Outbreak Investigation of Influenza-like illness in a Primary School, Lampang Province, Thailand, 2016
Article Sidebar
Main Article Content
Abstract
Background: On 11 Feb 2016, the Epidemiology Unit of Lampang Hospital was notified by the Lampang Provincial Health Office of a cluster of influenza-like illness (ILI) cases with a few confirmed cases of influenza among students in grade 1 of a primary school (school A). The outbreak investigation was conducted from 11 to 19 Feb 2016 by a team from Lampang Hospital together with the Mueang Lampang Surveillance and Rapid Response Team.
Objective: To verify an outbreak, describe its characteristics, identify risk factors and provide this school with control measures. Material and method: This outbreak investigation composed of laboratory investigation, analytic study using retrospective cohort method and environmental study. The study was
conducted on students and teachers from all 11 classes of grade 1 whom were interviewed by using structured questionnaires. Demographic data, symptoms, treatment, risk and protective behaviors were recorded. Multiple logistic regression analysis was used to determine adjusted odds ratio of risk factors.
Results: The probable cases were found in 107 of 357 students (30%) and 3 of 13 teachers (23%). Two of 12 students (17%) tested positive for influenza A by using rapid test. Playing with students who had ILI symptoms (adjusted OR=1.73, 95% CI=1.05 - 2.83) and sitting beside students who had ILI symptoms (adjusted OR=1.34, 95% CI=1.33 - 3.63) were statistically significant risk factors. Control measures consisted of screening for students who had ILI symptoms every morning, using individual water glasses, providing alcohol hand gel in every classroom and permitting sick teachers to be absent from school. Surveillance was continued for 3 weeks. There was no ILI case after 22 Feb 2016.
Conclusion: There was an influenza-like illness outbreak among students in grade 1 of a primary school. Playing with or sitting beside students with ILI symptoms were risk factors for this influenza A outbreak.
Article Details
บทความที่ส่งมาลงพิมพ์ต้องไม่เคยพิมพ์หรือกำลังได้รับการพิจารณาตีพิมพ์ในวารสารอื่น เนื้อหาในบทความต้องเป็นผลงานของผู้นิพนธ์เอง ไม่ได้ลอกเลียนหรือตัดทอนจากบทความอื่น โดยไม่ได้รับอนุญาตหรือไม่ได้อ้างอิงอย่างเหมาะสม การแก้ไขหรือให้ข้อมูลเพิ่มเติมแก่กองบรรณาธิการ จะต้องเสร็จสิ้นเป็นที่เรียบร้อยก่อนจะได้รับพิจารณาตีพิมพ์ และบทความที่ตีพิมพ์แล้วเป็นสมบัติ ของลำปางเวชสาร
References
2. Bureau of Epidemiology. Influenza situation in Thailand [internet]. 2016 [cited 2016 Oct 1]. Available from:http://www.boe.moph.go.th/boedb/surdata/506wk/y58/d15_5258.pdf
3. Neuzil KM, Zhu Y, Griffin MR, Edwards KM, Thompson JM, Tollefson SJ, et al. Burden of interpandemic influenza in children younger than 5 years: a 25-year prospective study. J Infect Dis 2002; 185(2): 147-52
4. Neuzil KM, Mellen BG, Wright PF, Mitchel EF Jr, Griffin MR. The effect of influenza on hospitalizations, outpatient visits, and courses of antibiotics in children. N Engl J Med 2000; 342(4): 225-31.
5. Lessler J, Reich NG, Cummings DT, Nair HP, Jordan HT, Thompson N, et.al. Outbreak of 2009 pandemic influenza A (H1N1) at a New York City school. N Engl J Med. 2009; 361(27): 2628-36.
6. Wutthanarungsan R, Areechokchai D, Jiamsiri S, Silaporn P, Poonaklom P, Jongcherdchootrakul K, et al. An outbreak investigation of influenza A (H1N1) in children development centre, Bangkok, November 2008. Weekly Epidemiological Surveillance Report 2010; 41(8): 113-9.
7. Liao CM, Chang CF, Liang HM. A probabilistic transmission dynamic model to assess indoor airborne infection risks. Risk Anal 2005; 25:1097-107.
8. Nimbalkar PM, Tripathi NK. Space-time epidemiology and effect of meteorological parameters on influenza-like illness in Phitsanulok, a northern province in Thailand. Geospat Health 2016; 11(3): 447.
9. Sirirungreung A, Yimchoho N, Monpungteim K, Pinthadis W, Jiraphongsa C. The 2009 pandemic influenza A virus in an outbreak during 2014 in Samutprakan Province, Thailand. OSIR 2015, 8(3): 1-7.
10. Centers for Disease Control and Prevention. Flu vaccine nearly 60 percent effective [internet]. 2016 [cited 2016 Oct 1]. Available from: http://www.cdc.gov/media/releases/2016/flu-vaccine-60-percent.html
11. Greenberg HB, Piedra PA. Immunization against viral respiratory disease: a review. Pediatr Infect Dis J 2004: 23 Suppl 11: S254-61.
12. Kim TH. Seasonal influenza and vaccine herd effect. Clin Exp Vaccine Res 2014; 3(2): 128-32.
13. Silvennoinen H, Peltola V, Lehtinen P, Vainionpää R, Heikkinen T. Clinical presentation of influenza in unselected children treated as outpatients. Pediatr Infect Dis J 2009; 28(5): 372-5. Dis 2002; 185(2): 147-52
4. Neuzil KM, Mellen BG, Wright PF, Mitchel EF Jr, Griffin MR. The effect of influenza on hospitalizations, outpatient visits, and courses of antibiotics in children. N Engl J Med 2000; 342(4): 225-31.
5. Lessler J, Reich NG, Cummings DT, Nair HP, Jordan HT, Thompson N, et.al. Outbreak of 2009 pandemic influenza A (H1N1) at a New York City school. N Engl J Med. 2009; 361(27): 2628-36.
6. Wutthanarungsan R, Areechokchai D, Jiamsiri S, Silaporn P, Poonaklom P, Jongcherdchootrakul K, et al. An outbreak investigation of influenza A (H1N1) in children development centre, Bangkok, November 2008. Weekly Epidemiological Surveillance Report 2010; 41(8): 113-9.
7. Liao CM, Chang CF, Liang HM. A probabilistic transmission dynamic model to assess indoor airborne infection risks. Risk Anal 2005; 25:1097-107.
8. Nimbalkar PM, Tripathi NK. Space-time epidemiology and effect of meteorological parameters on influenza-like illness in Phitsanulok, a northern province in Thailand. Geospat Health 2016; 11(3): 447.
9. Sirirungreung A, Yimchoho N, Monpungteim K, Pinthadis W, Jiraphongsa C. The 2009
pandemic influenza A virus in an outbreak during 2014 in Samutprakan Province, Thailand. OSIR 2015, 8(3): 1-7.
10. Centers for Disease Control and Prevention. Flu vaccine nearly 60 percent effective [internet].
2016 [cited 2016 Oct 1]. Available from: http://www.cdc.gov/media/releases/2016/flu-vaccine-60-percent.html
11. Greenberg HB, Piedra PA. Immunization against viral respiratory disease: a review. Pediatr Infect Dis J 2004: 23 Suppl 11: S254-61.
12. Kim TH. Seasonal influenza and vaccine herd effect. Clin Exp Vaccine Res 2014; 3(2): 128-32.
13. Silvennoinen H, Peltola V, Lehtinen P, Vainionpää R, Heikkinen T. Clinical presentation of influenza in unselected children treated as outpatients. Pediatr Infect Dis J 2009; 28(5): 372-5.