Kissler SM, et al. Geographic transmission hubs of the 2009 influenza pandemic in the United States. Epidemics. 2018 Oct 10.
A key issue in infectious disease epidemiology is to identify and predict geographic sites of epidemic establishment that contribute to onward spread, especially in the context of invasion waves of emerging pathogens. Conventional wisdom suggests that these sites are likely to be in densely-populated, well-connected areas. For pandemic influenza, however, epidemiological data have not been available at a fine enough geographic resolution to test this assumption. Here, we make use of fine-scale influenza-like illness incidence data derived from electronic medical claims records gathered from 834 3-digit ZIP (postal) codes across the US to identify the key geographic establishment sites, or "hubs", of the autumn wave of the 2009 A/H1N1pdm influenza pandemic in the United States. A mechanistic spatial transmission model is fit to epidemic onset times inferred from the data. Hubs are identified by tracing the most probable transmission routes back to a likely first establishment site. Four hubs are identified: two in the southeastern US, one in the central valley of California, and one in the midwestern US. According to the model, 75% of the 834 observed ZIP-level outbreaks in the US were seeded by these four hubs or their epidemiological descendants. Counter-intuitively, the pandemic hubs do not coincide with large and well-connected cities, indicating that factors beyond population density and travel volume are necessary to explain the establishment sites of the major autumn wave of the pandemic. Geographic regions are identified where infection can be statistically traced back to a hub, providing a testable prediction of the outbreak´s phylogeography. Our method therefore provides an important way forward to reconcile spatial diffusion patterns inferred from epidemiological surveillance data and pathogen sequence data.
See Also:
Latest articles in those days:
- [preprint]Egyptian rousette bat humoral immunity to H9 influenza hemagglutinin 14 hours ago
- The surveillance programme for avian influenza (AI) in Norwegian wildlife 2025 1 days ago
- The surveillance programme for avian influenza (AI) in poultry in Norway 2025 1 days ago
- Emergence of Novel Reassortant H3N2 Avian Influenza Viruses in Southern China: Genetic Complexity and Pathogenicity in Chickens and Mice 1 days ago
- Pathological evidence of neurotropism and oculotropism in wild black-headed gulls naturally infected with H5N1 high pathogenicity avian influenza 1 days ago
[Go Top] [Close Window]


