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Abstract

Introduction

Findings from the community-based Canadian Sentinel Practitioner Surveillance Network (SPSN) suggest children were more affected by the 2018/19 influenza A(H1N1)pdm09 epidemic.

Aim

To compare the age distribution of A(H1N1)pdm09 cases in 2018/19 to prior seasonal influenza epidemics in Canada.

Methods

The age distribution of unvaccinated influenza A(H1N1)pdm09 cases and test-negative controls were compared across A(H1N1)pdm09-dominant epidemics in 2018/19, 2015/16 and 2013/14 and with the general population of SPSN provinces. Similar comparisons were undertaken for influenza A(H3N2)-dominant epidemics.

Results

In 2018/19, more influenza A(H1N1)pdm09 cases were under 10 years old than controls (29% vs 16%; p < 0.001). In particular, children aged 5–9 years comprised 14% of cases, greater than their contribution to controls (4%) or the general population (5%) and at least twice their contribution in 2015/16 (7%; p < 0.001) or 2013/14 (5%; p < 0.001). Conversely, children aged 10–19 years (11% of the population) were under-represented among A(H1N1)pdm09 cases versus controls in 2018/19 (7% vs 12%; p < 0.001), 2015/16 (7% vs 13%; p < 0.001) and 2013/14 (9% vs 12%; p = 0.12).

Conclusion

Children under 10 years old contributed more to outpatient A(H1N1)pdm09 medical visits in 2018/19 than prior seasonal epidemics in Canada. In 2018/19, all children under 10 years old were born after the 2009 A(H1N1)pdm09 pandemic and therefore lacked pandemic-induced immunity. In addition, more than half those born after 2009 now attend school (i.e. 5–9-year-olds), a socio-behavioural context that may enhance transmission and did not apply during prior A(H1N1)pdm09 epidemics.

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/content/10.2807/1560-7917.ES.2019.24.15.1900104
2019-04-11
2024-04-19
http://instance.metastore.ingenta.com/content/10.2807/1560-7917.ES.2019.24.15.1900104
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Children under 10 years of age were more affected by the 2018/19 influenza A(H1N1)pdm09 epidemic in Canada: ‎possible cohort effect following the 2009 influenza pandemic
<p class="citation"> <span>Citation style for this article:</span> <span class="meta-value authors"> <a href="/search?value1=Danuta+M+Skowronski&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Skowronski Danuta M</a>, <a href="/search?value1=Siobhan+Leir&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Leir Siobhan</a>, <a href="/search?value1=Gaston+De+Serres&option1=author&noRedirect=true" class="nonDisambigAuthorLink">De Serres Gaston</a>, <a href="/search?value1=Michelle+Murti&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Murti Michelle</a>, <a href="/search?value1=James+A+Dickinson&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Dickinson James A</a>, <a href="/search?value1=Anne-Luise+Winter&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Winter Anne-Luise</a>, <a href="/search?value1=Romy+Olsha&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Olsha Romy</a>, <a href="/search?value1=Matthew+A+Croxen&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Croxen Matthew A</a>, <a href="/search?value1=Steven+J+Drews&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Drews Steven J</a>, <a href="/search?value1=Hugues+Charest&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Charest Hugues</a>, <a href="/search?value1=Christine+Martineau&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Martineau Christine</a>, <a href="/search?value1=Suzana+Sabaiduc&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Sabaiduc Suzana</a>, <a href="/search?value1=Nathalie+Bastien&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Bastien Nathalie</a>, <a href="/search?value1=Yan+Li&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Li Yan</a>, <a href="/search?value1=Martin+Petric&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Petric Martin</a>, <a href="/search?value1=Agatha+Jassem&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Jassem Agatha</a>, <a href="/search?value1=Mel+Krajden&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Krajden Mel</a>, <a href="/search?value1=Jonathan+B+Gubbay&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Gubbay Jonathan B</a></span>. Children under 10 years of age were more affected by the 2018/19 influenza A(H1N1)pdm09 epidemic in Canada: ‎possible cohort effect following the 2009 influenza pandemic. <a href="/content/ecdc">Euro Surveill.</a> 2019;24(15):pii=1900104. <a href="https://doi.org/10.2807/1560-7917.ES.2019.24.15.1900104" title="doi link" target="_blank">https://doi.org/10.2807/1560-7917.ES.2019.24.15.1900104</a> <span class="ES_Article_citation"> <span class="generated">Received</span>: 10 Feb 2019;&nbsp;&nbsp; <span class="generated">Accepted</span>: 12 Mar 2019 </span> </p>
/content/10.2807/1560-7917.ES.2019.24.15.1900104
/content/10.2807/1560-7917.ES.2019.24.15.1900104
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