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dc.contributor.authorLajous, Martin
dc.contributor.authorCohen, Ted
dc.contributor.authorWallinga, Jacco
dc.contributor.authorRiley, Steven
dc.contributor.authorDowell, Scott F.
dc.contributor.authorReed, Carrie
dc.contributor.authorMcCarron, Meg
dc.contributor.authorLipsitch, Marc
dc.contributor.authorO'Hagan, Justin John
dc.contributor.authorMiller, Joel C.
dc.contributor.authorGoldstein, Edward
dc.contributor.authorDanon, Leon
dc.date.accessioned2013-10-24T20:54:20Z
dc.date.issued2009
dc.identifier.citationLipsitch, Marc, Martin Lajous, Justin J. O'Hagan, Ted Cohen, Joel C. Miller, Edward Goldstein, Leon Danon, et al. 2009. Use of Cumulative Incidence of Novel Influenza A/H1N1 in Foreign Travelers to Estimate Lower Bounds on Cumulative Incidence in Mexico. PLoS ONE 4(9): e6895.en_US
dc.identifier.issn1932-6203en_US
dc.identifier.urihttp://nrs.harvard.edu/urn-3:HUL.InstRepos:11211552
dc.description.abstractBackground: An accurate estimate of the total number of cases and severity of illness of an emerging infectious disease is required both to define the burden of the epidemic and to determine the severity of disease. When a novel pathogen first appears, affected individuals with severe symptoms are more likely to be diagnosed. Accordingly, the total number of cases will be underestimated and disease severity overestimated. This problem is manifest in the current epidemic of novel influenza A/H1N1. Methods and Results: We used a simple approach to leverage measures of incident influenza A/H1N1 among a relatively small and well observed group of US, UK, Spanish and Canadian travelers who had visited Mexico to estimate the incidence among a much larger and less well surveyed population of Mexican residents. We estimate that a minimum of 113,000 to 375,000 cases of novel influenza A/H1N1 have occurred in Mexicans during the month of April, 2009. Such an estimate serves as a lower bound because it does not account for underreporting of cases in travelers or for nonrandom mixing between Mexican residents and visitors, which together could increase the estimates by more than an order of magnitude. Conclusions: We find that the number of cases in Mexican residents may exceed the number of confirmed cases by two to three orders of magnitude. While the extent of disease spread is greater than previously appreciated, our estimate suggests that severe disease is uncommon since the total number of cases is likely to be much larger than those of confirmed cases.en_US
dc.description.sponsorshipOther Research Uniten_US
dc.language.isoen_USen_US
dc.publisherPublic Library of Scienceen_US
dc.relation.isversionofdoi:10.1371/journal.pone.0006895en_US
dc.relation.hasversionhttp://www.ncbi.nlm.nih.gov/pmc/articles/PMC2731883/pdf/en_US
dash.licenseLAA
dc.subjectinfectious diseasesen_US
dc.subjectepidemiology and control of infectious diseasesen_US
dc.subjectviral infectionsen_US
dc.titleUse of Cumulative Incidence of Novel Influenza A/H1N1 in Foreign Travelers to Estimate Lower Bounds on Cumulative Incidence in Mexicoen_US
dc.typeJournal Articleen_US
dc.description.versionVersion of Recorden_US
dc.relation.journalPLoS ONEen_US
dash.depositing.authorLipsitch, Marc
dc.date.available2013-10-24T20:54:20Z
dash.affiliation.otherSPH^Epidemiologyen_US
dash.affiliation.otherSPH^Epidemiologyen_US
dash.affiliation.otherFAS^FCOL^Freshman Dean's Ofc - Other Academicen_US
dash.affiliation.otherSPH^Student Stipendsen_US
dash.affiliation.otherSPH^Epidemiologyen_US
dash.affiliation.otherSPH^Epidemiologyen_US
dc.identifier.doi10.1371/journal.pone.0006895*
workflow.legacycommentsFLAG8 should be HSPHen_US
dash.authorsorderedfalse
dash.contributor.affiliatedO'Hagan, Justin
dash.contributor.affiliatedMiller, Joel C.
dash.contributor.affiliatedDanon, Leon
dash.contributor.affiliatedGoldstein, Edward
dash.contributor.affiliatedLipsitch, Marc


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