Harwood Jared L, LaVan Joseph T, Brand George J
Disaster Med Public Health Prep. 2013 Feb;7(1):29-35. doi: 10.1001/dmp.2012.53.
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.
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.
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.
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.
2009年夏季，美国海军的“乔治·华盛顿”号（GW）和“罗纳德·里根”号（RR）两艘航空母舰几乎同时爆发了甲型H1N1流感。我们比较了各自采取的疫情防控措施以及后续吸取的经验教训。
整理两次疫情的数据，以评估包括发病率、隔离/检疫方案和治疗方法等各项因素。通过生存曲线分析比较每次疫情的持续时间。使用χ2分析比较每次疫情中受影响的人员数量。
两艘船上使用的方案存在差异。GW号在第14天前对约三分之二的患者使用了奥司他韦治疗，并在疫情期间对所有符合病例定义的患者进行了隔离。全程使用了口罩。RR号使用了奥司他韦，隔离的患者要少得多（分别在第5天和第3天之后）。第5天后未使用口罩。两次疫情的持续时间相似（GW = 25天，RR = 27天，P = 0.38），但RR号的病例明显更多（n = 253对142，P < 0.0001）。每组中的一部分样本通过聚合酶链反应确诊为H1N1。
GW号的方案，包括对三分之二的病例积极使用奥司他韦治疗以及全程隔离，减少了受影响人员的总数，可能降低了总体控制繁殖数。两次疫情的持续时间相似。尽管GW号比RR号消耗的资源要多得多，但如果2009年大流行的H1N1毒株在临床严重程度上与1918年大流行毒株相同，更严格的治疗方案可能是防止对行动产生重大影响的唯一方法。
