title: Measured dynamic social contact patterns explain the spread of H1N1v influenza.
abstract: Patterns of social mixing are key determinants of epidemic spread. Here we present the results of an internet-based social contact survey completed by a cohort of participants over 9,000 times between July 2009 and March 2010, during the 2009 H1N1v influenza epidemic. We quantify the changes in social contact patterns over time, finding that school children make 40% fewer contacts during holiday periods than during term time. We use these dynamically varying contact patterns to parameterise an age-structured model of influenza spread, capturing well the observed patterns of incidence; the changing contact patterns resulted in a fall of approximately 35% in the reproduction number of influenza during the holidays. This work illustrates the importance of including changing mixing patterns in epidemic models. We conclude that changes in contact patterns explain changes in disease incidence, and that the timing of school terms drove the 2009 H1N1v epidemic in the UK. Changes in social mixing patterns can be usefully measured through simple internet-based surveys.
authors.affiliation: Department of Infectious Disease Epidemiology, London School of Hygiene and Tropical Medicine, London, United Kingdom. Ken.Eames@lshtm.ac.uk
authors.forename: Ken T D
authors.initials: KT
authors.lastname: Eames
authors.forename: Natasha L
authors.initials: NL
authors.lastname: Tilston
authors.forename: Ellen
authors.initials: E
authors.lastname: Brooks-Pollock
authors.forename: W John
authors.initials: WJ
authors.lastname: Edmunds
mesh_terms: D016358:Contact Tracing / Q000706:statistics & numerical data*; D004196:Disease Outbreaks / Q000706:statistics & numerical data*; D006693:Holidays / Q000706:statistics & numerical data; D006801:Humans; D053118:Influenza A Virus, H1N1 Subtype; D007251:Influenza, Human / Q000453:epidemiology* / Q000635:transmission*; D015995:Prevalence; D016016:Proportional Hazards Models; D018570:Risk Assessment; D012307:Risk Factors; D012621:Seasons; D012919:Social Behavior; D006113:United Kingdom / Q000453:epidemiology