An outbreak investigation of influenza in a special education school, Phrae province, 2018
DOI:
https://doi.org/10.14456/dcj.2022.20Keywords:
outbreak investigation, influenza, special education school, ThailandAbstract
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.
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