Notes from the Field: Outbreak of 2009 Pandemic Influenza A (H1N1) Virus at a Large Public University in Delaware, April–May 2009

Iuliano, A. Danielle; Reed, Carrie; Guh, Alice; Desai, Mitesh; Dee, Deborah L.; Kutty, Preeta K.; Gould, L. Hannah; Sotir, Mark J.; Grant, Gavin B.; Lynch, Michael; Mitchell, Tarissa; Getchell, Jane P.; Shu, Bo; Villanueva, Julie; Lindstrom, Stephen; Massoudi, Mehran S.; Siebold, Joseph; Silverman, Paul; Armstrong, Gregory L.; Swerdlow, David L.

doi:10.1086/649555

Cited by 93 publications

(80 citation statements)

References 6 publications

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“…For the patients with pandemic (H1N1) 2009 virus infection, fever (91%) was the most common manifestation, being followed by cough (81.6%), myalgia (71.4%), headache (64.3%) and sore throat (53.7%). These manifestations appeared in similar proportions to those described in other European countries and the Unites States of America [9,10,11]. Manifestations such as diarrhoea and apyrexia were described in a greater proportion of patients from Asian countries.…”

Section: Discussionsupporting

confidence: 76%

Clinical manifestations of pandemic (H1N1) 2009 in the ambulatory setting

Duque

Vaz

Mota

et al. 2011

J Infect Dev Ctries

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Introduction: In June 2009, the World Health Organization declared an influenza pandemic associated with the pandemic (H1N1) 2009 strain. It was summer in the northern hemisphere, and therefore travelling and vacation time, which also provided an increased opportunity for the dissemination of respiratory diseases. Methodology: We reviewed the paper case report forms from all the patients with influenza-like illnesses with nasopharyngeal samples submitted for laboratory diagnosis of pandemic (H1N1) (75%) were the most affected. Most of the patients (91%) presented with fever. A group of symptoms were positively correlated with the probability of pandemic (H1N1) 2009 infection: cough, epistaxis, lack of dyspnea or vomiting, fever, headache and myalgia. Conclusions: During the first wave of the pandemic influenza, young individuals were the most affected, and in the ambulatory setting, presentation was of a mild febrile illness without complications.

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Section: Discussionsupporting

confidence: 76%

Clinical manifestations of pandemic (H1N1) 2009 in the ambulatory setting

Duque

Vaz

Mota

et al. 2011

J Infect Dev Ctries

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“…Of those who denied ARI, 36·9% had evidence of H1N1 virus infection as determined using complement fixation or hemagglutination‐inhibition antibody assays 13. Outbreaks of influenza have been documented in similarly congregate settings, including cruise ship travelers and university students 15, 16…”

Section: Discussionmentioning

confidence: 99%

Seroepidemiologic investigation of an outbreak of pandemic influenza A H1N1 2009 aboard a US Navy Vessel—San Diego, 2009

Khaokham

Selent

Loustalot

et al. 2013

Influenza Resp Viruses

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BackgroundDuring summer 2009, a US Navy ship experienced an influenza‐like illness outbreak with 126 laboratory‐confirmed cases of pandemic influenza A (H1N1) 2009 virus among the approximately 2000‐person crew.MethodsDuring September 24–October 9, 2009, a retrospective seroepidemiologic investigation was conducted to characterize the outbreak. We administered questionnaires, reviewed medical records, and collected post‐outbreak sera from systematically sampled crewmembers. We used real‐time reverse transcription‐PCR or microneutralization assays to detect evidence of H1N1 virus infection.ResultsRetrospective serologic data demonstrated that the overall H1N1 virus infection attack rate was 32%. Weighted H1N1 virus attack rates were higher among marines (37%), junior‐ranking personnel (34%), and persons aged 19–24 years (36%). In multivariable analysis, a higher risk of illness was found for women versus men (odds ratio [OR] = 2·2; 95% confidence interval [CI]: 1·1–4·4), marines versus navy personnel (OR = 1·7; 95% CI, 1·0–2·9), and those aged 19–24 versus ≥35 years (OR = 3·9; 95% CI, 1·2–12·8). Fifty‐three percent of infected persons did not recall respiratory illness symptoms. Among infected persons, only 35% met criteria for acute respiratory illness and 11% for influenza‐like illness.ConclusionsApproximately half of H1N1 infections were asymptomatic, and thus, the attack rate was higher than estimated by clinical illness alone. Enhanced infection control measures including pre‐embarkation illness screening, improved self‐reporting of illness, isolation of ill and quarantine of exposed contacts, and prompt antiviral chemoprophylaxis and treatment might be useful in controlling shipboard influenza outbreaks.

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“…An interesting observation was that the outbreak occurred in November as opposed to April to June as noted in other reports. [4][5][6][9][10][11] An outbreak was noted in Saudi Arabia in the month of October as well.…”

Section: Resultsmentioning

confidence: 99%

“…3 H1N1 has been reported at a number of universities and school across the globe. [4][5][6][7][8] these outbreaks present with different features and patterns and have been dealt with in a variety of ways. regardless the lack of guidelines for H1N1 outbreaks in universities and schools prove to be a challenge in tackling such conditions.…”

Section: Introductionmentioning

confidence: 99%

H1N1 outbreak in a medical college of Pakistan: Implications of control in a resource poor setting

Mahmood¹,

Kumar²,

Jamal³

2012

Int. j. infect. control

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In early November 2009, a pandemic H1N1 virus infection outbreak occurred in a university setting of KarachiPakistan. An unusually high number of students presented with influenza-like illness to the student health clinic and the emergency unit of Aga Khan University Hospital (AKUH) Karachi with a few requiring inpatient admission. We describe the clinical presentation and dynamics of this outbreak of suspected H1N1 as well as factors responsible for the outbreak and simple, cost-effective steps taken to tackle the situation.A brief self-administered questionnaire was distributed amongst students living in university accommodation and a case definition for presumed H1N1 was derived. One hundred and forty nine of these students reported having any of the questionnaire symptoms in the month of November, out of which 58 met the case definition of presumed H1N1. The overall attack rate for an influenza-like illness that describes our case definition of presumed H1N1 in November 2009 at AKUH hostels was 14%.In our study the initial lack of diagnostic facilities at the time of outbreak gives us limited information regarding the true number of H1N1 cases. In a resource limited setting, strategies such as communication and awareness can be most helpful in limiting the spread of the infection.

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Notes from the Field: Outbreak of 2009 Pandemic Influenza A (H1N1) Virus at a Large Public University in Delaware, April–May 2009

Cited by 93 publications

References 6 publications

Clinical manifestations of pandemic (H1N1) 2009 in the ambulatory setting

Clinical manifestations of pandemic (H1N1) 2009 in the ambulatory setting

Seroepidemiologic investigation of an outbreak of pandemic influenza A H1N1 2009 aboard a US Navy Vessel—San Diego, 2009

H1N1 outbreak in a medical college of Pakistan: Implications of control in a resource poor setting

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