期刊
AMERICAN JOURNAL OF EPIDEMIOLOGY
卷 182, 期 8, 页码 723-729出版社
OXFORD UNIV PRESS INC
DOI: 10.1093/aje/kwv115
关键词
incubation period; influenza; influenza A(H7N9); influenza A virus
资金
- Harvard Center for Communicable Disease Dynamics (from US National Institute of General Medical Sciences) [U54 GM088558]
- Health and Medical Research Fund of Health, Welfare and Food Bureau of Hong Kong SAR Government
- Area of Excellence Scheme of Hong Kong University Grants Committee [AoE/M-12/06]
- US National Institutes of Health (Comprehensive International Program for Research on AIDS) [U19 AI51915]
- Chinese Ministry of Science and Technology [2012 ZX10004-201]
- MedImmune Inc. (Gaithersburg, Maryland)
- Sanofi Pasteur (Lyon, France)
- Crucell N.V. (Leiden, the Netherlands)
A novel avian influenza virus, influenza A(H7N9), emerged in China in early 2013 and caused severe disease in humans, with infections occurring most frequently after recent exposure to live poultry. The distribution of A(H7N9) incubation periods is of interest to epidemiologists and public health officials, but estimation of the distribution is complicated by interval censoring of exposures. Imputation of the midpoint of intervals was used in some early studies, resulting in estimated mean incubation times of approximately 5 days. In this study, we estimated the incubation period distribution of human influenza A(H7N9) infections using exposure data available for 229 patients with laboratory-confirmed A(H7N9) infection from mainland China. A nonparametric model (Turnbull) and several parametric models accounting for the interval censoring in some exposures were fitted to the data. For the best-fitting parametric model (Weibull), the mean incubation period was 3.4 days (95% confidence interval: 3.0, 3.7) and the variance was 2.9 days; results were very similar for the nonparametric Turnbull estimate. Under the Weibull model, the 95th percentile of the incubation period distribution was 6.5 days (95% confidence interval: 5.9, 7.1). The midpoint approximation for interval-censored exposures led to overestimation of the mean incubation period. Public health observation of potentially exposed persons for 7 days after exposure would be appropriate.
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