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Epidemiologic Observations from Passive and Targeted Surveillance during the First Wave of the 2009 H1N1 Influenza Pandemic in Milwaukee, WI
Swati Kumar 1,2,3,4,5,*

,
Michael J. Chusid 2,4,5 
,
Rodney E. Willoughby 2,4,5 
,
Peter L. Havens 2,4,5 
,
Sue C. Kehl 2,3,5 
,
Nathan A. Ledeboer 3,6 
,
Pippa Simpson 2 
,
Meredith VanDyke 1,4 
,
Elizabeth Davis 1,4 
,
Kate Gaffney 1,4 
,
Shun-Hwa Li 2 
,
Michael E. Bose 1,4 
and
Kelly J. Henrickson 1,2,4,5 
1
Midwest Respiratory Virus Program (MRVP), Suite C450, Pediatric Infectious Diseases, Children\'s Hospital of Wisconsin, P.O. Box 1997, Milwaukee, WI 53201-1997,USA
2
Department of Pediatrics, 8701 Watertown Plank Road, Milwaukee, WI 53226, USA
3
Department of Pathology, Medical College of Wisconsin, Wisconsin, USA
4
Childrens Research Institute, 8701 Watertown Plank Road, Milwaukee, WI 53226, USA
5
Childrens Hospital of Wisconsin, 8701 Watertown Plank Road, Milwaukee, WI 53226, USA
6
Dynacare Laboratories, 8701 Watertown Plank Road, Milwaukee, WI 53226, USA
* Author to whom correspondence should be addressed.
Received: 7 December 2009; in revised form: 10 February 2010 / Accepted: 8 March 2010 / Published: 25 March 2010
Abstract: The first wave of the 2009 influenza H1N1 pandemic (H1N1pdm) in Milwaukee, WI has been recognized as the largest reported regional outbreak in the United States. The epidemiologic and clinical characteristics of this large first wave outbreak from April 28th 2009–July 25th 2009, studied using both passive and targeted surveillance methodologies are presented. A total of 2791 individuals with H1N1pdm infection were identified; 60 % were 5–18 years old. The 5–18 year and 0–4 year age groups had high infection (1131 and 1101 per 100,000) and hospitalization (49 and 12 per 100,000) rates respectively. Non-Hispanic blacks and Hispanics had the highest hospitalization and infection rates. In targeted surveillance, infected patients had fever (78%), cough (80%), sore throat (38%), and vomiting or diarrhea (8%). The “influenza like illness” definition captured only 68 % of infected patients. Modeling estimates that 10.3 % of Milwaukee population was infected in the first wave and 59% were asymptomatic. The distinct epidemiologic profile of H1N1pdm infections observed in the study has direct implications for predicting the burden of infection and hospitalization in the next waves of H1N1pdm. Careful consideration of demographic predictors of infection and hospitalization with H1N1pdm will be important for effective preparedness for subsequent influenza seasons.
Keywords: influenza; pandemic; H1N1
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Cite This Article
MDPI and ACS Style
Kumar, S.; Chusid, M.J.; Willoughby, R.E.; Havens, P.L.; Kehl, S.C.; Ledeboer, N.A.; Simpson, P.; VanDyke, M.; Davis, E.; Gaffney, K.; Li, S.-H.; Bose, M.E.; Henrickson, K.J. Epidemiologic Observations from Passive and Targeted Surveillance during the First Wave of the 2009 H1N1 Influenza Pandemic in Milwaukee, WI. Viruses 2010, 2, 782-795.
AMA Style
Kumar S, Chusid MJ, Willoughby RE, Havens PL, Kehl SC, Ledeboer NA, Simpson P, VanDyke M, Davis E, Gaffney K, Li S-H, Bose ME, Henrickson KJ. Epidemiologic Observations from Passive and Targeted Surveillance during the First Wave of the 2009 H1N1 Influenza Pandemic in Milwaukee, WI. Viruses. 2010; 2(4):782-795.
Chicago/Turabian Style
Kumar, Swati; Chusid, Michael J.; Willoughby, Rodney E.; Havens, Peter L.; Kehl, Sue C.; Ledeboer, Nathan A.; Simpson, Pippa; VanDyke, Meredith; Davis, Elizabeth; Gaffney, Kate; Li, Shun-Hwa; Bose, Michael E.; Henrickson, Kelly J. 2010. "Epidemiologic Observations from Passive and Targeted Surveillance during the First Wave of the 2009 H1N1 Influenza Pandemic in Milwaukee, WI." Viruses 2, no. 4: 782-795.