Outbreak of influenza A in a boarding school in South Africa, 2016
Identifieur interne : 000F99 ( Ncbi/Curation ); précédent : 000F98; suivant : 001000Outbreak of influenza A in a boarding school in South Africa, 2016
Auteurs : Jackie Kleynhans [Afrique du Sud] ; Florette Kathleen Treurnicht [Afrique du Sud] ; Cheryl Cohen [Afrique du Sud] ; Theesan Vedan [Afrique du Sud] ; Mpho Seleka [Afrique du Sud] ; Lwando Maki [Afrique du Sud] ; Anne Von Gottberg [Afrique du Sud] ; Kerrigan Mccarthy [Afrique du Sud] ; Wayne Ramkrishna [Afrique du Sud] ; Meredith Mcmorrow [États-Unis, Afrique du Sud] ; Sibongile Walaza [Afrique du Sud]Source :
- The Pan African Medical Journal [ 1937-8688 ] ; 2019.
Abstract
We investigated an outbreak of influenza-like illness (ILI) at a boarding school in Eastern Cape Province, South Africa. We aimed to confirm the etiological agent, estimate attack rates and identify risk factors for illness.
We conducted a retrospective cohort study including senior school boarders (n=308). Students with ILI (cough and fever) were identified through school medical records. We also conducted a questionnaire-based cross-sectional study among senior students including boarders (n=107) and day students (n=45). We collected respiratory specimens for respiratory pathogen testing by real-time polymerase chain reaction from a subset of symptomatic students. We calculated attack rates of medically attended ILI (medILI) and identified factors associated with medILI using logistic regression. We calculated seasonal influenza vaccine effectiveness (VE) against medILI.
Influenza A (H3N2) virus was detected in 61% (23/38) of specimens. Attack rate for medILI was 13% among boarders (39/308) in the cohort study and 20% in both day students (9/45) and boarders (21/107) in the cross-sectional study. Playing squash was associated with medILI (aOR 5.35, 95% confidence interval [95% CI]: 1.68-17.07). Of the boarders, 19% (57/308) were vaccinated before the outbreak. The adjusted VE against medILI was 18% (aOR 0.82, 95% CI 0.38-1.78). The outbreak led to cancellation of several events and the need for academic remedial sessions.
We confirmed an influenza A (H3N2) virus outbreak with a high attack rate. The outbreak affected academic and sports activities. Participation in sports and social gatherings while experiencing ILI should be discouraged to reduce viral transmission and impact on school activities.
Url:
DOI: 10.11604/pamj.2019.33.42.16666
PubMed: 31384357
PubMed Central: 6658148
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PMC:6658148Le document en format XML
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<sourceDesc><biblStruct><analytic><title xml:lang="en" level="a" type="main">Outbreak of influenza A in a boarding school in South Africa, 2016</title>
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<author><name sortKey="Treurnicht, Florette Kathleen" sort="Treurnicht, Florette Kathleen" uniqKey="Treurnicht F" first="Florette Kathleen" last="Treurnicht">Florette Kathleen Treurnicht</name>
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<author><name sortKey="Cohen, Cheryl" sort="Cohen, Cheryl" uniqKey="Cohen C" first="Cheryl" last="Cohen">Cheryl Cohen</name>
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<author><name sortKey="Vedan, Theesan" sort="Vedan, Theesan" uniqKey="Vedan T" first="Theesan" last="Vedan">Theesan Vedan</name>
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<author><name sortKey="Seleka, Mpho" sort="Seleka, Mpho" uniqKey="Seleka M" first="Mpho" last="Seleka">Mpho Seleka</name>
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<country xml:lang="fr">Afrique du Sud</country>
<wicri:regionArea>Centre for Respiratory Diseases and Meningitis (CRDM), National Institute for Communicable Diseases (NICD) of the National Health Laboratory Service (NHLS), Johannesburg</wicri:regionArea>
<wicri:noRegion>Johannesburg</wicri:noRegion>
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<author><name sortKey="Maki, Lwando" sort="Maki, Lwando" uniqKey="Maki L" first="Lwando" last="Maki">Lwando Maki</name>
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<author><name sortKey="Von Gottberg, Anne" sort="Von Gottberg, Anne" uniqKey="Von Gottberg A" first="Anne" last="Von Gottberg">Anne Von Gottberg</name>
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<country xml:lang="fr">Afrique du Sud</country>
<wicri:regionArea>Centre for Respiratory Diseases and Meningitis (CRDM), National Institute for Communicable Diseases (NICD) of the National Health Laboratory Service (NHLS), Johannesburg</wicri:regionArea>
<wicri:noRegion>Johannesburg</wicri:noRegion>
</affiliation>
<affiliation wicri:level="4"><nlm:aff id="aff0005">School of Pathology, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa</nlm:aff>
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<author><name sortKey="Mccarthy, Kerrigan" sort="Mccarthy, Kerrigan" uniqKey="Mccarthy K" first="Kerrigan" last="Mccarthy">Kerrigan Mccarthy</name>
