Attack Rates Assessment of the 2009 Pandemic H1N1 Influenza A in Children and Their Contacts A Systematic Review and Meta-Analysis.docVIP

AttackRatesAssessmentofthe2009PandemicH1N1 InfluenzaAinChildrenandTheirContacts:ASystematic ReviewandMeta-Analysis AharonaGlatman-Freedman1,2*,IanPortelli3,4,SusanK.Jacobs5,JustinI.Mathew6, JonathanE.Slutzman7,LewisR.Goldfrank3,4,SilasW.Smith3,4 1DepartmentofFamilyandCommunityMedicine,NewYorkMedicalCollege,Valhalla,NewYork,UnitedStatesofAmerica,2GlobalPublicHealthMaster’sProgram,New YorkUniversity,NewYork,NewYork,UnitedStatesofAmerica, 3DepartmentofEmergencyMedicine,NewYorkUniversitySchoolofMedicine,NewYork,NewYork, UnitedStatesofAmerica,4TheCenterforCatastrophePreparednessandResponse,NewYorkUniversity,NewYork,NewYork,UnitedStatesofAmerica,5ElmerHolmes BobstLibrary,NewYorkUniversity,NewYork,NewYork,UnitedStatesofAmerica,6HunterCollege,TheCityUniversityofNewYork,NewYork,NewYork,UnitedStates ofAmerica,7DepartmentofEmergencyMedicine,BrighamWomen’sHospital,MassachusettsGeneralHospital,HarvardMedicalSchool,Boston,Massachusetts,United StatesofAmerica Abstract Background: The recent H1N1 influenza A pandemic was marked by multiple reports of illness and hospitalization in children,suggestingthatchildrenmayhaveplayedamajorroleinthepropagationofthevirus.Acomprehensivedetailed analysisoftheattackratesamongchildrenascomparedwiththeircontactsinvarioussettingsisofgreatimportancefor understandingtheiruniqueroleininfluenzapandemics. Methodology/PrincipalFindings:WesearchedMEDLINE(PubMed)andEmbaseforpublishedstudiesreportingoutbreak investigations with direct measurements of attack rates of the 2009 pandemic H1N1 influenza A among children, and quantifiedhowthesecomparewiththoseoftheircontacts.Weidentified 50articlessuitableforreview,whichreported school, household, travel and social events. The selected reports and our meta-analysis indicated that children had significantly higher attack rates as compared to adults, and that this phenomenon was observed for both virologically confirmedandclinicalcases,invarioussettingsandlocationsaroundtheworld.Thereviewalsoprovidedins