wave: H7N9 endemic reassortant viruses and patient clusters. Journal of Infection in Developing Countries 2015. 9: 122127.
36. World Health Organization. Influenza at the human-animal interface: summary and assessment as of 31 March 2015 (http://www.who.int/influenza/human_animal_interface/Influenza_Summary_IRA_HA_interface_31_March_2015.pdf?ua=1). Accessed 15 May 2015.
37. World Health Organization. Antigenic and genetic characteristics of zoonotic influenza viruses and development of candidate vaccine viruses for pandemic preparedness, 2014 (http://www.who.int/influenza/vaccines/virus/201409_zoonotic_vaccinevirusupdate.pdf?ua=1). Accessed 8 Jan 2015.
38. Yi, L, et al. Family clusters of Avian influenza A H7N9 virus infection in Guangdong province, China. Journal of Clinical Microbiology 2015; 53: 2228.
39. Xu, C, et al. Monitoring avian influenza A(H7N9) virus through national influenza-like illness surveillance, China. Emerging Infectious Diseases 2013; 19: 12891292.
40. Gao, R, et al. Human infection with a novel avian-origin influenza A (H7N9) virus. New England Journal of Medicine 2013; 368: 18881897.
41. Cowling, BJ, et al. Comparative epidemiology of human infections with avian influenza A H7N9 and H5N1 viruses in China: a population-based study of laboratory-confirmed cases. Lancet 2013; 382: 129137.
42. European Centre for Disease Prevention and Control. Human infection with avian influenza A(H7N9) virus –fourth update. Rapid Risk Assessment 2015, Stockholm.
43. Wang, C, et al. Comparison of patients hospitalized with influenza a subtypes H7N9, H5N1, and 2009 pandemic H1N1. Clinical Infectious Diseases 2014; 58: 10951103.
44. Yang, Y, et al. Novel avian-origin influenza A (H7N9) in critically ill patients in China. Critical Care Medicine 2014; 43: 339345.
45. Ji, H, et al. Epidemiological and clinical characteristics and risk factors for death of patients with avian influenza a H7N9 virus infection from Jiangsu province, Eastern China. PLoS ONE 2014; 9: e89581
46. Watanabe, T, et al. Pandemic potential of avian influenza A (H7N9) viruses. Trends in Microbiology 2014; 22: 623631.
47. Siston, AM, et al. Pandemic 2009 influenza A(H1N1) virus illness among pregnant women in the United States. Journal of the American Medical Association 2010; 303: 15171525.
48. Guo, Q, et al. Delivery of fetus death with misoprostol in a pregnant woman with H7N9 avian influenza A virus pneumonia and ARDS. Critical Care 2014; 18: 589.
49. Qi, X, et al. Avian influenza A(H7N9) virus infection in pregnant woman, China, 2013. Emerging Infectious Diseases 2014; 20: 333334.
50. Qian, W, et al. Kinetic analysis of the immunity in a pregnant patient infected with avian influenza H7N9. International Journal of Clinical and Experimental Medicine 2014; 7: 17681774.
51. Hu, Y, et al. Association between adverse clinical outcome in human disease caused by novel influenza A H7N9 virus and sustained viral shedding and emergence of antiviral resistance. Lancet 2013; 381: 22732279.
52. To, KK, Chan, JF, Yuen, KY. Viral lung infections: epidemiology, virology, clinical features, and management of avian influenza A(H7N9). Current Opinion in Pulmonary medicine 2014; 20: 225232.
53. Gao, HN, et al. Clinical findings in 111 cases of influenza A (H7N9) virus infection. New England Journal of Medicine 2013; 368: 22772285.
54. Centers for Disease Control and Prevention Interim guidance on the use of antiviral agents for treatment of human infections with avian influenza A (H7N9) virus (http://www.cdc.gov/flu/avianflu/h7n9-antiviral-treatment.htm). Accessed 10 January 2015.
55. Hai, R, et al. Influenza A(H7N9) virus gains neuraminidase inhibitor resistance without loss of in vivo virulence or transmissibility. Nature Communications 2013; 4: 2854.
56. Liu, Q, et al. Emergence of a novel drug resistant H7N9 influenza virus: evidence based clinical potential of a natural IFN-alpha for infection control and treatment. Expert Review of Anti-infective Therapy 2014; 12: 165169.
