Preventive Medicine and Epidemiology Department, Hospital Clinic, Barcelona, Spain.
J Travel Med. 2012 Jan-Feb;19(1):9-14. doi: 10.1111/j.1708-8305.2011.00580.x. Epub 2011 Dec 8.
From the beginning of the influenza pandemic until the time the outbreak described here was detected, 77,201 cases of pandemic influenza A(H1N1) with 332 deaths had been reported worldwide, mostly in the United States and Mexico. All of the cases reported in Spain until then had a recent history of travel to Mexico, the Dominican Republic, or Chile. We describe an outbreak of influenza among medical students who traveled from Spain to the Dominican Republic in June 2009.
We collected diagnostic samples and clinical histories from consenting medical students who had traveled to the Dominican Republic and from their household contacts after their return to Spain.
Of 113 students on the trip, 62 (55%) developed symptoms; 39 (45%) of 86 students tested had laboratory evidence of influenza A(H1N1) infection. Most students developed symptoms either just before departure from the Dominican Republic or within days of returning to Spain. The estimated secondary attack rate of influenza-like illness among residential contacts of ill students after return to Spain was 2.1%.
The attack rate of influenza A(H1N1) can vary widely depending on the circumstances of exposure. We report a high attack rate among a group of traveling medical students but a much lower secondary attack rate among their contacts after return from the trip. These findings may aid the development of recommendations to prevent influenza.
自流感大流行开始至此次暴发被发现时，全世界已报告 77201 例甲型 H1N1 流感大流行病例，导致 332 人死亡，主要发生在美国和墨西哥。此前在西班牙报告的所有病例均有近期前往墨西哥、多米尼加共和国或智利的旅行史。我们描述了 2009 年 6 月从西班牙前往多米尼加共和国的医学生中暴发的流感疫情。
我们收集了有旅行史的医学生及其在返回西班牙后的家庭接触者的诊断样本和临床病史。
在 113 名出行学生中，62 名（55%）出现症状；86 名接受检测的学生中，39 名（45%）有甲型 H1N1 流感感染的实验室证据。大多数学生在离开多米尼加共和国之前或返回西班牙后的几天内出现症状。返回西班牙后，患病学生的同住接触者中流感样疾病的估计继发感染率为 2.1%。
甲型 H1N1 流感的发病率可能因暴露情况而异。我们报告了一组旅行医学生中发病率很高，但在旅行返回后其接触者中的继发感染率要低得多。这些发现可能有助于制定预防流感的建议。
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