Epidemiologic parameters and evaluation of control measure for 2009 novel influenza a (H1N1) in Xiamen, Fujian Province, China

BACKGROUND: Containment of influenza A H1N1 virus spread was implemented successfully in Xiamen, with large-scale inoculation to reduce morbidity. To identify beneficial elements and to guide decision-making in epidemic containment, we analyzed the epidemiologic parameters and evaluated the control measures. METHOD: We determined various parameters from laboratory-confirmed cases, including incubation period, duration of illness and reproductive number (R(0)), and evaluated the control measures. RESULTS: There were1414 cases with dates of onset between June 14, 2009 and March 22, 2010. The incidence was 56.79/100,000, and mortality was 0.12/100,000. The incidence during the community epidemic phase was 6.23 times higher than in the containment phase. A total of 296,888 subjects were inoculated with domestic influenza H1N1 virus cleavage vaccine. An epidemic curve showed that vaccination in students cut the peak incidence of illness significantly. Men (relative risk (RR) = 1.30, 95% confidence interval (CI): 1.17-1.45) and persons aged 0-14 years were at greater risk of infection. The incidence increased with younger age (χ(2 )= 950.675, p = ∞). Morbidity was lower in urban than in rural areas (RR = 0.56, 95%CI: 0.50-0.62). The median incubation time was 2 days, median duration of symptoms was 7 days, and the within-school reproductive number was 1.35. CONCLUSION: Our analysis indicated that the characteristics of this novel influenza virus were similar to those of seasonal influenza. The principle of "interception of imported cases" applied at Xiamen ports, and vaccination of students effectively limited the spread of the influenza pandemic and reduced the epidemic peak.