An investigation of Influenza B outbreak in a temple, Nakhon Sawan province, Thailand, September 2017

Authors

  • Yueayai K Field Epidemiology Training Program, Bureau of Epidemiology, Department of Diseases Control
  • Darasawang W Field Epidemiology Training Program, Bureau of Epidemiology, Department of Diseases Control
  • Sangsri R Field Epidemiology Training Program, Bureau of Epidemiology, Department of Diseases Control
  • Wongmuay S Bureau of Epidemiology, Department of Diseases, Control Ministry of Public Health
  • Wattanasri P Travel medicine residency training program, Institute of preventive medicine, Department of Diseases Control
  • Taweewigyakarn P Field Epidemiology Training Program, Bureau of Epidemiology, Department of Diseases Control

Keywords:

outbreak, influenza, temple, Nakhon Sawan

Abstract

Background: On 15th September 2017, Bureau of Epidemiology (BOE) received a notification from the Office of disease prevention and control 3 (ODPC 3), Nakhon Sawan Province that there were 29 novices in a temple had influenza-like illness (ILI) and four of them were confirmed influenza B infection. BOE, ODPC 3, Nakhon Sawan provincial health office, and Takfah hospital jointly investigated the outbreak to confirm diagnosis and outbreak, describe the outbreak characteristics and identify factors of the outbreak.
Methods: Descriptive study was done by reviewing influenza situation from BOE–surveillance database and medical records in the first aid room of the temple. Active case finding in the temple, specimen collection, and environmental study were done. Retrospective cohort study was done to identify risk factors of spreading.
Results: Out of 236 persons in the temple screened, 86 suspected cases were identified (attack rate = 36.44%), including 84 novices, a monk, and a chef. The median age of cases was 15 years (range 12–40 years). No pneumonia nor death case was found. All cases had fever (100.00%), followed by cough (85.25%), runny nose (84.47%). Seven specimens were positive for influenza B, 2 of them showed B/Phuket/3073/2013 by DNA sequencing. Classrooms, church, canteen, and parsonage for novices were crowded. No factor was found statistically significant for disease spreading. Half of people in the temple received influenza vaccine containing B/Brisbane/60/2008- like virus in the previous year.
Conclusions: The outbreak of influenza B in the temple occurred might be due to inadequate patient isolation in the early phase and delayed notification to officers for proper management. After control measures were implemented, the outbreak subsided. Influenza vaccination provided in the previous year might not help prevent an outbreak because of a different strain of virus circulating in the subsequent year.

References

Kile JC, Ren R, Liu L, Greene CM, Roguski K, Iuliano AD, Jang Y, Jones J, Thor S, Song Y, Zhou S. Update: increase in human infections with novel Asian lineage avian influenza A (H7 N9 ) viruses during the fifth epidemic—China, October 1, 2 0 1 6 – August 7 , 2017 . MMWR. 2017;66(35):928.

Zhou L, Ren R, Yang L, Bao C, Wu J, Wang D, Li C, Xiang N, Wang Y, Li D, Sui H. Sudden increase in human infection with avian influenza A (H7N9) virus in China, September–December 2016. WPSAR. 2017;8(1):6.

Garten R, Blanton L, Elal AI, Alabi N, Barnes J, Biggerstaff M, Brammer L, Budd AP, Burns E, Cummings CN, Davis T. Update: influenza activity in the United States during the 2017–18 season and composition of the 2018–19 influenza vaccine. MMWR. 2018;67(22):634.

WHO. Influenza. [cited 2017 Nov 10]. Available from: https://www.cdc.gov/flu/about/index.html

WHO. Program/influenza/influenzaupdate-307.Influenza (flu). [cited 2018 Jan 25]. Available from: http://www.who.int/influenza/surveillance_monitoring/updates/latest_update_GIP_surveillance/en/

Centers for Disease Control and Prevention. Influenza (flu) & Seasonal influenza (flu). About flu [cited 2017 Nov 10 ]. Available from: https://www.cdc.gov/flu/about/index.html

Public Health England. PHE guidance on use of antiviral agents for the treatment and prophylaxis of seasonal influenza. Version 7.0. PHE, 2016.

Bureau of Epidemiology. Department of Disease Control. Ministry of Public Health, Thailand. Event– based Surveillance Report program [cited 2 0 1 7 Sep 15]. Available from: http://www.boe.moph.go.th/eventbase/report/compound/>.

Centers for Disease Control and Prevention. Epi Info [cited 2017 Oct 19]. Available from: http://wwwn.cdc.gov/epiinfo/html/prevVersion.htm

Ip DK, Lau LL, Leung NH, Fang VJ, Chan KH, Chu DK, Leung GM, Peiris JM, Uyeki TM, Cowling BJ. Viral shedding and transmission potential of asymptomatic and paucisymptomatic influenza virus infections in the community. Clinical infectious diseases. 2017;64: 736–42.

Kiviniemi MT, Ram PK, Kozlowski LT, Smith KM. Perceptions of and willingness to engage in public health precautions to prevent 2009 H1N1 influenza transmission. BMC public health. 2011 Dec;11(1):1–8.

World Health Organization. Influenza [internet]. [cited 2017 Nov 10]. Available from: https://www.cdc.gov/flu /about/index.html

Bischoff WE, Swett K, Leng I, Peters TR. Exposure to influenza virus aerosols during routine patient care. The Journal of infectious diseases. 2013;207:1037–46.

Centers for Disease Control and Prevention (CDC). Interim guidance for airlines regarding flight crews arriving from domestic and international areas affected by swine influenza. [cited 2017 Nov 17]. Available from: http://www.cdc.gov/h1n1flu/guidance /air–crew–dom–intl.htm;2009

Dinh PN, Long HT, Tien NT, Hien NT, Mai LT, Phong LH, Van Tuan L, Van Tan H, Nguyen NB, Van Tu P, Phuong NT. Risk factors for human infection with avian influenza A H5N1, Vietnam, 2004. Emerging infectious diseases. 2006;12(12):1841

World Health Organization. Limiting spread: limiting the spread of pandemic, zoonotic, and seasonal epidemic influenza. Geneva, Switzerland: World Health Organization; 2010. [cited 2018 Jan 25]. Available from: http://www.who.int/influenza/resources/research/research_agenda_influenza_stream_2_limiting_spread.pdf

Centers for Disease Control and Prevention (CDC). Influenza (flu). Seasonal influenza (flu). About flu. How flu spread [cited 2017 Nov 10]. Available from: https://www.cdc.gov/flu/about/disease/spread.htm

Downloads

Published

2021-10-22

How to Cite

K, Y., W, D., R, S., S, W., P, W., & P, T. (2021). An investigation of Influenza B outbreak in a temple, Nakhon Sawan province, Thailand, September 2017. Weekly Epidemiological Surveillance Report, 52(41), 589–597. retrieved from https://he05.tci-thaijo.org/index.php/WESR/article/view/1760

Issue

Vol. 52 No. 41 (2021): 41st Week

Section

Original article

License

Copyright (c) 2021 Weekly Epidemiological Surveillance Report

Creative Commons License

This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.

Responsibility and Copyright

1. Author Responsibility and Editorial Disagreement

The content and data in all articles published in WESR are the direct opinions and responsibility of the article authors, and the Journal's Editorial Board is not necessarily in agreement with, or jointly responsible for, them.

2. Copyright and Referencing

All articles, data, content, figures, etc., published in WESR are considered the copyright of the academic journal. If any individual or entity wishes to disseminate all or any part of the published material, appropriate citation of the article is required.