Details:

Alternative Title:
PLoS One
Personal Author:
Farrell, Margaret ; Sebeny, Peter ; Klena, John D. ; DeMattos, Cecilia ; Pimentel, Guillermo ; ... More +
Farrell, Margaret ; Sebeny, Peter ; Klena, John D. ; DeMattos, Cecilia ; Pimentel, Guillermo ; Turner, Mark ; Joseph, Antony ; Espiritu, Jennifer ; Zumwalt, John ; Dueger, Erica Less -
Description:
Background

At the onset of an influenza pandemic, when the severity of a novel strain is still undetermined and there is a threat of introduction into a new environment, e.g., via the deployment of military troops, sensitive screening criteria and conservative isolation practices are generally recommended.

Objectives

In response to elevated rates of influenza-like illness among U.S. military base camps in Kuwait, U.S. Naval Medical Research Unit No. 3 partnered with local U.S. Army medical units to conduct an A(H1N1) pdm09 outbreak investigation.

Patients/Methods

Initial clinical data and nasal specimens were collected via the existent passive surveillance system and active surveillance was conducted using a modified version of the World Health Organization/U.S. Centers for Disease Control and Prevention influenza-like illness case definition [fever (T > 100.5˚F/38˚C) in addition to cough and/or sore throat in the previous 72 hours] as the screening criteria. Samples were tested via real-time reverse-transcription PCR and sequenced for comparison to global A(H1N1) pdm09 viruses from the same time period.

Results

The screening criteria used in Kuwait proved insensitive, capturing only 16% of A(H1N1) pdm09-positive individuals. While still not ideal, using cough as the sole screening criteria would have increased sensitivity to 73%.

Conclusions

The results of and lessons learned from this outbreak investigation suggest that pandemic influenza risk management should be a dynamic process (as information becomes available regarding true attack rates and associated mortality, screening and isolation criteria should be re-evaluated and revised as appropriate), and that military operational environments present unique challenges to influenza surveillance.


Subjects:
[+]
Cough Disease Outbreaks DNA, Viral Fever Humans Influenza, Human Influenza A Virus, H1N1 Subtype Mass Screening Military Personnel Pharyngitis Phylogeny Real-Time Polymerase Chain Reaction Risk Management
Source:
PLoS One. 2013; 8(7).
Document Type:
Journal Article
Place as Subject:
Kuwait ; United States
Kuwait ; United States Less -
Collection(s):
CDC Public Access
Main Document Checksum:
[+]
urn:sha256:a037f8411f8f925ef5cb0a5e85f9b1f2b296ccfabde31f6f2ef5fc2188b55485
Download URL:
https://stacks.cdc.gov/view/cdc/19604/cdc_19604_DS1.pdf
File Type:

Supporting Files

• 	license.txt	txt
  	pone.0068639.g001.gif	gif
  	pone.0068639.g001.jpg	jpeg
  	pone.0068639.nxml	txt

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