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Novel Influenza A (H1N1) Outbreak On Board a US Navy Vessel

Published online by Cambridge University Press:  08 April 2013

Abstract

Background and Methods: Fleet Week New York 2009 was the latest installment of an annual celebration to honor US service personnel. It takes place during Memorial Day and this year’s celebration coincided with the peak of novel influenza A (H1N1) virus (S-OIV) activity in New York City. Four service members from the USS Iwo Jima and USS Roosevelt contracted influenza while in New York City and were hospitalized in the Department of Veterans Affairs (VA)-New York Harbor Healthcare System to minimize the risk of widespread outbreak on board the naval vessels. No additional cases were identified on the USS Roosevelt. However, 135 service personnel on the USS Iwo Jima contracted influenza.

Results: Shipwide infection control measures including strict isolation and active case finding were instituted immediately with affected crew members and medical staff receiving oseltamivir. The new case rates remained high for 14 days, but the USS Iwo Jima was able to continue deployment. The secondary infectivity rate was 12.0%. The absolute end of the outbreak correlated with arrival at home port and the ability to move patients off board.

Conclusions: This outbreak not only reinforces the risk for rapid spread of novel strains of influenza A in confined populations but also demonstrates useful strategies to mitigate the severity of an outbreak, including isolation, infection control measures, and off board sick leave when feasible. (Disaster Med Public Health Preparedness. 2009;3(Suppl 2):S117–S120)

Type
Research
Copyright
Copyright © Society for Disaster Medicine and Public Health, Inc. 2009

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References

REFERENCES

1.Swine influenza A (H1N1) infection in two children—Southern California, March–April 2009. MMWR Morb Mortal Wkly Rep. 2009;58:400402.Google Scholar
2.2009 New York City Department of Health and Mental Hygiene Health Alert #20: Novel H1N1 Influenza Update May 24, 2009. http://www.nyc.gov/html/doh/downloads/pdf/cd/2009/09md20.pdf. Accessed August 12, 2009.Google Scholar
3.2009 New York City Department of Health and Mental Hygiene Health Alert #21: Novel H1N1 Influenza Update June 2, 2009. http://www.nyc.gov/html/doh/downloads/pdf/cd/2009/09md21.pdf. Accessed August 12, 2009.Google Scholar
4.VHA Handbook 0320.04—VA/DoD Contingency Plan. http://www1.va.gov/vhapublications/ViewPublication.asp?pub_ID=1629. Accessed July 30, 2009.Google Scholar
5.Preventing Transmission of Influenza, Including Novel H1N1 Cases, in Congregate Facilities. http://www.nyc.gov/html/doh/downloads/pdf/cd/h1n1_flu_congregate_faq.pdf. Accessed August 28, 2009.Google Scholar
6.Uyeki, TM, Prasad, R, Vukotich, C, et alLow sensitivity of rapid diagnostic test for influenza. Clin Infect Dis. 2009;48:e89e92.CrossRefGoogle ScholarPubMed
7.Update: novel influenza A (H1N1) virus infections—worldwide, May 6, 2009. MMWR Morb Mortal Wkly Rep. 2009;58:453–458. http://www.cdc.gov/mmwr/preview/mmwrhtml/mm5817a1.htm#tab. Accessed August 12, 2009.Google Scholar
8.Harper SA, Bradley JS, Englund JA, et al. Seasonal influenza in adults and children—diagnosis, treatment, chemoprophylaxis, and institutional outbreak management: clinical practice guidelines of the Infectious Diseases Society of America. http://www.journals.uchicago.edu/doi/pdf/10.1086/598513?cookieSet=1. Accessed August 20, 2009.Google Scholar
9.Epidemic and pandemic alert response: influenza A(H1N1) virus resistance to oseltamivir. World Health Organization Web site. December 30, 2008. http://www.who.int/csr/disease/influenza/h1n1_table/en/index.html. Accessed August 20, 2009.Google Scholar
10.St. Francis Prep Update: Swine Flu Outbreak. http://www.nyc.gov/html/doh/downloads/pdf/cd/h1n1_stfrancis_survey.pdf. Accessed August 19, 2009.Google Scholar
11.Earhart, KC, Beadle, C, Miller, LK, et alOutbreak of influenza in highly vaccinated crew of U.S. Navy ship. Emerg Infect Dis. 2001;7:463465.CrossRefGoogle ScholarPubMed
12.Assessing the severity of an influenza pandemic. World Health Organization Web site. May 11, 2009. http://www.who.int/csr/disease/swineflu/assess/disease_swineflu_assess_20090511/en/index.html. Accessed August 28, 2009.Google Scholar
13.Balicer, RD, Huerta, M, Levy, Y, et alInfluenza outbreak control in confined settings. Emerg Infect Dis. 2005;11:579583.CrossRefGoogle ScholarPubMed
14.Gaydos, JC, JrTop, FH, Hodder, RA, et alSwine influenza A outbreak, Fort Dix, New Jersey, 1976. Emerg Infect Dis. 2006;12:2328.CrossRefGoogle ScholarPubMed
15.McNeill, KM, Vaughn, BL, Brundage, MB, et alClinical presentations for influenza and influenza-like illness in young, immunized soldiers. Mil Med. 2005;170:9497.CrossRefGoogle ScholarPubMed
16.Sencer, DJ, Millar, JD.Reflections on the 1976 swine flu vaccination program. Emerg Infect Dis. 2006;12:2933.CrossRefGoogle ScholarPubMed