TY  - JOUR
A1  - von Kries, Rüdiger
A1  - Weiss, Susanne
A1  - Falkenhorst, Gerhard
A1  - Wirth, Stephan
A1  - Kaiser, Petra
A1  - Huppertz, Hans-Iko
A1  - Tenenbaum, Tobias
A1  - Schroten, Horst
A1  - Streng, Andrea
A1  - Liese, Johannes
A1  - Shai, Sonu
A1  - Niehues, Tim
A1  - Girschick, Hermann
A1  - Kuscher, Ellen
A1  - Sauerbrey, Axel
A1  - Peters, Jochen
A1  - Wirsing von Koenig, Carl Heinz
A1  - Rückinger, Simon
A1  - Hampl, Walter
A1  - Michel, Detlef
A1  - Mertens, Thomas
T1  - Post-Pandemic Seroprevalence of Pandemic Influenza A (H1N1) 2009 Infection (Swine Flu) among Children < 18 Years in Germany
JF  - PLoS ONE
N2  - Background: 

We determined antibodies to the pandemic influenza A (H1N1) 2009 virus in children to assess: the incidence of (H1N1) 2009 infections in the 2009/2010 season in Germany, the proportion of subclinical infections and to compare titers in vaccinated and infected children. 

Methodology/Principal Findings: 

Eight pediatric hospitals distributed over Germany prospectively provided sera from in-or outpatients aged 1 to 17 years from April 1(st) to July 31(st) 2010. Vaccination history, recall of infections and sociodemographic factors were ascertained. Antibody titers were measured with a sensitive and specific in-house hemagglutination inhibition test (HIT) and compared to age-matched sera collected during 6 months before the onset of the pandemic in Germany. We analyzed 1420 post-pandemic and 300 pre-pandemic sera. Among unvaccinated children aged 1-4 and 5-17 years the prevalence of HI titers (>= 1:10) was 27.1% (95% CI: 23.5-31.3) and 53.5% (95% CI: 50.9-56.2) compared to 1.7% and 5.5%, respectively, for pre-pandemic sera, accounting for a serologically determined incidence of influenza A (H1N1) 2009 during the season 2009/2010 of 25,4% (95% CI : 19.3-30.5) in children aged 1-4 years and 48.0% (95% CI: 42.6-52.0) in 5-17 year old children. Of children with HI titers >= 1: 10, 25.5% (95% CI: 22.5-28.8) reported no history of any infectious disease since June 2009. Among vaccinated children, 92% (95%-CI: 87.0-96.6) of the 5-17 year old but only 47.8% (95%-CI: 33.5-66.5) of the 1-4 year old children exhibited HI titers against influenza A virus (H1N1) 2009. 

Conclusion: 

Serologically determined incidence of influenza A (H1N1) 2009 infections in children indicates high infection rates with older children (5-17 years) infected twice as often as younger children. In about a quarter of the children with HI titers after the season 2009/2010 subclinical infections must be assumed. Low HI titers in young children after vaccination with the AS03(B)-adjuvanted split virion vaccine need further scrutiny.
KW  - Hemagglutination inhibition
KW  - Vaccine
KW  - Age
KW  - Immunogenicity
KW  - Prevalence
KW  - Antibody
KW  - Viruses
KW  - England
KW  - Safety
KW  - Risk
Y1  - 2011
U6  - http://nbn-resolving.de/urn/resolver.pl?urn:nbn:de:bvb:20-opus-141698
VL  - 6
IS  - 9
ER  -