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• W2074509941 abstract "Background: For pdmH1N1 influenza, presentation to medical care was an entry point for interventions like antiviral treatment, and influenza-like illness (ILI) reporting by care providers was also widely used to track the epidemic. We describe the symptoms and health-seeking behaviour in a cohort of community dwelling adults during the initial wave of pdmH1N1 influenza A from June through September 2009 in Singapore. Methods: The cohort was followed up with fortnightly telephone surveys and up to three blood samples in 2009 (end-June, before sustained transmission, late August after the peak and early October after epidemic activity subsided). Acute self-reported symptom episodes were classified as ARIs (Acute respiratory illness) if at least one respiratory symptom was reported; ARIs with self-reported fever were classified as FRIs (febrile respiratory illness). More stringent definitions of fever were also studied (ILI-1, ≥37.8̊C and ILI-2, ≥38.0̊C). Episodes were considered as compatible with seroconversion (≥four-fold rise in hemagglutination inhibition titres to A/California/7/2009 H1N1 between successive samples) only if they occurred before the sample where seroconversion was detected. Since some individuals had several episodes, we used multilevel mixed-effect multivariate logistic regression modelling to investigate associations between variables and medical care. Results: Of 727 participants with ≥1 follow-up blood sample, 365 (50.2%) reported ≥1 symptom episode. In 98 participants who seroconverted, 69.4%, 43.9%, 34.7% and 30.6% had episodes fulfilling case definitions for ARI, FRI, ILI-1 and ILI-2 respectively. Of 568 episodes, 97 (17.1%) were compatible with seroconversion; fever (50.5%), cough (51.6%) and breathlessness (16.5%) were significantly more common than in other episodes (20.2%, 36.5% and 4.3% respectively). Medical attention was sought for 38.2% of episodes. Episodes compatible with seroconversion were not significantly more likely to seek medical care. However, on multivariate analysis, episodes with fever, cough and sorethroat were significantly associated with medical care (OR 5.97, 2.18 and 2.98 respectively), as were individuals who were employed (OR 2.34). Conclusion: During the initial wave of pdmH1N1 infections, a third of seroconverting individuals had ILI symptoms. Medical care was associated with the nature of the symptoms rather than whether an episode was due to pdmH1N1, with employment status being the main socio-demographic determinant." @default.
• W2074509941 created "2016-06-24" @default.
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• W2074509941 date "2012-06-01" @default.
• W2074509941 modified "2023-09-29" @default.
• W2074509941 title "Clinical presentation and health-seeking behaviour for acute respiratory illness episodes in a cohort of community dwelling adults during the initial wave of pdmH1N1 influenza A from June to September 2009 in Singapore" @default.
• W2074509941 doi "https://doi.org/10.1016/j.ijid.2012.05.178" @default.
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