57. Sleeman, K, et al. R292 K substitution and drug susceptibility of influenza A(H7N9) viruses. Emerging Infectious Diseases 2013; 19: 15211524.
58. Furuta, Y, et al. Favipiravir (T-705), a novel viral RNA polymerase inhibitor. Antiviral Research 2013; 100: 446454.
59. Marjuki, H, et al. An investigational antiviral drug, DAS181, effectively inhibits replication of zoonotic influenza A virus subtype H7N9 and protects mice from lethality. Journal of Infectious Diseases 2014; 210: 435440.
60. Lu, S, et al. Analysis of the clinical characteristics and treatment of two patients with avian influenza virus (H7N9). Bioscience Trends 2013; 7: 109112.
61. To, KK, et al. The emergence of influenza A H7N9 in human beings 16 years after influenza A H5N1: a tale of two cities. Lancet Infectious Diseases 2013; 13: 809821.
62. Wiwanitkit, V. H7N9 influenza: The emerging infectious disease. North American Journal of Medical Sciences 2013; 5: 395398.
63. Xi, X, et al. Avian influenza A (H7N9) infections: intensivists as virus hunters in the new century. Journal of Critical Care 2013; 28: 528530.
64. World Health Organization Avian influenza A(H7N9) virus: post-exposure antiviral chemoprophylaxis of close contacts of a patient with confirmed H7N9 virus infection and/or high risk poultry/environmental exposures (http://www.who.int/influenza/human_animal_interface/influenza_h7n9/13_January_2013_PEP_recs.pdf). Accessed 15 January 2015.
65. World Health Organization Antigenic and genetic characteristics of zoonotic influenza viruses and development of candidate vaccine viruses for pandemic preparedness, 26 February, 2015. Accessed 15 May 2015.
66. Abdelwhab, EM, Veits, J, Mettenleiter, TC. Prevalence and control of H7 avian influenza viruses in birds and humans. Epidemiology and Infection 2014; 142: 896920.
67. Zhao, B, et al. Novel avian influenza A(H7N9) virus in tree sparrow, Shanghai, China, 2013. Emerging Infectious Diseases 2014; 20: 850853.
68. Zambon, M. Influenza and other emerging respiratory viruses. Medicine (United Kingdom) 2014; 42: 4551.
69. Ding, H, et al. Epidemiologic characterization of 30 confirmed cases of human infection with avian influenza A(H7N9) virus in Hangzhou, China. BMC Infectious Diseases 2014; 14: 175.
70. Abolnik, C. A current review of avian influenza in pigeons and doves (Columbidae). Veterinary Microbiology 2014; 170: 181196.
71. Chen, Z, et al. Detection of avian influenza A(H7N9) virus from live poultry markets in Guangzhou, China: a surveillance report. PLoS ONE 2014; 9: e107266.
72. Wang, C, et al. Relationship between domestic and wild birds in live poultry market and a novel human H7N9 virus in China. Journal of Infectious Diseases 2014; 209: 3437.
73. Ai, J, et al. Case-control study of risk factors for human infection with influenza A(H7N9) virus in Jiangsu Province, China, 2013. Eurosurveillance 2013; 18: 20510.
74. Zhang, Y, et al. The impact of temperature and humidity measures on influenza A (H7N9) outbreaks-evidence from China. International Journal of Infectious Diseases 2015; 30: 122124.
75. Brown, JD, et al. Avian influenza virus in water: infectivity is dependent on pH, salinity and temperature. Veterinary Microbiology 2009; 136: 2026.
76. Zou, S, et al. Inactivation of the novel avian influenza A (H7N9) virus under physical conditions or chemical agents treatment. Virology Journal 2013; 10: 289.
77. World Health Organization Avian influenza (http://www.who.int/mediacentre/factsheets/avian_influenza/en/) Accessed 23 February 2015.
78. Belser, JA, et al. Influenza A virus transmission: contributing factors and clinical implications. Expert Reviews in Molecular Medicine 2012; 12:e39.
79. Xiong, X, McCauley, JW, Steinhauer, DA. Receptor binding properties of the influenza virus hemagglutinin as a determinant of host range. Current Topics in Microbiology and Immunology 2014; 385: 6391.
