American Journal of Epidemiology Vol. 121, No. 6: 811-822
Copyright © 1985 by The Johns Hopkins University School of Hygiene and Public Health
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TECUMSEH STUDY OF ILLNESS. XIII. INFLUENZA INFECTION AND DISEASE, 1976–1981
1Department of Epidemiology, School of Public Health, University of Michigan Ann Arbor, MI 48109
2Department of Biostatistics, School of Public Health, University of Michigan Ann Arbor, MI.
Send reprint requests to Dr. Arnold S. Monto at this address
The occurrence of influenza was followed in Tecumseh, Michigan during the five year period 1976–1981 by identifying onset of acute respiratory illness and by virus isolation and serology. Type B outbreaks were observed in 1976–1977 and 1979–1980, type A (H3N2) in 1977–1978 and 1980–1981, and type A (H1N1) viruses in 1977–1978, 1978–1979, and 1980–1981. Evidence of low level circulation of viruses in the year preceding an outbreak was not obtained. Age-specific isolation rates from specimens collected by the community physicians differed from age-specific isolation rates from specimens collected from the surveillance, suggesting the operation of a selection mechanism in the former. Symptoms associated with virus isolation were strongly influenced by age. Within age groups, several variables, especially median duration, indicated type A (H3N2) had produced the most severe illnesses, type A (H1N1) the mildest, with type B intermediate. Age-specific infection rates determined by serology for the 1976–1977 and 1977–1978 influenza seasons confirmed the consistently high rates for type A (H3N2) in children with some fall-off with increasing age. Type A (H1N1) rates peaked in children aged 5–19 years and type B in children aged 5–14 years. This may be related in part to insensitivity of the hemagglutinatlon inhibition test in those under age 5 years. Infection with type A (H1N1) was detected at low frequency in adults. Pathogenicity was caiculated based on the serologic data. It was estimated for all ages combined that, at a minimum, typo A (H3N2) infection produced febrile illness in 25% of cases and type B infection produced respiratory illness in 34% of cases.
influenza; respiratory tract infections; serology
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