The Shifting Demographic Landscape of Pandemic Influenza




Bansal, Shweta
Pourbohloul, Babak
Hupert, Nathaniel
Grenfell, Bryan
Meyers, Lauren Ancel

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Public Library of Science


Background -- As Pandemic (H1N1) 2009 influenza spreads around the globe, it strikes school-age children more often than adults. Although there is some evidence of pre-existing immunity among older adults, this alone may not explain the significant gap in age-specific infection rates. Methods and Findings -- Based on a retrospective analysis of pandemic strains of influenza from the last century, we show that school-age children typically experience the highest attack rates in primarily naive populations, with the burden shifting to adults during the subsequent season. Using a parsimonious network-based mathematical model which incorporates the changing distribution of contacts in the susceptible population, we demonstrate that new pandemic strains of influenza are expected to shift the epidemiological landscape in exactly this way. Conclusions -- Our analysis provides a simple demographic explanation for the age bias observed for H1N1/09 attack rates, and suggests that this bias may shift in coming months. These results have significant implications for the allocation of public health resources for H1N1/09 and future influenza pandemics.


Shweta Bansal is with Pennsylvania State University and NIH, Babak Pourbohloul is with British Columbia Centre for Disease Control and University of British Columbia, Nathaniel Hupert is with Weill Cornell Medical College and CDC, Bryan Grenfell is with Princeton University, Lauren Ancel Meyers is with UT Austin and Santa Fe Institute.

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Bansal S, Pourbohloul B, Hupert N, Grenfell B, Meyers LA (2010) The Shifting Demographic Landscape of Pandemic Influenza. PLoS ONE 5(2): e9360. doi:10.1371/journal.pone.0009360