Comparative community burden and severity of seasonal and pandemic influenza: results of the Flu Watch cohort study Dr Andrew C Hayward, MD, Ellen B.

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Comparative community burden and severity of seasonal and pandemic influenza: results of the Flu Watch cohort study Dr Andrew C Hayward, MD, Ellen B Fragaszy, MSc, Alison Bermingham, PhD, Lili Wang, PhD, Andrew Copas, PhD, W John Edmunds, PhD, Neil Ferguson, DPhil, Nilu Goonetilleke, PhD, Gabrielle Harvey, MPH, Jana Kovar, PhD, Megan S C Lim, PhD, Andrew McMichael, PhD, Elizabeth R C Millett, MSc, Jonathan S Nguyen-Van-Tam, DM, Irwin Nazareth, PhD, Richard Pebody, MBChB, Faiza Tabassum, PhD, John M Watson, FRCP, Fatima B Wurie, BSc, Prof Anne M Johnson, MD, Maria Zambon, PhD The Lancet Respiratory Medicine Volume 2, Issue 6, Pages 445-454 (June 2014) DOI: 10.1016/S2213-2600(14)70034-7 Copyright © 2014 Hayward et al. Open Access article distributed under the terms of CC BY Terms and Conditions

Figure 1 Rates of illness or PCR-confirmed influenza standardised by age and region Rates of acute respiratory illness, influenza-like illness, and PCR-confirmed influenza per 100 000 person-weeks. Excludes illnesses known to be due to non-influenza viruses. The Lancet Respiratory Medicine 2014 2, 445-454DOI: (10.1016/S2213-2600(14)70034-7) Copyright © 2014 Hayward et al. Open Access article distributed under the terms of CC BY Terms and Conditions

Figure 2 Rates of seasonal and pandemic influenza A infection and PCR-confirmed disease Rates of infection established through seroconversion (four-fold titre rises in unvaccinated individuals) and rates of disease established through PCR-confirmation per 100 person-seasons (95% CIs). The Lancet Respiratory Medicine 2014 2, 445-454DOI: (10.1016/S2213-2600(14)70034-7) Copyright © 2014 Hayward et al. Open Access article distributed under the terms of CC BY Terms and Conditions

Figure 3 Number of expected events in a surveillance practice serving a population of 10 000 people Data for a typical influenza season. The Lancet Respiratory Medicine 2014 2, 445-454DOI: (10.1016/S2213-2600(14)70034-7) Copyright © 2014 Hayward et al. Open Access article distributed under the terms of CC BY Terms and Conditions

Figure 4 Immune profiles to influenza A(H1N1)pdm09 before each influenza season. Profiles before first wave (no vaccine; A), after second wave and before third wave (B), and after third wave (C). HI=haemagglutinin inhibition. The Lancet Respiratory Medicine 2014 2, 445-454DOI: (10.1016/S2213-2600(14)70034-7) Copyright © 2014 Hayward et al. Open Access article distributed under the terms of CC BY Terms and Conditions