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J Infect Dis. 2010 Sep 23. [Epub ahead of print]
Effectiveness of Public Health Measures in Mitigating Pandemic Influenza Spread: A Prospective Sero-Epidemiological Cohort Study.
Lee VJ, Yap J, Cook AR, Chen MI, Tay JK, Barr I, Kelso A, Tan BH, Loh JP, Lin R, Cui L, Kelly PM, Leo YS, Chia KS, Kang WL, Tambyah PA, Seet B.
Biodefence Centre, Ministry of Defence, 2 Centre for Health Services Research, 3Department of Epidemiology and Public Health, 4Department of Statistics and Applied Probability, and 5Division of Infectious Diseases, National University of Singapore, 6Department of Clinical Epidemiology and 7Department of Infectious Diseases, Tan Tock Seng Hospital, 8Defence Medical and Environmental Research Institute, DSO National Laboratories, 9National Public Health Laboratory, Ministry of Health, and 10Headquarters Medical Corps, Singapore Armed Forces, Singapore; 11National Centre for Epidemiology and Population Health, Australian National University and 12World Health Organization Collaborating Center for Reference and Research for Influenza, Melbourne, Australia.
Abstract
Background. Few studies have validated the effectiveness of public health interventions in reducing influenza spread in real-life settings. We aim to validate these measures used during the 2009 pandemic. Methods. From 22 June to 9 October 2009, we performed a prospective observational cohort study using paired serum samples and symptom review among 3 groups of Singapore military personnel. "Normal" units were subjected to prevailing pandemic response policies. "Essential" units and health care workers had additional public health interventions (eg, enhanced surveillance with isolation, segregation, personal protective equipment). Samples were tested by hemagglutination inhibition; the principal outcome was seroconversion to 2009 influenza A(H1N1). Results. In total, 1015 individuals in 14 units completed the study, with 29% overall seroconversion. Seroconversion among essential units (17%) and health care workers (11%) was significantly lower than that in normal units (44%) ([Formula: see text]). Symptomatic illness attributable to influenza was also lower in essential units (5%) and health care workers (2%) than in normal units (12%) ([Formula: see text]). Adjusted for confounders, unit type was the only significant variable influencing overall seroconversion ([Formula: see text]). From multivariate analysis within each unit, age ([Formula: see text]) and baseline antibody titer ([Formula: see text]) were inversely related to seroconversion risk. Conclusions. Public health measures are effective in limiting influenza transmission in closed environments.
PMID: 20863233 [PubMed - as supplied by publisher]
Effectiveness of Public Health Measures in Mitigating Pandemic Influenza Spread: A Prospective Sero-Epidemiological Cohort Study.
Lee VJ, Yap J, Cook AR, Chen MI, Tay JK, Barr I, Kelso A, Tan BH, Loh JP, Lin R, Cui L, Kelly PM, Leo YS, Chia KS, Kang WL, Tambyah PA, Seet B.
Biodefence Centre, Ministry of Defence, 2 Centre for Health Services Research, 3Department of Epidemiology and Public Health, 4Department of Statistics and Applied Probability, and 5Division of Infectious Diseases, National University of Singapore, 6Department of Clinical Epidemiology and 7Department of Infectious Diseases, Tan Tock Seng Hospital, 8Defence Medical and Environmental Research Institute, DSO National Laboratories, 9National Public Health Laboratory, Ministry of Health, and 10Headquarters Medical Corps, Singapore Armed Forces, Singapore; 11National Centre for Epidemiology and Population Health, Australian National University and 12World Health Organization Collaborating Center for Reference and Research for Influenza, Melbourne, Australia.
Abstract
Background. Few studies have validated the effectiveness of public health interventions in reducing influenza spread in real-life settings. We aim to validate these measures used during the 2009 pandemic. Methods. From 22 June to 9 October 2009, we performed a prospective observational cohort study using paired serum samples and symptom review among 3 groups of Singapore military personnel. "Normal" units were subjected to prevailing pandemic response policies. "Essential" units and health care workers had additional public health interventions (eg, enhanced surveillance with isolation, segregation, personal protective equipment). Samples were tested by hemagglutination inhibition; the principal outcome was seroconversion to 2009 influenza A(H1N1). Results. In total, 1015 individuals in 14 units completed the study, with 29% overall seroconversion. Seroconversion among essential units (17%) and health care workers (11%) was significantly lower than that in normal units (44%) ([Formula: see text]). Symptomatic illness attributable to influenza was also lower in essential units (5%) and health care workers (2%) than in normal units (12%) ([Formula: see text]). Adjusted for confounders, unit type was the only significant variable influencing overall seroconversion ([Formula: see text]). From multivariate analysis within each unit, age ([Formula: see text]) and baseline antibody titer ([Formula: see text]) were inversely related to seroconversion risk. Conclusions. Public health measures are effective in limiting influenza transmission in closed environments.
PMID: 20863233 [PubMed - as supplied by publisher]
