Anti-phase synchronization of influenza A/H1N1 and A/H3N2 in Hong Kong and countries in the North Temperate Zone

Epidemiological Characteristics of Influenza A and B in Macau, 2010-2018

Influenza is one of the major respiratory diseases in humans. Macau is a tourist city with high density of population and special population mobility. The study on the epidemiological characteristics of influenza in Macau should bring great value for preventing influenza in tourist cities like Macau in the world. In this study, we collected a total of 104,874 samples with influenza-like illness (ILI) in Macau from 2010 to 2018. Chi-square test and binary multivariable logistic regression were used to investigate the epidemiological characteristics of influenza A and B in Macau. Among these ILI samples, the overall positive rate is 17.17% for influenza A and 6.97% for influenza B. The epidemics of influenza in three years (i.e., 2012, 2017 and 2018) differ from the remaining years (i.e., normal years). In a normal year, influenza A occurs year-round whereas influenza B is seasonal. Our research shows significant differences in influenza infections between different age groups in normal years. Interestingly, our analysis shows no significant difference between locals and tourists in influenza A and B infection in a normal year, whereas the odds of influenza A in tourists were significantly higher than those in locals in July 2017 and the odds of influenza B in tourists were significantly higher than those in locals in January-February 2012 and January-February 2018. This is possibly attributed by the policy of free vaccination to everyone in Macau. These findings should be valuable for preventing influenza in not only Macau but also the world.

Mathematical models of transmission dynamics and vaccine strategies in Hong Kong during the 2017-2018 winter influenza season

Two mathematical models described by simple ordinary differential equations are developed to investigate the Hong Kong influenza epidemic during 2017-2018 winter, based on overall epidemic dynamics and different influenza subtypes. The first model, describing the overall epidemic dynamics, provides the starting data for the second model which different influenza subtypes, and whose dynamics is further investigated. Weekly data from December 2017 to May 2018 are obtained from the data base of the Centre of Health Protection in Hong Kong, and used to parametrise the models. With the help of these models, we investigate the impact of different vaccination strategies and determine the corresponding critical vaccination coverage for different vaccine efficacies. The results suggest that at least 72% of Hong Kong population should have been vaccinated during 2017-2018 winter to prevent the seasonal epidemic by herd immunity (while data showed that only a maximum of 11.6% of the population were vaccinated). Our results also show that the critical vaccination coverage decreases with increasing vaccine efficacy, and the increase in one influenza subtype vaccine efficacy may lead to an increase in infections caused by a different subtype.