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Local Spatial and Temporal Processes of Influenza in Pennsylvania, USA: 2003–2009
Authors
A Koch
AC Lowen
+44 more
AC Lowen
Alessandro Vespignani
AS Mugglin
Bard Ermentrout
BS Finkelman
C Viboud
C Viboud
C Viboud
C Viboud
D Gesch
D Onozuka
D Weycker
DB Gesch
Derek A. T. Cummings
Donald S. Burke
E de Arruda
EJ Crighton
FT Chew
H Jia
J Paget
J Shaman
J Shaman
James H. Stark
JB Wenger
JW Tang
JW Tang
KL Nichol
KM Sullivan
L Anselin
L Simonsen
L Simonsen
LAGC Waller
R Proff
Ravi Sharma
RM Assuncao
RM Merrill
S Altizer
S Greene
Samuel Stebbins
Stephen Ostroff
Stephen R. Wisniewski
T Sakai
TM Govaert
WJ Alonso
Publication date
28 March 2012
Publisher
Public Library of Science
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PubMed
Abstract
Background: Influenza is a contagious respiratory disease responsible for annual seasonal epidemics in temperate climates. An understanding of how influenza spreads geographically and temporally within regions could result in improved public health prevention programs. The purpose of this study was to summarize the spatial and temporal spread of influenza using data obtained from the Pennsylvania Department of Health's influenza surveillance system. Methodology and Findings: We evaluated the spatial and temporal patterns of laboratory-confirmed influenza cases in Pennsylvania, United States from six influenza seasons (2003-2009). Using a test of spatial autocorrelation, local clusters of elevated risk were identified in the South Central region of the state. Multivariable logistic regression indicated that lower monthly precipitation levels during the influenza season (OR = 0.52, 95% CI: 0.28, 0.94), fewer residents over age 64 (OR = 0.27, 95% CI: 0.10, 0.73) and fewer residents with more than a high school education (OR = 0.76, 95% CI: 0.61, 0.95) were significantly associated with membership in this cluster. In addition, time series analysis revealed a temporal lag in the peak timing of the influenza B epidemic compared to the influenza A epidemic. Conclusions: These findings illustrate a distinct spatial cluster of cases in the South Central region of Pennsylvania. Further examination of the regional transmission dynamics within these clusters may be useful in planning public health influenza prevention programs. © 2012 Stark et al
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