title: The role of cellular immunity in influenza H1N1 population dynamics.
abstract: BACKGROUND
  Pre-existing cellular immunity has been recognized as one of the key factors in determining the outcome of influenza infection by reducing the likelihood of clinical disease and mitigates illness. Whether, and to what extent, the effect of this self-protective mechanism can be captured in the population dynamics of an influenza epidemic has not been addressed.
  
  
  METHODS
  We applied previous findings regarding T-cell cross-reactivity between the 2009 pandemic H1N1 strain and seasonal H1N1 strains to investigate the possible changes in the magnitude and peak time of the epidemic. Continuous Monte-Carlo Markov Chain (MCMC) model was employed to simulate the role of pre-existing immunity on the dynamical behavior of epidemic peak.
  
  
  RESULTS
  From the MCMC model simulations, we observed that, as the size of subpopulation with partially effective pre-existing immunity increases, the mean magnitude of the epidemic peak decreases, while the mean time to reach the peak increases. However, the corresponding ranges of these variations are relatively small.
  
  
  CONCLUSIONS
  Our study concludes that the effective role of pre-existing immunity in alleviating disease outcomes (e.g., hospitalization) of novel influenza virus remains largely undetectable in population dynamics of an epidemic. The model outcome suggests that rapid clinical investigations on T-cell assays remain crucial for determining the protection level conferred by pre-existing cellular responses in the face of an emerging influenza virus.
authors.affiliation: Centre for Disease Modelling, York University, Toronto, Ontario. dvenkata@yorku.ca
authors.forename: Venkata R
authors.initials: VR
authors.lastname: Duvvuri
authors.forename: Jane M
authors.initials: JM
authors.lastname: Heffernan
authors.forename: Seyed M
authors.initials: SM
authors.lastname: Moghadas
authors.forename: Bhargavi
authors.initials: B
authors.lastname: Duvvuri
authors.forename: Hongbin
authors.initials: H
authors.lastname: Guo
authors.forename: David N
authors.initials: DN
authors.lastname: Fisman
authors.forename: Jianhong
authors.initials: J
authors.lastname: Wu
authors.forename: Gillian E
authors.initials: GE
authors.lastname: Wu
mesh_terms: D006801:Humans; D007111:Immunity, Cellular / Q000276:immunology*; D053118:Influenza A Virus, H1N1 Subtype / Q000276:immunology*; D007251:Influenza, Human / Q000276:immunology*; D008962:Models, Theoretical; D011157:Population Dynamics