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[비만] 미국의 비만 유병율, 2009-2010

건강과대안 — Thu, 29 Aug 2013 03:05:24 +0000

Prevalence of Obesity in the United States, 2009–2010

Cynthia L. Ogden, Ph.D.; Margaret D. Carroll, M.S.P.H.; Brian K. Kit, M.D., M.P.H.;
and Katherine M. Flegal, Ph.D.

NCHS Data Brief ■ No. 82 ■ January 2012

Key findings

Data from the National Health and Nutrition Examination Survey, 2009–2010
• More than one-third of adults and almost 17% of youth were obese in 2009–2010.
• There was no change in the prevalence of obesity among adults or children from 2007–2008 to 2009–2010.
• Obesity prevalence did not differ between men and women.
• Adults aged 60 and over were more likely to be obese than younger adults.

출처 : http://www.cdc.gov/nchs/data/databriefs/db82.pdf

============================================

Perspective: Overweight, mortality and survival.

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[조류독감] 중국 H7N9 조류독감 바이러스 분석 논문(Lancet)

건강과대안 — Mon, 24 Jun 2013 18:33:01 +0000

랜싯(The Lancet)지에 중국에서 발생한 H7N9 조류독감 바이러스에 대한 분석 논문이
게재되었습니다.

2013년 5월 28일까지 실험실 진단을 통해 H7N9 조류독감 바이러스에 감염된 확진
환자에 대한 정보를 분석했는데요, 5월 28일까지 확정진단을 받은 123명의 환자 중에서
37명(30%)가 사망했습니다. 연구진은 여전히 병원에 입원 중인 17명의 환자에 대한
불충분한 자료까지 포함하여 전 연령 층의 입원 환자 중 36%가 사망했다고 밝혔습니다.

연구진은 H7N9 조류독감의 위험도가 예전에 보고된 자료보다는 낮다고 평가했습니다.
그리고 가벼운 증상을 앓는 환자들이 상당히 발생하여 이미 치유가 되었을 가능성이
높다고 추정했습니다.

같은 날짜로 랜싯(The Lancet)지에 게재된 또 다른 논문에서는 H7N9 조류독감에 감염되어
확정진단을 받은 130명 환자의 평균 연령이 62세였으며, 지금까지 H5N1 조류독감에 감염되어
확정진단을 받은 43명 환자의 평균 연령은 26세였다고 비교하였습니다. 도시지역에서 H7N9과
H5N1 조류독감에 감염된 사람 중 남성이 74%였으나, 시골지역에서는 H7N9 조류독감에 감염
된 남성이 62%, H5N1 조류독감에 감염된 남성이 33%로 성별에 따른 차이가 있었음을
밝혔습니다.

그리고 H7N9 조류독감에 감염된 사람의 75%와 H5N1 조류독감에 감염된 사람의 71%가
감염되기 직전 가금류와 접촉한 사실이 있다고 밝혔습니다.(70% 이상의 사례에서 가금류를
매개로 한 인체전염이 밝혀진 셈입니다)

잠복기는 H7N9이 3.1일, H5N1이 3.3일이었으므로 거의 비슷하게 나왔고, 치명률은
H7N9이 36%, H5N1이 70%로 계산되었습니다.(치명률은 H5N1이 훨씬 더 병독력이 높은
것으로 나타났습니다)

The Lancet, Early Online Publication, 24 June 2013

doi:10.1016/S0140-6736(13)61207-

http://www.thelancet.com/journals/lancet/article/PIIS0140-6736(13)61207-6/abstract

Human infection with avian influenza A H7N9 virus: an assessment of clinical severity

Hongjie Yu MD a †, Benjamin J Cowling PhD e †, Luzhao Feng MD a †, Eric HY Lau PhD e †, Qiaohong Liao MD a, Tim K Tsang MPhil e, Zhibin Peng MD a, Peng Wu PhD e, Fengfeng Liu MD a, Vicky J Fang MPhil e, Honglong Zhang MD a, Ming Li ME a, Lingjia Zeng MSc a, Zhen Xu MD a, Zhongjie Li MD a, Huiming Luo MD b, Qun Li MD c, Zijian Feng MD c, Bin Cao PhD f, Weizhong Yang MD d, Dr Joseph T Wu PhD e , Dr Yu Wang PhD d , Prof Gabriel M Leung MD e

Summary

Background

Characterisation of the severity profile of human infections with influenza viruses of animal origin is a part of pandemic risk assessment, and an important part of the assessment of disease epidemiology. Our objective was to assess the clinical severity of human infections with avian influenza A H7N9 virus, which emerged in China in early 2013.

Methods

We obtained information about laboratory-confirmed cases of avian influenza A H7N9 virus infection reported as of May 28, 2013, from an integrated database built by the Chinese Center for Disease Control and Prevention. We estimated the risk of fatality, mechanical ventilation, and admission to the intensive care unit for patients who required hospital admission for medical reasons. We also used information about laboratory-confirmed cases detected through sentinel influenza-like illness surveillance to estimate the symptomatic case fatality risk.

