Post-pandemic seroprevalence of pandemic influenza A (H1N1) 2009 infection (swine flu) among children <18 years in Germany

We determined antibodies to the pandemic influenza A (H1N1) 2009 virus in children to assess: the incidence of (H1N1) 2009 infections in the 2009/2010 season in Germany, the proportion of subclinical infections and to compare titers in vaccinated and infected children. Eight pediatric hospitals dist...

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Bibliographic Details
Published in:PloS one 2011-09, Vol.6 (9), p.e23955-e23955
Main Authors: von Kries, Rüdiger, Weiss, Susanne, Falkenhorst, Gerhard, Wirth, Stephan, Kaiser, Petra, Huppertz, Hans-Iko, Tenenbaum, Tobias, Schroten, Horst, Streng, Andrea, Liese, Johannes, Shai, Sonu, Niehues, Tim, Girschick, Hermann, Kuscher, Ellen, Sauerbrey, Axel, Peters, Jochen, Wirsing von König, Carl Heinz, Rückinger, Simon, Hampl, Walter, Michel, Detlef, Mertens, Thomas
Format: Article
Language:English
Subjects:
Adolescent
Age Distribution
Antibodies
Biology
Child
Child, Preschool
Children
Female
Germany - epidemiology
Hemagglutination
Hemagglutination inhibition
Humans
Immunization
Incidence
Infant
Infections
Infectious diseases
Influenza
Influenza A
Influenza A virus
Influenza A Virus, H1N1 Subtype - immunology
Influenza A Virus, H1N1 Subtype - pathogenicity
Influenza Vaccines - immunology
Influenza, Human - epidemiology
Livestock
Male
Medicine
Pandemics
Seasons
Seroepidemiologic Studies
Serology
Swine
Swine flu
Vaccination
Vaccines
Virions
Viruses
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Summary:We determined antibodies to the pandemic influenza A (H1N1) 2009 virus in children to assess: the incidence of (H1N1) 2009 infections in the 2009/2010 season in Germany, the proportion of subclinical infections and to compare titers in vaccinated and infected children. Eight pediatric hospitals distributed over Germany prospectively provided sera from in- or outpatients aged 1 to 17 years from April 1(st) to July 31(st) 2010. Vaccination history, recall of infections and sociodemographic factors were ascertained. Antibody titers were measured with a sensitive and specific in-house hemagglutination inhibition test (HIT) and compared to age-matched sera collected during 6 months before the onset of the pandemic in Germany. We analyzed 1420 post-pandemic and 300 pre-pandemic sera. Among unvaccinated children aged 1-4 and 5-17 years the prevalence of HI titers (≥1∶10) was 27.1% (95% CI: 23.5-31.3) and 53.5% (95% CI: 50.9-56.2) compared to 1.7% and 5.5%, respectively, for pre-pandemic sera, accounting for a serologically determined incidence of influenza A (H1N1) 2009 during the season 2009/2010 of 25,4% (95% CI : 19.3-30.5) in children aged 1-4 years and 48.0% (95% CI: 42.6-52.0) in 5-17 year old children. Of children with HI titers ≥1∶10, 25.5% (95% CI: 22.5-28.8) reported no history of any infectious disease since June 2009. Among vaccinated children, 92% (95%-CI: 87.0-96.6) of the 5-17 year old but only 47.8% (95%-CI: 33.5-66.5) of the 1-4 year old children exhibited HI titers against influenza A virus (H1N1) 2009. Serologically determined incidence of influenza A (H1N1) 2009 infections in children indicates high infection rates with older children (5-17 years) infected twice as often as younger children. In about a quarter of the children with HI titers after the season 2009/2010 subclinical infections must be assumed. Low HI titers in young children after vaccination with the AS03(B)-adjuvanted split virion vaccine need further scrutiny.
ISSN:1932-6203
1932-6203
DOI:10.1371/journal.pone.0023955