determinants of the spatiotemporal dynamics of the 2009 h1n1 pandemic in europe implications for real-time modelling决定因素的时空动态2009年甲型h1n1流感大流行在欧洲对实时建模的影响.pdfVIP

Determinants of the Spatiotemporal Dynamics of the 2009 H1N1 Pandemic in Europe: Implications for Real- Time Modelling 1 1 2 3 Stefano Merler *, Marco Ajelli , Andrea Pugliese , Neil M. Ferguson 1 Bruno Kessler Foundation, Trento Povo, Italy, 2 Mathematics Department, University of Trento, Trento Povo, Italy, 3 MRC Centre for Outbreak Analysis and Modelling, Department of Infectious Disease Epidemiology, Faculty of Medicine, Imperial College London, London, United Kingdom Abstract Influenza pandemics in the last century were characterized by successive waves and differences in impact and timing between different regions, for reasons not clearly understood. The 2009 H1N1 pandemic showed rapid global spread, but with substantial heterogeneity in timing within each hemisphere. Even within Europe substantial variation was observed, with the UK being unique in experiencing a major first wave of transmission in early summer and all other countries having a single major epidemic in the autumn/winter, with a West to East pattern of spread. Here we show that a microsimulation model, parameterised using data about H1N1pdm collected by the beginning of June 2009, explains the occurrence of two waves in UK and a single wave in the rest of Europe as a consequence of timing of H1N1pdm spread, fluxes of travels from US and Mexico, and timing of school vacations. The model provides a description of pandemic spread through Europe, depending on intra-European mobility patterns and socio-demographic structure of the European populations, which is in broad agreement with observed timing of the pandemic in different countries. Attack rates are predicted to depend on the socio-demographic structure, with age dependent attack rates broadly agreeing with available serological