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2011-09-07Zeitschriftenartikel DOI: 10.1371/journal.pone.0023955
Post-Pandemic Seroprevalence of Pandemic Influenza A (H1N1) 2009 Infection (Swine Flu) among Children
Kries, Rüdiger von
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
König, Carl-Heinz Wirsing von
Rückinger, Simon
Hampl, Walter
Michel, Detlef
Mertens, Thomas
Background: 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. Methodology/Principal Findings: Eight pediatric hospitals distributed over Germany prospectively provided sera from in- or outpatients aged 1 to 17 years from April 1st to July 31st 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. Conclusion: 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 AS03B-adjuvanted split virion vaccine need further scrutiny.
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DOI
10.1371/journal.pone.0023955
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https://doi.org/10.1371/journal.pone.0023955
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<a href="https://doi.org/10.1371/journal.pone.0023955">https://doi.org/10.1371/journal.pone.0023955</a>