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Effectiveness of public health measures in mitigating pandemic influenza spread: A prospective sero-epidemiological cohort study

Lee, Vernon; Yap, Jonathan; Cook, Alex R; Chen, Mark; Tay, Joshua K; Barr, Ian G; Kelso, Anne; Tan, Boon Huan; Loh, Jin Phang; Lin, Raymond T P; Cui, Lin; Kelly, Paul; Leo, Yee-Sin; Chia, Kee Seng; Kang, Wee Lee; Tambyah, Paul A.; Seet, Benjamin

Description

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...[Show more]

dc.contributor.authorLee, Vernon
dc.contributor.authorYap, Jonathan
dc.contributor.authorCook, Alex R
dc.contributor.authorChen, Mark
dc.contributor.authorTay, Joshua K
dc.contributor.authorBarr, Ian G
dc.contributor.authorKelso, Anne
dc.contributor.authorTan, Boon Huan
dc.contributor.authorLoh, Jin Phang
dc.contributor.authorLin, Raymond T P
dc.contributor.authorCui, Lin
dc.contributor.authorKelly, Paul
dc.contributor.authorLeo, Yee-Sin
dc.contributor.authorChia, Kee Seng
dc.contributor.authorKang, Wee Lee
dc.contributor.authorTambyah, Paul A.
dc.contributor.authorSeet, Benjamin
dc.date.accessioned2015-12-10T23:13:14Z
dc.identifier.issn0022-1899
dc.identifier.urihttp://hdl.handle.net/1885/64335
dc.description.abstractBackground. 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%) (P < .001). Symptomatic illness attributable to influenza was also lower in essential units (5%) and health care workers (2%) than in normal units (12%) (P = .06). Adjusted for confounders, unit type was the only significant variable influencing overall seroconversion (P < .05). From multivariate analysis within each unit, age (P < .001) and baseline antibody titer (P = .012) were inversely related to seroconversion risk. Conclusions. Public health measures are effective in limiting influenza transmission in closed environments.
dc.publisherUniversity of Chicago Press
dc.sourceJournal of Infectious Diseases
dc.subjectKeywords: influenza vaccine; antibody titer; article; cohort analysis; disease transmission; environmental factor; female; health care personnel; health care policy; health promotion; hemagglutination; human; influenza; influenza A (H1N1); intervention study; isola
dc.titleEffectiveness of public health measures in mitigating pandemic influenza spread: A prospective sero-epidemiological cohort study
dc.typeJournal article
local.description.notesImported from ARIES
local.identifier.citationvolume202
dc.date.issued2010
local.identifier.absfor111706 - Epidemiology
local.identifier.absfor110309 - Infectious Diseases
local.identifier.ariespublicationf2965xPUB919
local.type.statusPublished Version
local.contributor.affiliationLee, Vernon, College of Medicine, Biology and Environment, ANU
local.contributor.affiliationYap, Jonathan, Singapore Ministry of Defence
local.contributor.affiliationCook, Alex R, National University of Singapore
local.contributor.affiliationChen, Mark, Tan Tock Seng Hospital Singapore
local.contributor.affiliationTay, Joshua K, Ministry of Defence
local.contributor.affiliationBarr, Ian G, World Health Organisation
local.contributor.affiliationKelso, Anne, World Health Organization
local.contributor.affiliationTan, Boon Huan, DSO National Laboratories
local.contributor.affiliationLoh, Jin Phang, DSO National Laboratories
local.contributor.affiliationLin, Raymond T P, Ministry of Health, Singapore
local.contributor.affiliationCui, Lin, Ministry of Health, Singapore
local.contributor.affiliationKelly, Paul, College of Medicine, Biology and Environment, ANU
local.contributor.affiliationLeo, Yee-Sin, Ministry of Health, Singapore
local.contributor.affiliationChia, Kee Seng, National University of Singapore
local.contributor.affiliationKang, Wee Lee, Singapore Armed Forces
local.contributor.affiliationTambyah, Paul A., Ministry of Defence
local.contributor.affiliationSeet, Benjamin, Singapore Armed Forces
local.description.embargo2037-12-31
local.bibliographicCitation.issue9
local.bibliographicCitation.startpage1319
local.bibliographicCitation.lastpage1326
local.identifier.doi10.1086/656480
dc.date.updated2016-02-24T08:33:54Z
local.identifier.scopusID2-s2.0-77958112854
local.identifier.thomsonID000282367900005
CollectionsANU Research Publications

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