Biodefence Centre, Ministry of Defence, Department of Epidemiology and Public Health, National University of Singapore, Singapore Armed Forces, Singapore.
J Infect Dis. 2010 Nov 1;202(9):1319-26. doi: 10.1086/656480.
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.
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).
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.
Public health measures are effective in limiting influenza transmission in closed environments.
在现实环境中，很少有研究验证公共卫生干预措施在减少流感传播方面的有效性。我们旨在验证这些在 2009 年大流行期间使用的措施。
从 2009 年 6 月 22 日至 10 月 9 日，我们使用配对血清样本和症状回顾对新加坡军事人员的 3 组进行了前瞻性观察性队列研究。“正常”单位受当时流行的大流行应对政策影响。“必要”单位和医护人员采取了额外的公共卫生干预措施（例如，加强监测，隔离，个人防护设备）。通过血凝抑制试验对样本进行检测；主要结果是针对 2009 年甲型 H1N1 流感的血清转化率。
共有 14 个单位的 1015 人完成了研究，总体血清转化率为 29％。必要单位（17％）和医护人员（11％）的血清转化率明显低于正常单位（44％）（P ＜0.001）。必要单位（5％）和医护人员（2％）的流感相关症状疾病也明显低于正常单位（12％）（P ＝0.06）。调整混杂因素后，单位类型是唯一影响总体血清转化率的重要变量（P ＜0.05）。在每个单位内进行多变量分析时，年龄（P ＜0.001）和基线抗体滴度（P ＝0.012）与血清转化率风险呈负相关。
公共卫生措施可有效限制封闭环境中的流感传播。
