Location-specific patterns of exposure to recent pre-pandemic strains of influenza A in southern China

Justin Lessler, Derek A.T. Cummings, Jonathan M. Read, Shuying Wang, Huachen Zhu, Gavin J.D. Smith, Yi Guan, Chao Qiang Jiang, Steven Riley

Research output: Contribution to journalArticlepeer-review

26 Scopus citations


Variation in influenza incidence between locations is commonly observed on large spatial scales. It is unclear whether such variation occurs on smaller spatial scales and whether it is the result of heterogeneities in population demographics or more subtle differences in population structure and connectivity. Here we show that significant differences in immunity to influenza A viruses among communities in China are not explained by differences in population demographics. We randomly selected households from five randomly selected locations near Guangzhou, China to answer a questionnaire and provide a blood sample for serological testing against five recently circulating influenza viruses. We find a significant reduction in the frequency of detectable neutralization titers with increasing age, levelling off in older age groups. There are significant differences between locations in age, employment status, vaccination history, household size and housing conditions. However, after adjustment, significant variations in the frequency of detectable neutralization titers persists between locations. These results suggest there are characteristics of communities that drive influenza transmission dynamics apart from individual and household level risk factors, and that such factors have effects independent of strain.

Original languageEnglish (US)
Article number423
JournalNature communications
Issue number1
StatePublished - 2011

ASJC Scopus subject areas

  • Chemistry(all)
  • Biochemistry, Genetics and Molecular Biology(all)
  • Physics and Astronomy(all)


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