Epidemiological investigation of an outbreak of pandemic influenza A (H1N1) 2009 in a boarding school: serological analysis of 1570 cases
Abstract
Background A large number of 2009 pandemic influenza A (H1N1) infections were localized in school populations.Objectives To describe the epidemiology, clinical features and risk factors associated with an outbreak that occurred at a vocational boarding school in Guangzhou, P.R. China.Study design Data were collected prospectively and retrospectively through the use of on-site doctors and a post-outbreak survey and blood collection. The survey was used to confirm symptoms, and to investigate a series of flu-related factors such as dormitory conditions, health habits, vaccine history and population contact history. Blood samples were taken for serological analysis. Pandemic H1N1 infection was initially confirmed by a real-time RT-PCR assay. Following the identification of the outbreak by the Guangzhou CDC on September 4, cases were diagnosed symptomatically and retrospectively by serological analysis using the hemagglutination inhibition assay and a neutralization assay.Results The infection rate was 32% (505/1570) and the attack rate was 22.2% (349/1570). The asymptomatic infection rate was 9.9% (156/1570). Sharing a classroom (OR=2.17, 95% CI: 1.62-2.91) and dormitory space (OR=2.32, 95% CI: 1.84-2.93) was associated with higher rates of infection. Opening windows for ventilation was the only control measure that significantly protected against infection.Conclusion Social isolation and quarantine should be used to prevent the spread of infection. Ventilation and a control of air flow between classrooms and dorms should be implemented as possible. School closures may be effective if implemented early.
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- Authors
- Li, T., Liu, Y., Di, B., Wang, M., Shen, J., Zhang, Y., Chen, X., Yuan, J., Wu, J., & Li, K.
- Affiliations
- Guangzhou Center for Disease Control and Prevention (CN)
- Corresponding author
- Wang, Ming
- Venue
- Journal of Clinical Virology
- Publisher
- Elsevier BV
- Published
- 2011-03
- Volume
- 50
- Issue
- 3
- Pages
- 235-239
- ISSN
- 1386-6532 (ISSN-L)
- OpenAlex
- W2139444345
- Cited by
- 25
- References
- 19
- Citations by year
- 2024: 1 · 2022: 1 · 2021: 2 · 2020: 1 · 2018: 2 · 2017: 5 · 2015: 4 · 2013: 5 · 2012: 1
- FWCI
- 2.09
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Journal of Clinical Virology (publishedVersion)
- PubMed (publishedVersion)
- The HKU Scholars Hub (University of Hong Kong) (submittedVersion)
- Topics
- Health Sciences › Medicine › Epidemiology › Influenza Virus Research Studies
- Health Sciences › Medicine › Epidemiology › Respiratory viral infections research
- Health Sciences › Medicine › Infectious Diseases › Viral Infections and Outbreaks Research
- Keywords
- 2009 pandemic influenza A (H1N1), influenza outbreak, boarding schools, school outbreak, seroprevalence, asymptomatic infection, risk factors, ventilation, social isolation, quarantine, school closures, hemagglutination inhibition test, neutralization test
- MeSH terms
- Adolescent, Antibodies, Viral, China, Disease Outbreaks, Female, Hemagglutination Inhibition Tests, Humans, Influenza, Human, Male, Surveys and Questionnaires, Risk Factors, RNA, Viral, Schools, Reverse Transcriptase Polymerase Chain Reaction, Influenza A Virus, H1N1 Subtype, Young Adult
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