Epidemiology and clinical features of interpandemic influenza

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Discussion topics from Pandemic Influenza, 2nd Edition
Edited by Jonathan Van-Tam, MBE BmedSci (Hons) BMBS DM FFPH FRSPH, Professor of Health Protection University of Nottingham, UK and Chloe Sellwood, BSc (Hons) PhD FRSPH DipHEP, Pandemic and Seasonal Influenza Resilience Manager, NHS London, UK
© CAB International 2013. All rights reserved. No part of this publication may be reproduced in any form or by any means, electronically, mechanically, by photocopying, recording or otherwise, without the prior permission of the copyright owners.

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Epidemiology and clinical features of interpandemic influenza

By J Van-Tam and C Sellwood

What is the public health importance of interpandemic influenza?

Because of its recurrent nature, and its occurrence in short but intense epidemics the public health importance of interpandemic (or seasonal) influenza is considerable. It is estimated that in the relatively ‘quiet' period between 1990 and 1999 in the USA, interpandemic influenza accounted for 36,000 deaths per annum. Short epidemic periods of intense activity also produce pressure on health services.

What is the relationship between pandemic and interpandemic influenza?

Pandemic viruses are, by definition, novel in humans. However they go on to become ‘normal' interpandemic or seasonal viruses. The A(H3N2) viruses in current circulation are in fact no more than distant evolved relatives of the A(H3N2) virus that cause the 1968 pandemic. Influenza A(H1N1)pdm09 was classified as a pandemic virus in winter 2009/10 but as a seasonal virus in winter 2010-11.

What are the characteristic epidemiological features of interpandemic influenza?

Interpandemic influenza is characterized by distinct seasonality in the temperate zones of the world (winter activity), explosive epidemics typically lasting 6-8 weeks, and serological attack rates of 5-15% of whom perhaps one half become ill with symptoms.

Who carries the main burden of interpandemic influenza?

Paradoxically, interpandemic influenza is a disease of pre-school and school age children in whom the highest attack rates are recorded. However the burden of excess mortality and complications are concentrated in the very young (typically under 2 years of age), the elderly and people with underlying high-risk conditions such as diabetes, lung disease and heart disease.
"Interpandemic influenza is the technically more correct term for seasonal influenza’"


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