An outbreak investigation of influenza in a special education school, Phrae province, 2018

Authors

  • Charuttaporn Jitpeera Division of Epidemiology, Department of Disease Control
  • Suphanat Wongsanuphat Division of Epidemiology, Department of Disease Control
  • Bhurinud Salakij Division of Epidemiology, Department of Disease Control
  • Prangsiri Nalam Division of Epidemiology, Department of Disease Control
  • Thawabhorn Jannok Division of Communicable Diseases, Department of Disease Control
  • Watcharapon Sinprawat Provincial Health Office, Phrae
  • Amnuay Tipsriraj Office of Disease Prevention and Control, Region 1 Chiang Mai
  • Nattapon Ekrarakrungreung Office of Disease Prevention and Control, Region 1 Chiang Mai

DOI:

https://doi.org/10.14456/dcj.2022.20

Keywords:

outbreak investigation, influenza, special education school, Thailand

Abstract

On 9 August 2018, the Bureau of Epidemiology (BOE) received a notification that there was a cluster of influenza-like illness (ILI) cases in a Special Education School located in Phrae province. A joint investigation team conducted an outbreak investigation to confirm the diagnosis of influenza and implemented control measures. A retrospective cohort study was conducted and active case finding was performed. Suspected cases were defined as any person in the school who had at least 2 of the following symptoms: fever, cough, and sore throat during 14 July to 17 August 2018. Specimens from suspected cases were collected by nasopharyngeal or throat swab for real-time reverse transcription-polymerase chain reaction (rRT-PCR). Confirmed cases were suspected cases with RT-PCR positive for influenza. An environmental study was conducted. Univariate and multivariate analysis were done to identify related factors of influenza infection. Risk Ratio (RR) and 95% Confidence Interval (CI) were used. We found 89 suspected cases and 13 confirmed cases among 317 screened people (attack rate 29.0%). The source of this outbreak cannot be identified, but the outbreak had occurred after Buddhist Lent holiday. All confirmed cases’ specimens were positive for influenza A (H1N1) pandemic 2009. We found a protective factor among students was hand washing (RR=0.22, 95% CI=0.04-0.84), and the risk factor among staff and teachers was sharing clothes with others (RR=2.14, 95% CI=1.12-4.06). All patients received Oseltamivir and one week school closure was implemented to stop the spreading. Students in the school were in a risk group and influenza vaccination was recommended.

References

Centers for Disease Control and Prevention. Influenza (Flu) [Internet]. 2018 [cited 2018 Oct 10]. Available from: https://www.cdc.gov/flu/keyfacts.htm

Centers for Disease Control and Prevention. Flu symptoms & diagnosis [Internet]. 2018 [cited 2018 Oct 10]. Available from: https://www.cdc.gov/flu/symptoms/index.html.

Centers for Disease Control and Prevention. Flu & young children [Internet]. 2018 [cited 2018 Oct 10]. Available from: https://www.cdc.gov/flu/highrisk/children.htm

Influenza in children. Paediatr Child Health. 2005;10(8):485-487. doi:10.1093/pch/10.8.485

Centers for Disease Control and Prevention. People at High Risk For Flu Complications [Internet]. 2018 [cited 2018 Oct 10]. Available from: https://www.cdc.gov/flu/highrisk/index.htm

Centers for Disease Control and Prevention. Who Needs a Flu Vaccine and When [Internet]. 2018 [cited 2018 Oct 10]. Available from: https://www.cdc.gov/flu/prevent/vaccinations.htm

Division of Epidemiology, Department of Disease Control, Ministry Of Public Health. R506 Influenza [Internet]. 2018 [cited 2018 Oct 10]. Available from: http://www.boe.moph.go.th/boedb/surdata/disease.php?ds=15 (in Thai)

Division of Epidemiology, Department of Disease Control, Ministry Of Public Health. Outbreak verification [Internet]. 2018 [cited 2018 Oct 10]. Available from: http://www.boeeoc.moph.go.th/eventbase (in Thai)

Suthachana S, Saritapirak N. Event-based surveillance of influenza outbreak in Thailand during 2016-2018. Weekly Epidemiological Surveillance Report. 2018; 49: 577-85. (in Thai)

