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A school outbreak of pandemic (H1N1) 2009 infection: assessment of secondary household transmission and the protective role of oseltamivir

  • Y. H. LEUNG (a1), M. P. LI (a1) and S. K. CHUANG (a1)
  • DOI:
  • Published online: 21 June 2010

In mid-June 2009, an outbreak of pandemic (H1N1) 2009 (pH1N1) infection occurred in a secondary school in Hong Kong. We carried out an epidemiological investigation to delineate the characteristics of the outbreak, gauge the extent of secondary household transmission, and assess the protective role of oseltamivir in household contacts. We interviewed pH1N1-confirmed cases using a standardized questionnaire. Sixty-five of 511 students in the school were affected. Of the 205 household contacts identified, 12 were confirmed as cases. All cases recovered. The estimated secondary household attack rate was 5·9% (95% CI 2·7–9·1). Household contacts aged <18 years were about 15 times more likely to be infected than older contacts. Household contacts who had received oseltamivir prophylaxis were less likely to acquire a secondary infection than those who had not (odds ratio=0). The estimated mean household serial interval of pH1N1 virus was 2·8 days (95% CI 2·1–3·4 days).

Corresponding author
*Author for correspondence: Y. H. Leung, Field Epidemiology Training Programme, Centre for Health Protection, Department of Health, Room 325, 147C Argyle Street, Kowloon, Hong Kong. (Email:
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This list contains references from the content that can be linked to their source. For a full set of references and notes please see the PDF or HTML where available.

1.Centers for Disease Control and Prevention. Swine influenza A (H1N1) infection in two children – southern California, March–April 2009. Morbidity and Mortality Weekly Report 2009; 58: 400402.

2.Centers for Disease Control and Prevention. Outbreak of swine-origin influenza A (H1N1) virus infection – Mexico, March–April 2009. Morbidity and Mortality Weekly Report 2009; 58: 463466.

4.J Lessler , Outbreak of 2009 pandemic influenza A (H1N1) at a New York City school. New England Journal of Medicine 2009; 361: 26282636.

6.Health Protection Agency West Midlands H1N1v Investigation Team. Preliminary descriptive epidemiology of a large school outbreak of influenza A(H1N1)v in the West Midlands, United Kingdom, May 2009. Eurosurveillance 2009; 14: pii=19264.

7.World Health Organization. Transmission dynamics and impact of pandemic influenza A (H1N1) 2009 virus. Weekly Epidemiological Record 2009; 84: 481484.

9.S Cauchemez , Household transmission of 2009 pandemic influenza A (H1N1) virus in the United States. New England Journal of Medicine 2009; 361: 26192627.

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Epidemiology & Infection
  • ISSN: 0950-2688
  • EISSN: 1469-4409
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