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Two Aircraft Carriers’ Perspectives: A Comparative of Control Measures in Shipboard H1N1 Outbreaks

Published online by Cambridge University Press:  25 April 2013

Jared L. Harwood ,
Joseph T. LaVan  and
George J. Brand II
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Abstract

Background

The USS George Washington (GW) and the USS Ronald Reagan (RR), 2 US Navy aircraft carriers, experienced almost simultaneous outbreaks of novel H1N1 influenza A in the summer of 2009. We compared the respective epidemic control measures taken and subsequent lessons learned.

Methods

Data were collated from both outbreaks to assess various elements including attack rate, isolation/quarantine protocols, and treatment methods. The respective duration of each outbreak was compared with survival curve analysis. The number of personnel affected in each outbreak was compared using χ2 analysis.

Results

Differences were found in the protocols used on the 2 ships. The GW treated about two-thirds of the patients with oseltamivir through day 14 and quarantined all patients meeting case definition throughout the outbreak. Face masks were used throughout. The RR used oseltamivir and quarantined many fewer patients (through days 5 and 3, respectively). No face masks were used after day 5. The outbreaks were similar in duration (GW = 25 days, RR = 27 days, P = .38), but the RR had significantly more cases (n = 253 vs 142, P < .0001). A portion of each group had samples that were confirmed H1N1 by polymerase chain reaction.

Conclusions

GW's protocol, including aggressive oseltamivir treatment of two-thirds of the cases and quarantine throughout the duration decreased the overall number of personnel affected, likely reducing the overall control reproduction number. Both outbreaks were similar in duration. Even though the GW expended significantly more resources than the RR, if the 2009 pandemic H1N1 strain had been as clinically severe as the 1918 pandemic, a more stringent treatment protocol may have been the only way to prevent significant operational impact.(Disaster Med Public Health Preparedness. 2013;7:29-35)

Keywords

H1N1influenzapandemicisolationoutbreaknaval vesselaircraft carriertreatment protocoloperational impactinfection containment
Type
Original Research
Information
Disaster Medicine and Public Health Preparedness , Volume 7 , Issue 1 , February 2013 , pp. 29 - 35
Copyright
Copyright © Society for Disaster Medicine and Public Health, Inc. 2013

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References

1.Roos, R. Study puts global 2009 H1N1 infection rate at 11-21%. Minneapolis, Minnesota: Center for Infectious Disease Research and Policy; August 8, 2011.Google Scholar
2.World Health Organization. Pandemic (H1N1). 2009 - update 112. Geneva, Switzerland: World Health Organization; August 6, 2010.Google Scholar
3. World Health Organization Influenza-like illness in the United States and Mexico; Geneva, Switzerland: World Health Organization; April 29, 2009.Google Scholar
4.World Health Organization 2009. WHO pandemic phase descriptions and main actions by phase. http://www.who.int/influenza/resources/documents/pandemic_phase_descriptions_and_actions.pdf. Accessed August 8, 2012.Google Scholar
5.Kelly, HA, Mercer, GN, Fielding, JE, etal. Pandemic (H1N1) 2009 influenza community transmission was established in one Australian state when the virus was first identified in North America. PLoS One. 2010;5(6):e11341.CrossRefGoogle ScholarPubMed
6.Fraser, C, Donnelly, CA, Cauchemez, S, etal; WHO Rapid Pandemic Assessment Collaboration. Pandemic potential of a strain of influenza A (H1N1): early findings. Science. 2009;324(5934):1557-1561.CrossRefGoogle ScholarPubMed
7.Kelso, JK, Milne, GJ, Kelly, H. Simulation suggests that rapid activation of social distancing can arrest epidemic development due to a novel strain of influenza. BMC Public Health. 2009;9:117.CrossRefGoogle ScholarPubMed
8.Halder, N, Kelso, JK, Milne, GJ. Analysis of the effectiveness of interventions used during the 2009 A/H1N1 influenza pandemic. BMC Public Health. 2010;10:168.CrossRefGoogle ScholarPubMed
9.Vera, DM, Gonzaga, V, Hora, RA, etal. Outbreak of 2009 pandemic influenza A (H1N1) on a Peruvian Navy ship—June-July 2009. Morbid Mortal Weekly Rep MMWR. 2010;59(6):162-165.Google Scholar
10.Dill, CE, Favata, MA. Novel influenza A (H1N1) outbreak on board a US navy vessel. Disaster Med Public Health Prep. 2009;3(suppl 2):S117-S120.CrossRefGoogle Scholar
11.Ling, LM, Chow, AL, Lye, DC, etal. Effects of early oseltamivir therapy on viral shedding in 2009 pandemic influenza A (H1N1) virus infection. Clin Infect Dis. 2010;50(7):963-969.CrossRefGoogle Scholar
12.Ng, S, Cowling, BJ, Fang, VJ, etal. Effects of oseltamivir treatment on duration of clinical illness and viral shedding and household transmission of influenza virus. Clin Infect Dis. 2010;50(5):707-714.CrossRefGoogle ScholarPubMed
13.Carcione, D, Giele, C, Dowse, GK, etal. Comparison of pandemic (H1N1) 2009 and seasonal influenza, Western Australia, 2009. Emerg Infect Dis. 2010;16(9):1388-1395.CrossRefGoogle ScholarPubMed