The University of Southampton
University of Southampton Institutional Repository

The epidemic potential of avian influenza A (H7N9) virus in humans in mainland China: A two-stage risk analysis

The epidemic potential of avian influenza A (H7N9) virus in humans in mainland China: A two-stage risk analysis
The epidemic potential of avian influenza A (H7N9) virus in humans in mainland China: A two-stage risk analysis

BACKGROUND: From 2013 to 2017, more than one thousand avian influenza A (H7N9) confirmed cases with hundreds of deaths were reported in mainland China. To identify priorities for epidemic prevention and control, a risk assessing framework for subnational variations is needed to define the epidemic potential of A (H7N9).

METHODS: We established a consolidated two-stage framework that outlined the potential epidemic of H7N9 in humans: The Stage 1, index-case potential, used a Boosted Regression Trees model to assess population at risk due to spillover from poultry; the Stage 2, epidemic potential, synthesized the variables upon a framework of the Index for Risk Management to measure epidemic potential based on the probability of hazards and exposure, the vulnerability and coping capacity.

RESULTS: Provinces in southern and eastern China, especially Jiangsu, Zhejiang, Guangzhou, have high index-case potential of human infected with A (H7N9), while northern coastal provinces and municipalities with low morbidity, i.e. Tianjin and Liaoning, have an increasing risk of A (H7N9) infection. Provinces in central China are likely to have high potential of epidemic due to the high vulnerability and the lack of coping capacity.

CONCLUSIONS: This study provides a unified risk assessment of A (H7N9) to detect the two-stage heterogeneity of epidemic potential among different provinces in mainland China, allowing proactively evaluate health preparedness at subnational levels to improve surveillance, diagnostic capabilities, and health promotion.

1932-6203
Shan, Xuzheng
dfcadbf2-c33d-4110-8a7f-84a54d1d1a8e
Lai, Shengjie
b57a5fe8-cfb6-4fa7-b414-a98bb891b001
Liao, Hongxiu
0a02f780-f6a9-4dd0-8153-14958517bde9
Li, Zhongjie
f89a98f7-f6d3-4312-995a-bc658ae9a93f
Lan, Yajia
1c3b4eec-04e2-4852-898d-af5ab6a95b07
Yang, Weizhong
65d18fbc-d752-42a7-ac38-01534ceda15c
Shan, Xuzheng
dfcadbf2-c33d-4110-8a7f-84a54d1d1a8e
Lai, Shengjie
b57a5fe8-cfb6-4fa7-b414-a98bb891b001
Liao, Hongxiu
0a02f780-f6a9-4dd0-8153-14958517bde9
Li, Zhongjie
f89a98f7-f6d3-4312-995a-bc658ae9a93f
Lan, Yajia
1c3b4eec-04e2-4852-898d-af5ab6a95b07
Yang, Weizhong
65d18fbc-d752-42a7-ac38-01534ceda15c

Shan, Xuzheng, Lai, Shengjie, Liao, Hongxiu, Li, Zhongjie, Lan, Yajia and Yang, Weizhong (2019) The epidemic potential of avian influenza A (H7N9) virus in humans in mainland China: A two-stage risk analysis. PLoS ONE, 14 (4), [e0215857]. (doi:10.1371/journal.pone.0215857).

Record type: Article

Abstract

BACKGROUND: From 2013 to 2017, more than one thousand avian influenza A (H7N9) confirmed cases with hundreds of deaths were reported in mainland China. To identify priorities for epidemic prevention and control, a risk assessing framework for subnational variations is needed to define the epidemic potential of A (H7N9).

METHODS: We established a consolidated two-stage framework that outlined the potential epidemic of H7N9 in humans: The Stage 1, index-case potential, used a Boosted Regression Trees model to assess population at risk due to spillover from poultry; the Stage 2, epidemic potential, synthesized the variables upon a framework of the Index for Risk Management to measure epidemic potential based on the probability of hazards and exposure, the vulnerability and coping capacity.

RESULTS: Provinces in southern and eastern China, especially Jiangsu, Zhejiang, Guangzhou, have high index-case potential of human infected with A (H7N9), while northern coastal provinces and municipalities with low morbidity, i.e. Tianjin and Liaoning, have an increasing risk of A (H7N9) infection. Provinces in central China are likely to have high potential of epidemic due to the high vulnerability and the lack of coping capacity.

CONCLUSIONS: This study provides a unified risk assessment of A (H7N9) to detect the two-stage heterogeneity of epidemic potential among different provinces in mainland China, allowing proactively evaluate health preparedness at subnational levels to improve surveillance, diagnostic capabilities, and health promotion.

Full text not available from this repository.

More information

Submitted date: 11 December 2018
Accepted/In Press date: 9 April 2019
Published date: 19 April 2019

Identifiers

Local EPrints ID: 430736
URI: http://eprints.soton.ac.uk/id/eprint/430736
ISSN: 1932-6203
PURE UUID: 4ffbabe5-0c68-49ee-bcfd-cc1aafc899f5
ORCID for Shengjie Lai: ORCID iD orcid.org/0000-0001-9781-8148

Catalogue record

Date deposited: 09 May 2019 16:30
Last modified: 25 Jul 2019 00:22

Export record

Altmetrics

Download statistics

Downloads from ePrints over the past year. Other digital versions may also be available to download e.g. from the publisher's website.

View more statistics

Atom RSS 1.0 RSS 2.0

Contact ePrints Soton: eprints@soton.ac.uk

ePrints Soton supports OAI 2.0 with a base URL of http://eprints.soton.ac.uk/cgi/oai2

This repository has been built using EPrints software, developed at the University of Southampton, but available to everyone to use.

We use cookies to ensure that we give you the best experience on our website. If you continue without changing your settings, we will assume that you are happy to receive cookies on the University of Southampton website.

×