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Assessment of serosurveys for H5N1

Toner, ES and Adalja, AA and Nuzzo, JB and Inglesby, TV and Henderson, DA and Burke, DS (2013) Assessment of serosurveys for H5N1. Clinical Infectious Diseases, 56 (9). 1206 - 1212. ISSN 1058-4838

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Background. It has been suggested that the true case-fatality rate of human H5N1 influenza infection is appreciably less than the figure of approximately 60% that is based on official World Health Organization (WHO)-confirmed case reports because asymptomatic cases may have been missed. A number of seroepidemiologic studies have been conducted in an attempt to identify such missed cases.Methods. We conducted a comprehensive literature review of all English-language H5N1 human serology surveys with detailed attention to laboratory methodology used (including whether investigators used criteria set by the WHO to define positive cases), laboratory controls used, and the clades/genotypes involved.Results. Twenty-nine studies were included in the analysis. Few reported using unexposed control groups and one-third did not apply WHO criteria. Of studies that used WHO criteria, only 4 found any seropositive results to clades/genotypes of H5N1 that are currently circulating. No studies reported seropositive results to the clade 2/genotype Z viruses that have spread throughout Eurasia and Africa.Conclusions. This review suggests that the frequency of positive H5 serology results is likely to be low; therefore, it is essential that future studies adhere to WHO criteria and include unexposed controls in their laboratory assays to limit the likelihood of false-positive results. © 2012 The Author.


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Item Type: Article
Status: Published
CreatorsEmailPitt UsernameORCID
Toner, ES
Adalja, AA
Nuzzo, JB
Inglesby, TV
Henderson, DA
Burke, DSdonburke@pitt.eduDONBURKE
Centers: Other Centers, Institutes, Offices, or Units > Center for Vaccine Research
Date: 1 May 2013
Date Type: Publication
Journal or Publication Title: Clinical Infectious Diseases
Volume: 56
Number: 9
Page Range: 1206 - 1212
DOI or Unique Handle: 10.1093/cid/cit047
Schools and Programs: School of Public Health > Epidemiology
Refereed: Yes
ISSN: 1058-4838
Date Deposited: 06 Apr 2015 17:31
Last Modified: 02 Feb 2019 16:57


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