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<wicri:regionArea>Division of Public Health, Surveillance and Response (DPHSR), NICD of the NHLS, Johannesburg</wicri:regionArea>
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<author><name sortKey="Ramkrishna, Wayne" sort="Ramkrishna, Wayne" uniqKey="Ramkrishna W" first="Wayne" last="Ramkrishna">Wayne Ramkrishna</name>
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<country xml:lang="fr">Afrique du Sud</country>
<wicri:regionArea>South African National Department of Health (NDoH), Pretoria</wicri:regionArea>
<wicri:noRegion>Pretoria</wicri:noRegion>
</affiliation>
</author>
<author><name sortKey="Mcmorrow, Meredith" sort="Mcmorrow, Meredith" uniqKey="Mcmorrow M" first="Meredith" last="Mcmorrow">Meredith Mcmorrow</name>
<affiliation wicri:level="2"><nlm:aff id="aff0007">Influenza Division, Centers for Disease Control and Prevention, Atlanta, Georgia, United States of America</nlm:aff>
<country xml:lang="fr">États-Unis</country>
<wicri:regionArea>Influenza Division, Centers for Disease Control and Prevention, Atlanta, Georgia</wicri:regionArea>
<placeName><region type="state">Géorgie (États-Unis)</region>
</placeName>
</affiliation>
<affiliation wicri:level="1"><nlm:aff id="aff0008">U.S. Centers for Disease Control and Prevention, Pretoria, South Africa</nlm:aff>
<country xml:lang="fr">Afrique du Sud</country>
<wicri:regionArea>U.S. Centers for Disease Control and Prevention, Pretoria</wicri:regionArea>
<wicri:noRegion>Pretoria</wicri:noRegion>
</affiliation>
</author>
<author><name sortKey="Walaza, Sibongile" sort="Walaza, Sibongile" uniqKey="Walaza S" first="Sibongile" last="Walaza">Sibongile Walaza</name>
<affiliation wicri:level="1"><nlm:aff id="aff0001">Centre for Respiratory Diseases and Meningitis (CRDM), National Institute for Communicable Diseases (NICD) of the National Health Laboratory Service (NHLS), Johannesburg, South Africa</nlm:aff>
<country xml:lang="fr">Afrique du Sud</country>
<wicri:regionArea>Centre for Respiratory Diseases and Meningitis (CRDM), National Institute for Communicable Diseases (NICD) of the National Health Laboratory Service (NHLS), Johannesburg</wicri:regionArea>
<wicri:noRegion>Johannesburg</wicri:noRegion>
</affiliation>
<affiliation wicri:level="4"><nlm:aff id="aff0003">School of Public Health, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa</nlm:aff>
<country xml:lang="fr">Afrique du Sud</country>
<wicri:regionArea>School of Public Health, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg</wicri:regionArea>
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</placeName>
</affiliation>
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<series><title level="j">The Pan African Medical Journal</title>
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<front><div type="abstract" xml:lang="en"><sec id="s1"><title>Introduction</title>
<p>We investigated an outbreak of influenza-like illness (ILI) at a boarding school in Eastern Cape Province, South Africa. We aimed to confirm the etiological agent, estimate attack rates and identify risk factors for illness.</p>
</sec>
<sec id="s2"><title>Methods</title>
<p>We conducted a retrospective cohort study including senior school boarders (n=308). Students with ILI (cough and fever) were identified through school medical records. We also conducted a questionnaire-based cross-sectional study among senior students including boarders (n=107) and day students (n=45). We collected respiratory specimens for respiratory pathogen testing by real-time polymerase chain reaction from a subset of symptomatic students. We calculated attack rates of medically attended ILI (medILI) and identified factors associated with medILI using logistic regression. We calculated seasonal influenza vaccine effectiveness (VE) against medILI.</p>
</sec>
<sec id="s3"><title>Results</title>
<p>Influenza A (H3N2) virus was detected in 61% (23/38) of specimens. Attack rate for medILI was 13% among boarders (39/308) in the cohort study and 20% in both day students (9/45) and boarders (21/107) in the cross-sectional study. Playing squash was associated with medILI (aOR 5.35, 95% confidence interval [95% CI]: 1.68-17.07). Of the boarders, 19% (57/308) were vaccinated before the outbreak. The adjusted VE against medILI was 18% (aOR 0.82, 95% CI 0.38-1.78). The outbreak led to cancellation of several events and the need for academic remedial sessions.</p>
</sec>
<sec id="s4"><title>Conclusion</title>
<p>We confirmed an influenza A (H3N2) virus outbreak with a high attack rate. The outbreak affected academic and sports activities. Participation in sports and social gatherings while experiencing ILI should be discouraged to reduce viral transmission and impact on school activities.</p>
</sec>
</div>
</front>
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</TEI>
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