80. Zhou, J, et al. Biological features of novel avian influenza A (H7N9) virus. Nature 2013; 499: 500503.
81. Xiong, X, et al. Receptor binding by an H7N9 influenza virus from humans. Nature 2013; 499: 496499.
82. de Graaf, M, Fouchier, RA. Role of receptor binding specificity in influenza A virus transmission and pathogenesis. EMBO Journal 2014; 33: 823841.
83. Knepper, J, et al. The novel human influenza A(H7N9) virus is naturally adapted to efficient growth in human lung tissue. mBio 2013; 4: e0060100613.
84. Gabbard, JD, et al. Novel H7N9 influenza virus shows low infectious dose, high growth rate, and efficient contact transmission in the guinea pig model. Journal of Virology 2014; 88: 15021512.
85. Bi, Y, et al. Assessment of the internal genes of influenza A (H7N9) virus contributing to high pathogenicity in mice. Journal of Virology 2015; 89: 213.
86. Jonges, M, et al. Emergence of the virulence-associated PB2 E627 K substitution in a fatal human case of highly pathogenic avian influenza virus A(H7N7) infection as determined by Illumina ultra-deep sequencing. Journal of Virology 2014; 88: 16941702.
87. Xu, W, et al. Serological investigation of subclinical influenza A(H7H9) infection among healthcare and non-healthcare workers in Zhejiang province, China. Clinical Infectious Diseases 2013; 57: 919921.
88. Watanabe, T, et al. Characterization of H7N9 influenza A viruses isolated from humans. Nature 2013; 501: 551555.
89. Meijer, A, et al. Measurement of antibodies to avian influenza virus A(H7N7) in humans by hemagglutination inhibition test. Journal of Virological Methods 2006; 132: 113120.
90. De Groot, AS, et al. Low immunogenicity predicted for emerging avian-origin H7N9: implication for influenza vaccine design. Human Vaccines & Immunotherapeutics 2013; 9: 950956.
91. Qi, X, et al. Probable person to person transmission of novel avian influenza A (H7N9) virus in Eastern China, 2013: epidemiological investigation. British Medical Journal 2013; 347: f4752.
92. Belser, JA, et al. Pathogenesis and transmission of avian influenza A (H7N9) virus in ferrets and mice. Nature 2013; 501: 556559.
93. Zhu, H, et al. Infectivity, transmission, and pathology of human-isolated H7N9 influenza virus in ferrets and pigs. Science 2013; 341: 183186.
94. Richard, M, et al. Limited airborne transmission of H7N9 influenza A virus between ferrets. Nature 2013; 501: 560563.
95. Xu, L, et al. Novel avian-origin human influenza A(H7N9) can be transmitted between ferrets via respiratory droplets. Journal of Infectious Diseases 2014; 209: 551556.
96. Zhang, Q, et al. H7N9 influenza viruses are transmissible in ferrets by respiratory droplet. Science 2013; 341: 410414.
97. Zhu, Y, et al. Human co-infection with novel avian influenza A H7N9 and influenza A H3N2 viruses in Jiangsu province, China. Lancet 2013; 381: 2134.
98. Ke, C, et al. Circulation of reassortant influenza A(H7N9) viruses in poultry and humans, Guangdong Province, China, 2013. Emerging Infectious Diseases 2014; 20: 20342040.
99. Meng, Z, et al. Possible pandemic threat from new reassortment of influenza A(H7N9) virus in China. Eurosurveillance 2014; 19: pii=20699.
100. Ferguson, NM, et al. Public health. Public health risk from the avian H5N1 influenza epidemic. Science 2004; 304: 968969.
101. Nishiura, H, Mizumoto, K, Ejima, K. How to interpret the transmissibility of novel influenza A(H7N9): An analysis of initial epidemiological data of human cases from China. Theoretical Biology and Medical Modelling 2013; 10: 30.
102. Xiao, Y, et al. Transmission potential of the novel avian influenza A(H7N9) infection in mainland China. Journal of Theoretical Biology 2014; 352: 15.
103. Kucharski, AJ, Edmunds, WJ. Cross-immunity and age patterns of influenza A(H5N1) infection. Epidemiology and Infection 2015; 143: 11191124.
