title: Cumulative incidence of pandemic influenza A (H1N1) 2009 by a community-based serological cohort study in Selenghe Province, Mongolia.
abstract: BACKGROUND
  Large community outbreaks of pandemic A (H1N1) 2009 occurred between October and December 2009 in Mongolia. A serological study was conducted among the general population by testing paired sera collected before and after the first wave of pandemic in Selenghe province, Mongolia. None of the study participants had been vaccinated for pandemic A (H1N1) 2009 before the second samples were collected.
  
  
  OBJECTIVE
  The objective of this study was to estimate cumulative incidence of pandemic A (H1N1) 2009 in different age-groups of Selenghe province residents.
  
  
  METHODS
  After informed consent was obtained from apparently healthy volunteers, the paired sera and background information were collected. Antibody titers were measured using hemagglutinin inhibition (HI) and microneutralization (MN) assays for A/California/07/2009pdm. A fourfold rise in antibody titers was regarded as the evidence of infection.
  
  
  RESULTS
  The overall cumulative incidences in the study group for all ages were 28.8% (76/264) by HI, 35.2% (93/264) by MN, and 25.0% (66/264) by both HI and MN. Cumulative incidences of infection varied among age-groups, with children aged 2-4 and 5-9 years having high cumulative incidence of infection. Overall cumulative incidences of infection in the whole population were estimated to be 23.0% (4946/21460) by HI, 30.2% (6473/21460) by MN, and 18.8% (4036/21460) by both HI and MN.
  
  
  CONCLUSIONS
  This study indicates that about one-fourth of the total population in Selenghe province was infected with pandemic A (H1N1) 2009 virus during the first wave of the pandemic.
authors.affiliation: National Influenza Center, National Center of Communicable Diseases, Ulaanbaatar, Mongolia.
authors.forename: Alexanderyn
authors.initials: A
authors.lastname: Burmaa
authors.forename: Sosorbaramyn
authors.initials: S
authors.lastname: Tsatsral
authors.forename: Takashi
authors.initials: T
authors.lastname: Odagiri
authors.forename: Akira
authors.initials: A
authors.lastname: Suzuki
authors.forename: Hitoshi
authors.initials: H
authors.lastname: Oshitani
authors.forename: Pagbajabyn
authors.initials: P
authors.lastname: Nymadawa
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000914:Antibodies, Viral / Q000097:blood*; D002648:Child; D002675:Child, Preschool; D015331:Cohort Studies; D005260:Female; D006385:Hemagglutination Inhibition Tests; D006801:Humans; D015994:Incidence; D007223:Infant; D053118:Influenza A Virus, H1N1 Subtype / Q000276:immunology*; D007251:Influenza, Human / Q000453:epidemiology* / Q000821:virology*; D008297:Male; D008875:Middle Aged; D008986:Mongolia / Q000453:epidemiology; D009500:Neutralization Tests; D055815:Young Adult
chemical_list: D000914:Antibodies, Viral