{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,9]],"date-time":"2026-10-09T06:03:49Z","timestamp":1791525829420,"version":"4.3.4"},"reference-count":20,"publisher":"Wiley","issue":"6","license":[{"start":{"date-parts":[[2022,8,3]],"date-time":"2022-08-03T00:00:00Z","timestamp":1659484800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/100010269","name":"Wellcome Trust","doi-asserted-by":"publisher","award":["201440\/Z\/16\/Z"],"award-info":[{"award-number":["201440\/Z\/16\/Z"]}],"id":[{"id":"10.13039\/100010269","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100000780","name":"European Commission","doi-asserted-by":"publisher","award":["231807"],"award-info":[{"award-number":["231807"]}],"id":[{"id":"10.13039\/501100000780","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Influenza Resp Viruses"],"published-print":{"date-parts":[[2022,11]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Better understanding of risk factors for influenza could help improve seasonal and pandemic planning. There is a dearth of literature on area\u2010level risk factors such as population density and rural\/urban living.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We used data from Flusurvey, an online community\u2010based cohort that records influenza events. The study outcome was symptoms of influenza\u2010like illness (ILI). Multivariable Poisson regression analysis was used to explore associations of both population density and rural\/urban status with rate of ILI symptoms and whether these effects differed by vaccination status.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Of the 6177 study participants, the median age was 45 (IQR 32\u201357), 65.73% were female, and 66% reported at least one episode of ILI symptoms between 2011 and 2016. We found no evidence to suggest that the rate of ILI symptoms was higher in the medium [RR 1.02 (95% CI 0.95\u20131.09)] or high [RR 1.02 (95% CI 0.96\u20131.09)] population density group versus the low population density group. This was the same for the effect of urban living [RR 0.96 (95% CI 0.90\u20131.03)] versus rural living on symptom rate. There was weak evidence to suggest that the ILI symptom rate was lower in urban areas compared with rural areas among unvaccinated individuals only [RR 0.90 (95% CI 0.83\u20130.99)], whereas no difference was seen among vaccinated individuals [1.04 (95% CI 0.94\u20131.16)].<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Although neither population density nor rural\/urban status was associated with ILI symptom rate in this community cohort, future research that incorporates activity and contact patterns will help to elucidate this relationship further.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/irv.13032","type":"journal-article","created":{"date-parts":[[2022,8,3]],"date-time":"2022-08-03T23:40:05Z","timestamp":1659570005000},"page":"1183-1190","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":11,"title":["Investigating the effects of population density of residence and rural\/urban\u00a0classification on rate of influenza\u2010like illness symptoms in England and Wales"],"prefix":"10.1111","volume":"16","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-8537-2855","authenticated-orcid":false,"given":"Louis","family":"Tunnicliffe","sequence":"first","affiliation":[{"name":"Department of Non\u2010communicable Disease Epidemiology, Faculty of Epidemiology and Population Health London School of Hygiene and Tropical Medicine  London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4524-3180","authenticated-orcid":false,"given":"Charlotte","family":"Warren\u2010Gash","sequence":"additional","affiliation":[{"name":"Department of Non\u2010communicable Disease Epidemiology, Faculty of Epidemiology and Population Health London School of Hygiene and Tropical Medicine  London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2022,8,3]]},"reference":[{"key":"e_1_2_9_2_1","unstructured":"Public Health England.Surveillance of influenza and other respiratory viruses in the UK Winter 2018 to 2019. Public Health England;2019:1\u201057."},{"key":"e_1_2_9_3_1","doi-asserted-by":"publisher","DOI":"10.2105\/AJPH.2015.303018"},{"key":"e_1_2_9_4_1","doi-asserted-by":"publisher","DOI":"10.1126\/science.aat6030"},{"key":"e_1_2_9_5_1","doi-asserted-by":"publisher","DOI":"10.20955\/r.90.74\u201094"},{"key":"e_1_2_9_6_1","doi-asserted-by":"publisher","DOI":"10.1098\/rspb.2007.1477"},{"key":"e_1_2_9_7_1","unstructured":"NishiuraH ChowellG.Rurality and pandemic influenza: geographic heterogeneity in the risks of infection and death in Kanagawa Japan (1918\u20131919)."},{"key":"e_1_2_9_8_1","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0031162"},{"key":"e_1_2_9_9_1","doi-asserted-by":"publisher","DOI":"10.1186\/1471\u20102334\u201011\u201068"},{"key":"e_1_2_9_10_1","doi-asserted-by":"publisher","DOI":"10.1017\/S0950268811001804"},{"key":"e_1_2_9_11_1","doi-asserted-by":"publisher","DOI":"10.3390\/v12010095"},{"key":"e_1_2_9_12_1","unstructured":"Office for National Statistics.National Records of Scotland.Northern Ireland Statistics and Research Agency.2011 Census aggregate data. UK Data Service;2016."},{"key":"e_1_2_9_13_1","unstructured":"Office for National Statistics.2001 Census aggregate data. UK Data Service;2011."},{"key":"e_1_2_9_14_1","doi-asserted-by":"publisher","DOI":"10.1097\/EDE.0000000000000340"},{"key":"e_1_2_9_15_1","doi-asserted-by":"publisher","DOI":"10.1093\/pubmed\/fdx048"},{"issue":"1","key":"e_1_2_9_16_1","first-page":"2","article-title":"A narrative review of influenza: a seasonal and pandemic disease","volume":"42","author":"Moghadami M","year":"2017","journal-title":"Iran J Med Sci"},{"key":"e_1_2_9_17_1","doi-asserted-by":"publisher","DOI":"10.2807\/1560\u20107917.ES.2017.22.14.30504"},{"key":"e_1_2_9_18_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmjopen\u20102011\u2010000234"},{"key":"e_1_2_9_19_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmjopen\u20102020\u2010039849"},{"key":"e_1_2_9_20_1","unstructured":"Ministry of Housing Communities and Local Government.The English indices of deprivation 2019. London: Ministry of Housing Communities and Local Government;2019:1\u201087."},{"key":"e_1_2_9_21_1","article-title":"Comparison of risk factor associations in UK Biobank against representative, general population based studies with conventional response rates: prospective cohort study and individual participant meta\u2010analysis","author":"Batty GD","year":"2020","journal-title":"BMJ"}],"container-title":["Influenza and Other Respiratory Viruses"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/irv.13032","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1111\/irv.13032","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/irv.13032","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,7,31]],"date-time":"2024-07-31T12:00:07Z","timestamp":1722427207000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/irv.13032"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2022,8,3]]},"references-count":20,"journal-issue":{"issue":"6","published-print":{"date-parts":[[2022,11]]}},"alternative-id":["10.1111\/irv.13032"],"URL":"https:\/\/doi.org\/10.1111\/irv.13032","archive":["Portico"],"relation":{"has-review":[{"id-type":"doi","id":"10.1111\/IRV.13032\/v1\/decision1","asserted-by":"object"},{"id-type":"doi","id":"10.1111\/IRV.13032\/v2\/response1","asserted-by":"object"},{"id-type":"doi","id":"10.1111\/IRV.13032\/v2\/decision1","asserted-by":"object"}]},"ISSN":["1750-2640","1750-2659"],"issn-type":[{"value":"1750-2640","type":"print"},{"value":"1750-2659","type":"electronic"}],"subject":[],"published":{"date-parts":[[2022,8,3]]},"assertion":[{"value":"2022-06-06","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2022-07-21","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2022-08-03","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}