104. Fraser, C, et al. Pandemic potential of a strain of influenza A (H1N1): early findings. Science 2009; 324: 15571561.
105. Yang, Y, et al. The transmissibility and control of pandemic influenza A (H1N1) virus. Science 2009; 326: 729733.
106. Van Kerkhove, MD, et al. Epidemiologic and virologic assessment of the 2009 influenza A (H1N1) pandemic on selected temperate countries in the Southern Hemisphere: Argentina, Australia, Chile, New Zealand and South Africa. Influenza and Other Respiratory Viruses 2011; 5: e487e498.
107. Fang, LQ, et al. Mapping spread and risk of avian influenza A (H7N9) in China. Scientific Reports 2013; 3: 2722.
108. Shi, B, et al. Inferring the potential risks of H7N9 infection by spatiotemporally characterizing bird migration and poultry distribution in eastern China. Infectious Diseases of Poverty 2013; 2: 8.
109. Rivers, C, et al. Estimating human cases of avian influenza A(H7N9) from poultry exposure. PLoS Currents 2013; 5: pii.
110. De Nardi, M, et al. Development of a risk assessment methodological framework for potentially pandemic influenza strains (FLURISK). European Food Safety Authority, 2013; EFSA supporting publication 2014: EN–571.
111. Cox, NJ, Trock, SC, Burke, SA. Pandemic preparedness and the Influenza Risk Assessment Tool (IRAT). Current Topics in Microbiology and Immunology 2014; 385: 119136.
112. Liu, W, et al. Spatial and temporal analysis of human infection with avian influenza A(H7N9) virus in China, 2013. Eurosurveillance 2013; 18: pii: 20640.
113. Qiu, J, et al. Spatiotemporal pattern and risk factors of the reported novel avian-origin influenza A(H7N9) cases in China. Preventive Veterinary Medicine 2014; 115: 229237.
114. Fuller, T, et al. Identifying areas with a high risk of human infection with the avian influenza A (H7N9) virus in East Asia. Journal of Infection 2014; 69: 174181.
115. Gilbert, M, et al. Predicting the risk of avian influenza A H7N9 infection in live-poultry markets across Asia. Nature Communications 2014; 5: 4116.
116. Yu, H, et al. Effect of closure of live poultry markets on poultry-to-person transmission of avian influenza A H7N9 virus: an ecological study. Lancet 2014; 383: 541548.
117. Liu, S, et al. Global dynamics of avian influenza epidemic models with psychological effect. Computational and Mathematical Methods in Medicine 2015; 2015: 112.
118. Hsieh, YH, et al. Quantification of bird-to-bird and bird-to-human infections during 2013 novel H7N9 avian influenza outbreak in China. PLoS ONE 2014; 9: e111834.
119. Trock, S, et al. Development of an Influenza Risk Assessment Tool, 2012 (http://www.usaha.org/Portals/6/Committees/foreign-emerging/presentations2012/Trock-FluRiskAssessmentTool-FED2012.pdf). Accessed 20 May 2015.
120. World Health Organization. WHO risk assessment as of 23 February 2015 (http://www.who.int/influenza/human_animal_interface/influenza_h7n9/RiskAssessment_H7N9_23Feb20115.pdf?ua=1). Accessed 24 March 2015.
121. Van Kerkhove, MD, et al. Estimating age-specific cumulative incidence for the 2009 influenza pandemic: a meta-analysis of A(H1N1)pdm09 serological studies from 19 countries. Influenza and Other Respiratory Viruses 2013; 7: 872886.
122. Eibach, D, et al. Routes of transmission during a nosocomial influenza A(H3N2) outbreak among geriatric patients and healthcare workers. Journal of Hospital Infection 2014; 86: 188193.
123. Lo, YC, et al. Surveillance and vaccine effectiveness of an influenza epidemic predominated by vaccine-mismatched influenza B/Yamagata-lineage viruses in Taiwan, 2011–12 season. PLoS ONE 2013; 8: e58222.

Keywords

Metrics

Altmetric attention score

Full text views

Total number of HTML views: 0
Total number of PDF views: 0 *
Loading metrics...

Abstract views

Total abstract views: 0 *
Loading metrics...

* Views captured on Cambridge Core between <date>. This data will be updated every 24 hours.

Usage data cannot currently be displayed