Pandemic Paradox: Early Life H2N2 Pandemic Influenza Infection Enhanced Susceptibility to Death during the 2009 H1N1 Pandemic

Recent outbreaks of H5, H7, and H9 influenza A viruses in humans have served as a vivid reminder of the potentially devastating effects that a novel pandemic could exert on the modern world. Those who have survived infections with influenza viruses in the past have been protected from subsequent ant...

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Main Authors: Alain Gagnon, Enrique Acosta, Stacey Hallman, Robert Bourbeau, Lisa Y. Dillon, Nadine Ouellette, David J. D. Earn, D. Ann Herring, Kris Inwood, Joaquin Madrenas, Matthew S. Miller, W. Ian Lipkin
Format: Article
Language:English
Published: American Society for Microbiology 2018-01-01
Series:mBio
Online Access:http://mbio.asm.org/cgi/content/full/9/1/e02091-17
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spelling doaj-6bb04a35a8854f10a727767c660f864c2021-07-02T13:56:12ZengAmerican Society for MicrobiologymBio2150-75112018-01-0191e02091-1710.1128/mBio.02091-17Pandemic Paradox: Early Life H2N2 Pandemic Influenza Infection Enhanced Susceptibility to Death during the 2009 H1N1 PandemicAlain GagnonEnrique AcostaStacey HallmanRobert BourbeauLisa Y. DillonNadine OuelletteDavid J. D. EarnD. Ann HerringKris InwoodJoaquin MadrenasMatthew S. MillerW. Ian LipkinRecent outbreaks of H5, H7, and H9 influenza A viruses in humans have served as a vivid reminder of the potentially devastating effects that a novel pandemic could exert on the modern world. Those who have survived infections with influenza viruses in the past have been protected from subsequent antigenically similar pandemics through adaptive immunity. For example, during the 2009 H1N1 “swine flu” pandemic, those exposed to H1N1 viruses that circulated between 1918 and the 1940s were at a decreased risk for mortality as a result of their previous immunity. It is also generally thought that past exposures to antigenically dissimilar strains of influenza virus may also be beneficial due to cross-reactive cellular immunity. However, cohorts born during prior heterosubtypic pandemics have previously experienced elevated risk of death relative to surrounding cohorts of the same population. Indeed, individuals born during the 1890 H3Nx pandemic experienced the highest levels of excess mortality during the 1918 “Spanish flu.” Applying Serfling models to monthly mortality and influenza circulation data between October 1997 and July 2014 in the United States and Mexico, we show corresponding peaks in excess mortality during the 2009 H1N1 “swine flu” pandemic and during the resurgent 2013–2014 H1N1 outbreak for those born at the time of the 1957 H2N2 “Asian flu” pandemic. We suggest that the phenomenon observed in 1918 is not unique and points to exposure to pandemic influenza early in life as a risk factor for mortality during subsequent heterosubtypic pandemics.http://mbio.asm.org/cgi/content/full/9/1/e02091-17
collection DOAJ
language English
format Article
sources DOAJ
author Alain Gagnon
Enrique Acosta
Stacey Hallman
Robert Bourbeau
Lisa Y. Dillon
Nadine Ouellette
David J. D. Earn
D. Ann Herring
Kris Inwood
Joaquin Madrenas
Matthew S. Miller
W. Ian Lipkin
spellingShingle Alain Gagnon
Enrique Acosta
Stacey Hallman
Robert Bourbeau
Lisa Y. Dillon
Nadine Ouellette
David J. D. Earn
D. Ann Herring
Kris Inwood
Joaquin Madrenas
Matthew S. Miller
W. Ian Lipkin
Pandemic Paradox: Early Life H2N2 Pandemic Influenza Infection Enhanced Susceptibility to Death during the 2009 H1N1 Pandemic
mBio
author_facet Alain Gagnon
Enrique Acosta
Stacey Hallman
Robert Bourbeau
Lisa Y. Dillon
Nadine Ouellette
David J. D. Earn
D. Ann Herring
Kris Inwood
Joaquin Madrenas
Matthew S. Miller
W. Ian Lipkin
author_sort Alain Gagnon
title Pandemic Paradox: Early Life H2N2 Pandemic Influenza Infection Enhanced Susceptibility to Death during the 2009 H1N1 Pandemic
title_short Pandemic Paradox: Early Life H2N2 Pandemic Influenza Infection Enhanced Susceptibility to Death during the 2009 H1N1 Pandemic
title_full Pandemic Paradox: Early Life H2N2 Pandemic Influenza Infection Enhanced Susceptibility to Death during the 2009 H1N1 Pandemic
title_fullStr Pandemic Paradox: Early Life H2N2 Pandemic Influenza Infection Enhanced Susceptibility to Death during the 2009 H1N1 Pandemic
title_full_unstemmed Pandemic Paradox: Early Life H2N2 Pandemic Influenza Infection Enhanced Susceptibility to Death during the 2009 H1N1 Pandemic
title_sort pandemic paradox: early life h2n2 pandemic influenza infection enhanced susceptibility to death during the 2009 h1n1 pandemic
publisher American Society for Microbiology
series mBio
issn 2150-7511
publishDate 2018-01-01
description Recent outbreaks of H5, H7, and H9 influenza A viruses in humans have served as a vivid reminder of the potentially devastating effects that a novel pandemic could exert on the modern world. Those who have survived infections with influenza viruses in the past have been protected from subsequent antigenically similar pandemics through adaptive immunity. For example, during the 2009 H1N1 “swine flu” pandemic, those exposed to H1N1 viruses that circulated between 1918 and the 1940s were at a decreased risk for mortality as a result of their previous immunity. It is also generally thought that past exposures to antigenically dissimilar strains of influenza virus may also be beneficial due to cross-reactive cellular immunity. However, cohorts born during prior heterosubtypic pandemics have previously experienced elevated risk of death relative to surrounding cohorts of the same population. Indeed, individuals born during the 1890 H3Nx pandemic experienced the highest levels of excess mortality during the 1918 “Spanish flu.” Applying Serfling models to monthly mortality and influenza circulation data between October 1997 and July 2014 in the United States and Mexico, we show corresponding peaks in excess mortality during the 2009 H1N1 “swine flu” pandemic and during the resurgent 2013–2014 H1N1 outbreak for those born at the time of the 1957 H2N2 “Asian flu” pandemic. We suggest that the phenomenon observed in 1918 is not unique and points to exposure to pandemic influenza early in life as a risk factor for mortality during subsequent heterosubtypic pandemics.
url http://mbio.asm.org/cgi/content/full/9/1/e02091-17
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