Outbreak investigation of upper respiratory tract infection in a prison, Uthaithani province, October 2022

Abstract

On October 28^th, 2022, the situation awareness team of the office of the department of disease control regional 3 (ODPC3) received notification by phone from the prison in Uthaithani province about a cluster of upper respiratory tract symptoms within male prisoners. The investigators including the team from ODPC3, Uthaithani provincial health office, and Uthaithani provincial hospital performed the investigation with the objectives to confirm the diagnosis, describe the outbreak epidemiologically, identify risk factors, and propose the control measures for the outbreak. The investigation activities included: a review of the sick registration book, active case finding among prisoners and warden by using the inclusion criteria of 2 or more symptoms of fever, cough, rhinorrhea, sore throat, difficulty breathing, dyspnea, myalgia, headache, chest pain or diarrhea between 10^th October to 3^rd November 2022, environmental study, specimen sampling for identify the pathogens and finding related contagious behaviors by comparing patients’ behavior with non-sick prisoner using multiple logistic regression statistical model. Result: 78 cases were identified calculated to an attack rate of 10.4%, all were male prisoners without female prisoners or warden who had met the inclusion criteria. The nasal and throat specimens were collected from 9 patients, 5 out of 9 patients were positive for Respiratory syncytial virus. The history of having activities near others within 1 meter had found statistically significantly related to sickness (adjusted OR 7.97, 95% CI 1.82-34.87). This outbreak was controlled after the big cleaning on 29^th – 30^th October 2022, isolation of symptomatic patients, strengthening the measures of masks and use of personal belonging such as glass and towels between prisoners.