Detection of Novel Influenza Viruses Through Community and Healthcare Testing: Implications for Surveillance Efforts in the United States

IF 4.3 4区 医学 Q1 INFECTIOUS DISEASES
Sinead E. Morris, Matthew Gilmer, Ryan Threlkel, Lynnette Brammer, Alicia P. Budd, A. Danielle Iuliano, Carrie Reed, Matthew Biggerstaff
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引用次数: 0

Abstract

Background

Novel influenza viruses pose a potential pandemic risk, and rapid detection of infections in humans is critical to characterizing the virus and facilitating the implementation of public health response measures.

Methods

We use a probabilistic framework to estimate the likelihood that novel influenza virus cases would be detected through testing in different community and healthcare settings (urgent care, emergency department, hospital, and intensive care unit [ICU]) while at low frequencies in the United States. Parameters were informed by data on seasonal influenza virus activity and existing testing practices.

Results

In a baseline scenario reflecting the presence of 100 novel virus infections with similar severity to seasonal influenza viruses, the median probability of detecting at least one infection per month was highest in urgent care settings (72%) and when community testing was conducted at random among the general population (77%). However, urgent care testing was over 15 times more efficient (estimated as the number of cases detected per 100,000 tests) due to the larger number of tests required for community testing. In scenarios that assumed increased clinical severity of novel virus infection, median detection probabilities increased across all healthcare settings, particularly in hospitals and ICUs (up to 100%) where testing also became more efficient.

Conclusions

Our results suggest that novel influenza virus circulation is likely to be detected through existing healthcare surveillance, with the most efficient testing setting impacted by the disease severity profile. These analyses can help inform future testing strategies to maximize the likelihood of novel influenza detection.

Abstract Image

通过社区和医疗保健检测发现新型流感病毒:对美国监测工作的影响》。
背景:新型流感病毒具有潜在的大流行风险,快速检测出人类感染病例对于确定病毒特征和促进公共卫生应对措施的实施至关重要:方法:我们采用概率框架来估算新型流感病毒病例在美国不同社区和医疗机构(紧急护理、急诊科、医院和重症监护室[ICU])中低频检测到的可能性。检测参数参考了季节性流感病毒活动数据和现有检测方法:结果:在反映存在 100 种新型病毒感染且严重程度与季节性流感病毒相似的基线情况下,每月至少检测出一种感染的中位概率在急诊医疗机构(72%)和在普通人群中随机进行社区检测时(77%)最高。然而,由于社区检测所需的检测次数较多,紧急护理检测的效率(按每 10 万次检测发现的病例数估算)要高出 15 倍以上。在假定新型病毒感染的临床严重程度增加的情况下,所有医疗机构的检测概率中位数都有所增加,尤其是医院和重症监护室(高达 100%)的检测效率更高:我们的研究结果表明,新型流感病毒循环有可能通过现有的医疗保健监测发现,最有效的检测环境受疾病严重程度的影响。这些分析有助于为未来的检测策略提供信息,从而最大限度地提高新型流感检测的可能性。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
CiteScore
7.20
自引率
4.50%
发文量
120
审稿时长
6-12 weeks
期刊介绍: Influenza and Other Respiratory Viruses is the official journal of the International Society of Influenza and Other Respiratory Virus Diseases - an independent scientific professional society - dedicated to promoting the prevention, detection, treatment, and control of influenza and other respiratory virus diseases. Influenza and Other Respiratory Viruses is an Open Access journal. Copyright on any research article published by Influenza and Other Respiratory Viruses is retained by the author(s). Authors grant Wiley a license to publish the article and identify itself as the original publisher. Authors also grant any third party the right to use the article freely as long as its integrity is maintained and its original authors, citation details and publisher are identified.
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