Findings

Of 123 patients with laboratory-confirmed avian influenza A H7N9 virus infection who were admitted to hospital, 37 (30%) had died and 69 (56%) had recovered by May 28, 2013. After we accounted for incomplete data for 17 patients who were still in hospital, we estimated the fatality risk for all ages to be 36% (95% CI 26—45) on admission to hospital. Risks of mechanical ventilation or fatality (69%, 95% CI 60—77) and of admission to an intensive care unit, mechanical ventilation, or fatality (83%, 76—90) were high. With assumptions about coverage of the sentinel surveillance network and health-care-seeking behaviour for patients with influenza-like illness associated with influenza A H7N9 virus infection, and pro-rata extrapolation, we estimated that the symptomatic case fatality risk could be between 160 (63—460) and 2800 (1000—9400) per 100 000 symptomatic cases.

Interpretation

Human infections with avian influenza A H7N9 virus seem to be less serious than has been previously reported. Many mild cases might already have occurred. Continued vigilance and sustained intensive control efforts are needed to minimise the risk of human infection.

Funding

Chinese Ministry of Science and Technology; Research Fund for the Control of Infectious Disease; Hong Kong University Grants Committee; China—US Collaborative Program on Emerging and Re-emerging Infectious Diseases; Harvard Center for Communicable Disease Dynamics; US National Institute of Allergy and Infectious Disease; and the US National Institutes of Health.

==============

The Lancet, Early Online Publication, 24 June 2013

doi:10.1016/S0140-6736(13)61171-X

http://www.thelancet.com/journals/lancet/article/PIIS0140-6736(13)61171-X/abstract

Comparative epidemiology of human infections with avian influenza A H7N9 and H5N1 viruses in China: a population-based study of laboratory-confirmed cases

Benjamin J Cowling PhD a †, Lianmei Jin MD b †, Eric HY Lau PhD a, Qiaohong Liao MD c, Peng Wu PhD a, Hui Jiang MD c, Tim K Tsang MPhil a, Jiandong Zheng PhD c, Vicky J Fang MPhil a, Zhaorui Chang MD c, Michael Y Ni MPH a, Qian Zhang MD c, Dennis KM Ip MPhil a, Jianxing Yu MD c, Yu Li MD c, Liping Wang PhD c, Wenxiao Tu MD b, Ling Meng MD b, Joseph T Wu PhD a, Huiming Luo MD d, Qun Li MD b, Yuelong Shu PhD e, Zhongjie Li MD c, Zijian Feng MD b, Weizhong Yang MD f, Yu Wang PhD f, Prof Gabriel M Leung MD a , Dr Hongjie Yu MD c

Summary

Background

The novel influenza A H7N9 virus emerged recently in mainland China, whereas the influenza A H5N1 virus has infected people in China since 2003. Both infections are thought to be mainly zoonotic. We aimed to compare the epidemiological characteristics of the complete series of laboratory-confirmed cases of both viruses in mainland China so far.

Methods

An integrated database was constructed with information about demographic, epidemiological, and clinical variables of laboratory-confirmed cases of H7N9 (130 patients) and H5N1 (43 patients) that were reported to the Chinese Centre for Disease Control and Prevention until May 24, 2013. We described disease occurrence by age, sex, and geography, and estimated key epidemiological variables. We used survival analysis techniques to estimate the following distributions: infection to onset, onset to admission, onset to laboratory confirmation, admission to death, and admission to discharge.

Findings

The median age of the 130 individuals with confirmed infection with H7N9 was 62 years and of the 43 with H5N1 was 26 years. In urban areas, 74% of cases of both viruses were in men, whereas in rural areas the proportions of the viruses in men were 62% for H7N9 and 33% for H5N1. 75% of patients infected with H7N9 and 71% of those with H5N1 reported recent exposure to poultry. The mean incubation period of H7N9 was 3·1 days and of H5N1 was 3·3 days. On average, 21 contacts were traced for each case of H7N9 in urban areas and 18 in rural areas, compared with 90 and 63 for H5N1. The fatality risk on admission to hospital was 36% (95% CI 26—45) for H7N9 and 70% (56—83%) for H5N1.

Interpretation

The sex ratios in urban compared with rural cases are consistent with exposure to poultry driving the risk of infection—a higher risk in men was only recorded in urban areas but not in rural areas, and the increased risk for men was of a similar magnitude for H7N9 and H5N1. However, the difference in susceptibility to serious illness with the two different viruses remains unexplained, since most cases of H7N9 were in older adults whereas most cases of H5N1 were in younger people. A limitation of our study is that we compared laboratory-confirmed cases of H7N9 and H5N1 infection, and some infections might not have been ascertained.

Funding

Ministry of Science and Technology, China; Research Fund for the Control of Infectious Disease and University Grants Committee, Hong Kong Special Administrative Region, China; and the US National Institutes of Health.

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