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An Outbreak of 2009 Pandemic Influenza A (H1N1) Virus Infection in an Elementary School in Pennsylvania

tetano

Editor, Senior Moderator
Clinical Infectious Diseases

An Outbreak of 2009 Pandemic Influenza A (H1N1) Virus Infection in an Elementary School in Pennsylvania

1. Tiffany L. Marchbanks1,
2. Achuyt Bhattarai2,
3. Ryan P. Fagan2,
4. Stephen Ostroff3,
5. Samir V. Sodha2,
6. M?ria E. Moll3,
7. Bruce Y. Lee4,5,6,
8. Chung-Chou H. Chang4,7,
9. Brent Ennis3,
10. Phyllis Britz3,
11. Anthony Fiore2,
12. Michael Nguyen2,
13. Rakhee Palekar2,
14. W. Roodly Archer2,
15. Thomas L. Gift2,
16. Rebecca Leap2,
17. Benjamin L. Nygren2,
18. Simon Cauchemez8,
19. Frederick J. Angulo2,
20. David Swerdlow2, and
21. Pennsylvania Working Groupa

+ Author Affiliations

1.
1Centers for Disease Control and Prevention/Council of State and Territorial Epidemiologists Applied Epidemiology Fellowship Program, Pennsylvania Department of Health, Harrisburg, Pennsylvania
2.
2Centers for Disease Control and Prevention, Atlanta, Georgia
3.
3Pennsylvania Department of Health, Harrisburg, Harrisburg, Pennsylvania
4.
4Departments of Medicine, Pittsburgh, Pennsylvania
5.
5Epidemiology, Pittsburgh, Pennsylvania
6.
6Biomedical Informatics, Pittsburgh, Pennsylvania
7.
7Biostatistics, University of Pittsburgh School of Medicine and Graduate School of Public Health, Pittsburgh, Pennsylvania
8.
8Centre for Outbreak Analysis and Modelling, Department of Infectious Disease Epidemiology, Imperial College, London, United Kingdom

1. Correspondence: Tiffany L. Marchbanks, MPH, Div of Communicable Disease Control, St. Louis County Dept of Health, 111 S. Meramec Avenue, Clayton, MO 63105 (tmarchbanks@stlouisco.com)

Abstract

In May 2009, one of the earliest outbreaks of 2009 pandemic influenza A virus (pH1N1) infection resulted in the closure of a semi-rural Pennsylvania elementary school. Two sequential telephone surveys were administered to 1345 students (85% of the students enrolled in the school) and household members in 313 households to collect data on influenza-like illness (ILI). A total of 167 persons (12.4%) among those in the surveyed households, including 93 (24.0%) of the School A students, reported ILI. Students were 3.1 times more likely than were other household members to develop ILI (95% confidence interval [CI], 2.3?4.1). Fourth-grade students were more likely to be affected than were students in other grades (relative risk, 2.2; 95% CI, 1.2?3.9). pH1N1 was confirmed in 26 (72.2%) of the individuals tested by real-time reverse-transcriptase polymerase chain reaction. The outbreak did not resume upon the reopening of the school after the 7-day closure. This investigation found that pH1N1 outbreaks at schools can have substantial attack rates; however, grades and classrooms are affected variably. Additioanl study is warranted to determine the effectiveness of school closure during outbreaks.


http://cid.oxfordjournals.org/content/52/suppl_1/S154.full
 
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