title: Relative timing of influenza disease by age group.
abstract: A detailed understanding of influenza movement in communities during yearly epidemics is needed to inform improved influenza control programs. We sought to determine the relative timing of influenza presentation and symptom onset by age group and influenza strain. Prospective, laboratory-confirmed surveillance was performed over three moderate influenza seasons in emergency departments and inpatient settings of both medical centers in Winston-Salem, NC. Influenza disease presented first in school age children through community epidemics of influenza A(H1N1)pdm09 and influenza B, and first in persons 5-49 years old for influenza A(H3N2). This finding indicates that influenza prevention in persons 5-49 years of age may be particularly important in influenza epidemic control.
authors.affiliation: Department of Pediatrics, Wake Forest School of Medicine, Medical Center Boulevard, Winston-Salem, NC 27157, USA. Electronic address: tpeters@wakehealth.edu.
authors.forename: Timothy R
authors.initials: TR
authors.lastname: Peters
authors.affiliation: Department of Biostatistical Sciences, Wake Forest School of Medicine, Medical Center Boulevard, Winston-Salem, NC 27157, USA. Electronic address: bmellen@wakehealth.edu.
authors.forename: Beverly M
authors.initials: BM
authors.lastname: Snively
authors.affiliation: Department of Biostatistical Sciences, Wake Forest School of Medicine, Medical Center Boulevard, Winston-Salem, NC 27157, USA. Electronic address: csuerken@wakehealth.edu.
authors.forename: Cynthia K
authors.initials: CK
authors.lastname: Suerken
authors.affiliation: Department of Pediatrics, Wake Forest School of Medicine, Medical Center Boulevard, Winston-Salem, NC 27157, USA. Electronic address: eblakene@wakehealth.edu.
authors.forename: Elizabeth
authors.initials: E
authors.lastname: Blakeney
authors.affiliation: Department of Pediatrics, Wake Forest School of Medicine, Medical Center Boulevard, Winston-Salem, NC 27157, USA. Electronic address: lvannoy@wakehealth.edu.
authors.forename: Lauren
authors.initials: L
authors.lastname: Vannoy
authors.affiliation: Department of Pediatrics, Wake Forest School of Medicine, Medical Center Boulevard, Winston-Salem, NC 27157, USA; Department of Pediatrics and Epidemiology and Prevention, Wake Forest School of Medicine, Medical Center Boulevard, Winston-Salem, NC 27157, USA. Electronic address: kpoehlin@wakehealth.edu.
authors.forename: Katherine A
authors.initials: KA
authors.lastname: Poehling
mesh_terms: D000293:Adolescent; D000328:Adult; D017677:Age Distribution; D002648:Child; D002675:Child, Preschool; D005260:Female; D006801:Humans; D053118:Influenza A Virus, H1N1 Subtype; D053122:Influenza A Virus, H3N2 Subtype; D009981:Influenza B virus; D007251:Influenza, Human / Q000453:epidemiology*; D008297:Male; D008875:Middle Aged; D009657:North Carolina; D011159:Population Surveillance; D011446:Prospective Studies; D013997:Time Factors; D055815:Young Adult
keywords: Epidemiology; Hospital emergency services; Human influenza; Influenza A virus; Influenza B virus; Inpatient