PLoS ONE (Apr 2011)

The seroprevalence of pandemic influenza H1N1 (2009) virus in China.

  • Cuiling Xu,
  • Tian Bai,
  • A Danielle Iuliano,
  • Min Wang,
  • Lei Yang,
  • Leying Wen,
  • Yuhong Zeng,
  • Xiaodan Li,
  • Tao Chen,
  • Wei Wang,
  • Ying Hu,
  • Limei Yang,
  • Zi Li,
  • Shumei Zou,
  • Dexin Li,
  • Shiwen Wang,
  • Zijian Feng,
  • Yanping Zhang,
  • Hongjie Yu,
  • Weizhong Yang,
  • Yu Wang,
  • Marc-Alain Widdowson,
  • Yuelong Shu

DOI
https://doi.org/10.1371/journal.pone.0017919
Journal volume & issue
Vol. 6, no. 4
p. e17919

Abstract

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BackgroundMainland China experienced pandemic influenza H1N1 (2009) virus (pH1N1) with peak activity during November-December 2009. To understand the geographic extent, risk factors, and attack rate of pH1N1 infection in China we conducted a nationwide serological survey to determine the prevalence of antibodies to pH1N1.Methodology/principal findingsStored serum samples (n = 2,379) collected during 2006-2008 were used to estimate baseline serum reactogenicity to pH1N1. In January 2010, we used a multistage-stratified random sampling method to select 50,111 subjects who met eligibility criteria and collected serum samples and administered a standardized questionnaire. Antibody response to pH1N1 was measured using haemagglutination inhibition (HI) assay and the weighted seroprevalence was calculated using the Taylor series linearization method. Multivariable logistic regression analyses were used to examine risk factors for pH1N1 seropositivity. Baseline seroprevalence of pH1N1 antibody (HI titer ≥40) was 1.2%. The weighted seroprevalence of pH1N1 among the Chinese population was 21.5%(vaccinated: 62.0%; unvaccinated: 17.1%). Among unvaccinated participants, those aged 6-15 years (32.9%) and 16-24 years (30.3%) had higher seroprevalence compared with participants aged 25-59 years (10.7%) and ≥60 years (9.9%, PConclusions/significanceThe Chinese population had low pre-existing immunity to pH1N1 and experienced a relatively high attack rate in 2009 of this virus. We recommend routine control measures such as vaccination to reduce transmission and spread of seasonal and pandemic influenza viruses.