The Spread of Influenza AH1N1pdm09 in Victorian School Children in 2009: Implications for Revised Pandemic PlanningReportar como inadecuado




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Background

Victoria was the first state in Australia to experience community transmission of influenza AH1N1pdm09. We undertook a descriptive epidemiological analysis of the first 1,000 notified cases to describe the epidemic associated with school children and explore implications for school closure and antiviral distribution policy in revised pandemic plans.

Methods

Records of the first 1,000 laboratory-confirmed cases of influenza AH1N1pdm09 notified to the Victorian Government Department of Health between 20 May and 5 June 2009 were extracted from the state’s notifiable infectious diseases database. Descriptive analyses were conducted on case demographics, symptoms, case treatment, prophylaxis of contacts and distribution of cases in schools.

Results

Two-thirds of the first 1,000 cases were school-aged 5–17 years with cases in 203 schools, particularly along the north and western peripheries of the metropolitan area. Cases in one school accounted for nearly 8% of all cases but the school was not closed until nine days after symptom onset of the first identified case. Amongst all cases, cough 85% was the most commonly reported symptom followed by fever 68% although this was significantly higher in primary school children 76%. The risk of hospitalisation was 2%. The median time between illness onset and notification of laboratory confirmation was four days, with only 10% of cases notified within two days of onset and thus eligible for oseltamivir treatment. Nearly 6,000 contacts were followed up for prophylaxis.

Conclusions

With a generally mild clinical course and widespread transmission before its detection, limited and short-term school closures appeared to have minimal impact on influenza AH1N1pdm09 transmission. Antiviral treatment could rarely be delivered to cases within 48 hours of symptom onset. These scenarios and lessons learned from them need to be incorporated into revisions of pandemic plans.



Autor: James E. Fielding , Isabel Bergeri, Nasra Higgins, Heath A. Kelly, Julian Meagher, Emma S. McBryde, Rodney Moran, Margaret E. Hel

Fuente: http://plos.srce.hr/



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