Outbreak of 2009 Pandemic Influenza A (H1N1) at a New York City School
Outbreak of 2009 Pandemic Influenza A (H1N1) at a New York City School
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DOI：
10.1056/nejmoa0906089
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发表时间：
2009-12-31
影响因子：
158.5
通讯作者：
Cummings, Derek A. T.
中科院分区：
文献类型：
--
作者：
Lessler, Justin;Reich, Nicholas G.;Cummings, Derek A. T.
背景：2009年4月，在纽约皇后区的一所高中爆发了一场新型猪源性甲型流感（2009 H1N1流感）。我们描述疫情和特征的临床和流行病学方面的这种新型病毒。方法纽约市卫生和精神卫生部门通过实验室确认鼻咽和口咽标本中存在2009年H1N1病毒以及通过在线调查获得的信息来确定疫情的特征。使用已确立的技术，利用接触和症状发作的详细信息来估计与2009年H1N1流感相关的潜伏期、产生时间和在校繁殖数。结果从4月24日到5月8日，124名高中学生和员工被证实感染了2009年H1N1病毒。在回答在线问卷时，800多名学生和员工（35%的学生受访者和10%的员工受访者）报告在此期间患有流感样疾病。2009年H1N1流感确诊患者或流感样疾病患者均无严重症状。已确定与前往墨西哥的旅行有关。确诊的2009年H1N1流感的估计中位潜伏期为1.4天（95%置信区间[CI]， 1.0至1.8），95%的病例出现症状的时间为2.2天（95% CI， 1.7至2.6）。估计中位生成时间为2.7天（95% CI， 2.0至3.5）。我们估计校内繁殖数为3.3。结论2009年H1N1流感在高中流行，但未引起严重疾病。流感样疾病迅速和广泛传播的原因尚不清楚。2009年H1N1流感病毒的自然历史和传播似乎与以前观察到的流行大流行和大流行间流感病毒相似。
BACKGROUNDIn April 2009, an outbreak of novel swine-origin influenza A ( 2009 H1N1 influenza) occurred at a high school in Queens, New York. We describe the outbreak and characterize the clinical and epidemiologic aspects of this novel virus.METHODSThe New York City Department of Health and Mental Hygiene characterized the outbreak through laboratory confirmation of the presence of the 2009 H1N1 virus in nasopharyngeal and oropharyngeal specimens and through information obtained from an online survey. Detailed information on exposure and the onset of symptoms was used to estimate the incubation period, generation time, and within-school reproductive number associated with 2009 H1N1 influenza, with the use of established techniques.RESULTSFrom April 24 through May 8, infection with the 2009 H1N1 virus was confirmed in 124 high-school students and employees. In responses to the online questionnaire, more than 800 students and employees (35% of student respondents and 10% of employee respondents) reported having an influenza-like illness during this period. No persons with confirmed 2009 H1N1 influenza or with influenza-like illness had severe symptoms. A linkage with travel to Mexico was identified. The estimated median incubation period for confirmed 2009 H1N1 influenza was 1.4 days (95% confidence interval [CI], 1.0 to 1.8), with symptoms developing in 95% of cases by 2.2 days (95% CI, 1.7 to 2.6). The estimated median generation time was 2.7 days (95% CI, 2.0 to 3.5). We estimate that the within-school reproductive number was 3.3.CONCLUSIONSThe findings from this investigation suggest that 2009 H1N1 influenza in the high school was widespread but did not cause severe illness. The reasons for the rapid and extensive spread of influenza-like illnesses are unknown. The natural history and transmission of the 2009 H1N1 influenza virus appear to be similar to those of previously observed circulating pandemic and interpandemic influenza viruses.