Seasonal Synchronization of Influenza in the United States Older Adult Population 英文参考文献.docVIP

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Seasonal Synchronization of Influenza in the United States Older Adult Population 英文参考文献.doc

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SeasonalSynchronizationofInfluenzaintheUnited StatesOlderAdultPopulation JuliaB.Wenger,ElenaN.Naumova* DepartmentofPublicHealthandCommunityMedicine,TuftsUniversitySchoolofMedicine,Boston,Massachusetts,UnitedStatesofAmerica Abstract Background:Intemperateregions,influenzaepidemicsoccurannuallywiththehighestactivityoccurringduringthewinter months.Whileseasonaldynamicsoftheinfluenzavirus,suchastimeofonsetandcirculatingstrains,arewelldocumented by the Centers for Disease Control and Prevention Influenza Surveillance System, an accurate prediction of timing, magnitude, and composition of circulating strains of seasonal influenza remains elusive. To facilitate public health preparednessforseasonalinfluenzaandtoobtainbetterinsightsintothespatiotemporalbehaviorofemergingstrains,itis important to develop measurable characteristics of seasonal oscillation and to quantify the relationships between those parametersonaspatialscale.Theobjectivesofourresearchweretoexaminetheseasonalityofinfluenzaonanationaland state level as well as the relationship between peak timing and intensity of influenza in the United States older adult population. Methodology/PrincipalFindings:Atotalof248,889hospitalizationrecordswereextractedfromtheCentersforMedicare andMedicaidServicesfortheinfluenzaseasons1991–2004.Harmonicregressionmodelswereusedtoquantifythepeak timingandabsoluteintensityforeachofthe48contiguousstatesandWashington,DC.Wefoundthatindividualinfluenza seasonsshowedspatialsynchronywithconsistentlateorearlytimingoccurringacrossall48statesduringeachinfluenza seasonincomparisontotheoverallaverage.Onanationallevel,seasonsthathadanearlierpeakalsohadhigherratesof influenza(rs=20.5).Wedemonstratedaspatialtrendinpeaktimingofinfluenza;westernstatessuchasNevada,Utah,and CaliforniapeakedearlierandNewEnglandStatessuchasRhodeIsland,Maine,andNewHampshirepeakedlater. Conclusions/Significance: Ourfindingssuggestthatasystematicdescriptionofinfluenzaseasonalpatternsisavaluable tool for disease surveillan