epidemiology
Last edited 02/2022
Epidemics of influenza are associated with antigenic drift which results in failure of recognition by the immune system.
- the severity of these annual epidemics may vary according to the types, subtypes and strains of circulating viruses, and the level of protective antibodies in the general population (1)
- peak incidence in influenza usually occurs
- May to September - in temperate regions of the southern hemisphere
- December and March and lasts for 6–8 weeks - in temperate regions of the northern hemisphere
- variable times of the year in tropical and subtropical countries and can cause isolated cases because influenza viruses in these regions circulate at low levels throughout the year (1)
- epidemics take 4 weeks to peak and last for 8–10 weeks.
Pandemics of influenza occur as a result of antigenic shift throwing up an entirely new combination of antigens.
- influenza infection rates are generally higher in all age groups during pandemics than during annual epidemics
- school-age children play an important role in the spread of the disease in the community
- three pandemics have occurred during the 20th century; In all instances, the spread of the infection throughout the world was seen within a year of its initial detection
- 1918–1919 the “Spanish flu” A(H1N1) - caused death to more than 40 million people
- 1957–1958 the “Asian flu” A(H2N2) - responsible for more than 1 million deaths globally
- 1968–1969 “Hong Kong flu” A(H3N2) - mortality rate was estimated to be around 1 million
- the pandemic (H1N1) in 2009 had spread to all six WHO regions within 6 weeks of first being described which resulted in the declaration of a pandemic
GP consultations for influenza vary according to the prevalence of the disease:
- 30 consultations/100000 population is a winter baseline
- 100-150 consultations/100000 are seen in an epidemic
- 600 consultations/100000 represents a severe outbreak
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