TY - JOUR
T1 - Influenza in outpatient ILI case-patients in national hospital-based surveillance, Bangladesh, 2007-2008
AU - Zaman, Rashid Uz
AU - Alamgir, A. S.M.
AU - Rahman, Mustafizur
AU - Azziz-Baumgartner, Eduardo
AU - Gurley, Emily S.
AU - Sharker, M. Abu Yushuf
AU - Brooks, W. Abdullah
AU - Azim, Tasnim
AU - Fry, Alicia M.
AU - Lindstrom, Stephen
AU - Gubareva, Larisa V.
AU - Xu, Xiyan
AU - Garten, Rebecca J.
AU - Hossain, M. Jahangir
AU - Khan, Salah Uddin
AU - Faruque, Labib Imran
AU - Ameer, Syeda Shegufta
AU - Klimov, Alexander I.
AU - Rahman, Mahmudur
AU - Luby, Stephen P.
PY - 2009
Y1 - 2009
N2 - Background: Recent population-based estimates in a Dhaka low-income community suggest that influenza was prevalent among children. To explore the epidemiology and seasonality of influenza throughout the country and among all age groups, we established nationally representative hospital-based surveillance necessary to guide influenza prevention and control efforts. Methodolgy/Principal Findings: We conducted influenza-like illness and severe acute respiratory illness sentinel surveillance in 12 hospitals across Bangladesh during May 2007-December 2008. We collected specimens from 3,699 patients, 385 (10%) which were influenza positive by real time RT-PCR. Among the sample-positive patients, 192 (51%) were type A and 188 (49%) were type B. Hemagglutinin subtyping of type A viruses detected 137 (71%) A/H1 and 55 (29%) A/H3, but no A/H5 or other novel influenza strains. The frequency of influenza cases was highest among children aged under 5 years (44%), while the proportions of laboratory confirmed cases was highest among participants aged 11-15 (18%). We applied kriging, a geo-statistical technique, to explore the spatial and temporal spread of influenza and found that, during 2008, influenza was first identified in large port cities and then gradually spread to other parts of the country. We identified a distinct influenza peak during the rainy season (May-September). Conclusions/Significance: Our surveillance data confirms that influenza is prevalent throughout Bangladesh, affecting a wide range of ages and causing considerable morbidity and hospital care. A unimodal influenza seasonality may allow Bangladesh to time annual influenza prevention messages and vaccination campaigns to reduce the national influenza burden. To scale-up such national interventions, we need to quantify the national rates of influenza and the economic burden associated with this disease through further studies.
AB - Background: Recent population-based estimates in a Dhaka low-income community suggest that influenza was prevalent among children. To explore the epidemiology and seasonality of influenza throughout the country and among all age groups, we established nationally representative hospital-based surveillance necessary to guide influenza prevention and control efforts. Methodolgy/Principal Findings: We conducted influenza-like illness and severe acute respiratory illness sentinel surveillance in 12 hospitals across Bangladesh during May 2007-December 2008. We collected specimens from 3,699 patients, 385 (10%) which were influenza positive by real time RT-PCR. Among the sample-positive patients, 192 (51%) were type A and 188 (49%) were type B. Hemagglutinin subtyping of type A viruses detected 137 (71%) A/H1 and 55 (29%) A/H3, but no A/H5 or other novel influenza strains. The frequency of influenza cases was highest among children aged under 5 years (44%), while the proportions of laboratory confirmed cases was highest among participants aged 11-15 (18%). We applied kriging, a geo-statistical technique, to explore the spatial and temporal spread of influenza and found that, during 2008, influenza was first identified in large port cities and then gradually spread to other parts of the country. We identified a distinct influenza peak during the rainy season (May-September). Conclusions/Significance: Our surveillance data confirms that influenza is prevalent throughout Bangladesh, affecting a wide range of ages and causing considerable morbidity and hospital care. A unimodal influenza seasonality may allow Bangladesh to time annual influenza prevention messages and vaccination campaigns to reduce the national influenza burden. To scale-up such national interventions, we need to quantify the national rates of influenza and the economic burden associated with this disease through further studies.
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U2 - 10.1371/journal.pone.0008452
DO - 10.1371/journal.pone.0008452
M3 - Article
C2 - 20041114
AN - SCOPUS:77949521506
SN - 1932-6203
VL - 4
JO - PloS one
JF - PloS one
IS - 12
M1 - e8452
ER -