Equity in the Receipt of Oseltamivir in the United States During the H1N1 Pandemic

Abstract Background Annual influenza outbreaks constitute a major public health concern, both in the United States and worldwide. Comparisons of the health burdens of outbreaks might lead to the identification of specific at-risk populations, for whom public health resources should be marshaled appropriately and equitably. Methods We examined the disease burden of the 2009-10 influenza A (H1N1) pandemic relating to illnesses, medical visits, hospitalizations, and mortality, compared to influenza seasons 2010 to 2019, in the United States, as compiled by the Centers for Disease Control. Results With regard to seasonal influenza, rates of illnesses and medical visits were highest in infants aged 0–4 years, followed by adults aged 50–64 years. Rates of hospitalizations and deaths evinced a starkly different pattern, both dominated by elderly adults aged 65 and over. Youths aged 0 to 17 years were especially adversely affected by the H1N1 pandemic relative to hospitalizations and mortality compared to seasonal influenza; but curiously the opposite pattern was observed in elderly adults (aged 65 and older). Conclusions The disease burden of the 2009-10 influenza A pandemic was strikingly unlike that observed in the subsequent influenza seasons 2010 to 2019, in the United States: the past did not predict the future.

Download Full-text

Narcolepsy and influenza A(H1N1) pandemic 2009 vaccination in the United States

Neurology ◽

10.1212/wnl.0000000000000987 ◽

2014 ◽

Vol 83 (20) ◽

pp. 1823-1830 ◽

Cited By ~ 46

Author(s):

J. Duffy ◽

E. Weintraub ◽

C. Vellozzi ◽

F. DeStefano ◽

Keyword(s):

United States ◽

Influenza A ◽

The United States ◽

H1n1 Pandemic ◽

Influenza A H1n1

Download Full-text

Historical and clinical aspects of the 1918 H1N1 pandemic in the United States

Virology ◽

10.1016/j.virol.2018.10.019 ◽

2019 ◽

Vol 527 ◽

pp. 32-37 ◽

Cited By ~ 8

Author(s):

Barbara Jester ◽

Timothy M. Uyeki ◽

Daniel B. Jernigan ◽

Terrence M. Tumpey

Keyword(s):

United States ◽

The United States ◽

Clinical Aspects ◽

H1n1 Pandemic

Download Full-text

Weekly influenza-like-Illness rates were significantly lower in areas where schools were not in session in the United States during the 2009 H1N1 pandemic.

PLoS Currents ◽

10.1371/currents.rrn1234 ◽

2011 ◽

Vol 3 ◽

pp. RRN1234 ◽

Cited By ~ 1

Author(s):

Olivia Briffault

Keyword(s):

United States ◽

The United States ◽

H1n1 Pandemic ◽

Influenza Like Illness ◽

2009 H1n1

Download Full-text

Reassortment between Swine H3N2 and 2009 Pandemic H1N1 in the United States Resulted in Influenza A Viruses with Diverse Genetic Constellations with Variable Virulence in Pigs

Journal of Virology ◽

10.1128/jvi.01763-16 ◽

2016 ◽

Vol 91 (4) ◽

Cited By ~ 21

Author(s):

Daniela S. Rajão ◽

Rasna R. Walia ◽

Brian Campbell ◽

Phillip C. Gauger ◽

Alicia Janas-Martindale ◽

...

Keyword(s):

Public Health ◽

United States ◽

Genetic Diversity ◽

Influenza A ◽

The United States ◽

H1n1 Pandemic ◽

Influenza A Viruses ◽

Swine Industry ◽

Viral Shedding ◽

Increased Risk

ABSTRACT Repeated spillovers of the H1N1 pandemic virus (H1N1pdm09) from humans to pigs resulted in substantial evolution of influenza A viruses infecting swine, contributing to the genetic and antigenic diversity of influenza A viruses (IAV) currently circulating in swine. The reassortment with endemic swine viruses and maintenance of some of the H1N1pdm09 internal genes resulted in the circulation of different genomic constellations in pigs. Here, we performed a whole-genome phylogenetic analysis of 368 IAV circulating in swine from 2009 to 2016 in the United States. We identified 44 different genotypes, with the most common genotype (32.33%) containing a clade IV-A HA gene, a 2002-lineage NA gene, an M-pdm09 gene, and remaining gene segments of triple reassortant internal gene (TRIG) origin. To understand how different genetic constellations may relate to viral fitness, we compared the pathogenesis and transmission in pigs of six representative genotypes. Although all six genotypes efficiently infected pigs, they resulted in different degrees of pathology and viral shedding. These results highlight the vast H3N2 genetic diversity circulating in U.S. swine after 2009. This diversity has important implications in the control of this disease by the swine industry, as well as a potential risk for public health if swine-adapted viruses with H1N1pdm09 genes have an increased risk to humans, as occurred in the 2011-2012 and 2016 human variant H3N2v cases associated with exhibition swine. IMPORTANCE People continue to spread the 2009 H1N1 pandemic (H1N1pdm09) IAV to pigs, allowing H1N1pdm09 to reassort with endemic swine IAV. In this study, we determined the 8 gene combinations of swine H3N2 IAV detected from 2009 to 2016. We identified 44 different genotypes of H3N2, the majority of which contained at least one H1N1pdm09 gene segment. We compared six representative genotypes of H3N2 in pigs. All six genotypes efficiently infected pigs, but they resulted in different degrees of lung damage and viral shedding. These results highlight the vast genetic diversity of H3N2 circulating in U.S. swine after 2009, with important implications for the control of IAV for the swine industry. Because H1N1pdm09 is also highly adapted to humans, these swine viruses pose a potential risk to public health if swine-adapted viruses with H1N1pdm09 genes also have an increased risk for human infection.

Download Full-text