Centers for Disease Control and Prevention. Disability and Health [Internet]. 2018 [cited 2018 Dec 1]. Available from: https://www.cdc.gov/ncbddd/disabilityandhealth/relatedconditions.html

Thirasak S, Kantanon O. An outbreak investigation of influenza B in the boarding school of Takuapa district, Phang nga Province, Thailand, 17–29 January 2018. Weekly Epidemiological Surveillance Report 2019; 50: 757–64

Namwong T, Wisitphachonchai P, Khampat S, Viriyapan S, Theangthonglang P, Wongwien K, Chaytong R. An outbreak investigation of Influenza B in high school A, Yasothon Province, Thailand, 19–22 February 2014. Weekly Epidemiological Surveillance Report 2016; 47: 785-91.

Chaichin P, Sutthi P. Outbreak investigation of influenza A H3N2 in a primary school, Prakhon Chai, Buriram province, Thailand, 10 July-10 September 2015. Weekly Epidemiological Surveillance Report 2016; 47: S1-8.

Division of Epidemiology, Department of Disease Control. Case definition for Communicable Diseases Surveillance, Thailand, 2020. Nonthaburi: Division of Epidemiology, Department of Control (TH); 2020.

Moreau JF, Fink EL, Hartman ME, Angus DC, Bell MJ, Linde-Zwirble WT, et al. Hospitalizations of Children With Neurologic Disorders in the United States. Pediatric Critical Care Medicine. 2013;14(8):801

Wongsanuphat S, Wonghirundecha T, Boonwisat P, Kerdsalung K, Ploddi K, SawangjaengI, et al. Behavioral and environmental factors associated with an influenza outbreak in a prison of Thailand. OSIR. 2019 Sep;12(4):116-125.

Huai Y, Lin J, Varma JK, Peng Z, He J, Cheng C, et al. Original Article: A primary school outbreak of pandemic 2009 influenza A (H1N1) in China. Influenza and Other Respiratory Viruses. 2010;4(5):259–66.

Duong TN, Tho NTT, Hien NT, Olowokure B. An outbreak of influenza A(H1N1) pdm09 virus in a primary school in Vietnam. BMC Research Notes. 2015;8(1):1-4.

Thaihealth.or.th. Promoting 7 risk groups for influenza vaccination - Thaihealth.or.th | Thai Health Promotion Foundation [Internet]. 2018 [cited 2018 Nov 28]. Available from: http://www.thaihealth.or.th/Content/42702-รณรงค์ 7 กลุ่มเสี่ยงรับวัคซีนป้องกันไข้หวัดใหญ่.html (in Thai)

Centers for Disease Control and Prevention. CDC Newsroom [Internet]. 2018 [cited 2018 Oct 10]. Available from: https://www.cdc.gov/media/releases/2017/p0403-flu-vaccine.html

Centers for Disease Control and Prevention. Influenza (Flu) [Internet]. 2018 [cited 2018 Oct 10]. Available from: https://www.cdc.gov/flu/protect/neurologic-pediatric.htm

Mizumoto K, Yamamoto T, Nishiura H. Contact behaviour of children and parental employment behaviour during school closures against the pandemic influenza A (H1N1-2009) in Japan. Journal of International Medical Research. 2013;41(3):716–24.

Braunack-Mayer A, Tooher R, Collins JE, Street JM, Marshall H. Understanding the school community’s response to school closures during the H1N1 2009 influenza pandemic. BMC Public Health. 2013;13(1):344-359.

Jackson C, Vynnycky E, Hawker J, Olowokure B, Mangtani P. School closures and influenza: systematic review of epidemiological studies. BMJ Open. 2013;3(2):1-10.

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Published

2022-03-30

How to Cite

1.
Jitpeera C, Wongsanuphat S, Salakij B, Nalam P, Jannok T, Sinprawat W, Tipsriraj A, Ekrarakrungreung N. An outbreak investigation of influenza in a special education school, Phrae province, 2018. Dis Control J [Internet]. 2022 Mar. 30 [cited 2024 Apr. 24];48(1):227-38. Available from: https://he01.tci-thaijo.org/index.php/DCJ/article/view/248329

Issue

Vol. 48 No. 1 (2022): January-March

Section

Outbreak Investigation

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