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Pandemic (H1N1) 2009 virus outbreak in a school in London, April–May 2009: an observational study

  • L. CALATAYUD (a1) (a2), S. KURKELA (a2) (a3), P. E. NEAVE (a4), A. BROCK (a4), S. PERKINS (a4), M. ZUCKERMAN (a5), M. SUDHANVA (a5), A. BERMINGHAM (a2), J. ELLIS (a2), R. PEBODY (a2), M. CATCHPOLE (a2), R. HEATHCOCK (a4) and H. MAGUIRE (a6)
  • DOI:
  • Published online: 20 November 2009

On 29 April 2009, an imported case of pandemic (H1N1) 2009 virus infection was detected in a London school. As further cases, pupils and staff members were identified, school closure and mass prophylaxis were implemented. An observational descriptive study was conducted to provide an insight into the clinical presentation and transmission dynamics in this setting. Between 15 April and 15 May 2009, 91 symptomatic cases were identified: 33 were confirmed positive for pandemic (H1N1) 2009 virus infection; 57 were tested negative; in one the results were unavailable. Transmission occurred first within the school, and subsequently outside. Attack rates were 2% in pupils (15% in the 11–12 years age group) and 17% in household contacts. The predominant symptoms were fever (97%), respiratory symptoms (91%), and sore throat (79%). Limited spread in the school may have been due to a combination of school closure and mass prophylaxis. However, transmission continued through household contacts to other schools.

Corresponding author
*Author for correspondence: Dr H. Maguire Health Protection Agency, Regional Epidemiology Unit, 7th Floor, Holborn Gate, 330 High Holborn, WC1V 7PP London, UK. (Email:
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1.F Charatan . UN warns that swine flu outbreak could turn into pandemic. British Medical Journal 2009; 338: b1751.

2.J Cohen . Swine flu outbreak. Out of Mexico? Scientists ponder swine flu's origin. Science 2009; 324: 700702.

3.World Health Organization. Influenza A(H1N1) Update 55 (29 June). ( Accessed 1 July 2009.

4.Health Protection Agency and Health Protection Scotland Influenza virus A(H1N1) Investigation Teams. Epidemiology of influenza virus A(H1N1)v in the United Kingdom, April–May 2009. Eurosurveillance 2009; 14(19): pii=19213.

5.AS Monto . Interrupting the transmission of respiratory tract infections: theory and practice. Clinical Infectious Diseases 1999; 28: 200204.

6.WP Glezen , Influenza virus infections in infants. Pediatric Infectious Disease Journal 1997; 16: 10651068.

7.WP Glezen . Herd protection against influenza. Journal of Clinical Virology 2006; 37: 237243.

8.C Viboud , Risk factors of influenza transmission in households. British Journal of General Practice 2004; 54: 684689.

9.CDC. Swine-Origin Influenza A (H1N1) Virus Infections in a School – New York City, April 2009. Morbidity and Mortality Weekly Reports 2009; 58: 470472.

10.Anon. Human infection with influenza virus A(H1N1): clinical observations from a school-associated outbreak in Kobe, Japan, May 2009. WHO Weekly Epidemiological Record 2009; 24: 237248.

11.J McMenamin , Minimum dataset for confirmed human cases of influenza H5N1. Lancet 2008; 372: 696697.

12.Novel Swine-Origin Influenza A (H1N1) investigation Team. Emergence of a novel swine-origin influenza A (H1N1) virus in humans. New England Journal of Medicine 2009; 360: 26052615.

13.LM Glass , RJ Glass . Social contact networks for the spread of pandemic influenza in children and teenagers. BMC Public Health 2008; 8: 61.

14.G Brankston , Transmission of influenza A in human beings. Lancet Infectious Diseases 2007; 7: 257265.

15.KM Neuzil , C Hohlbein , Y Zhu . Illness among schoolchildren during influenza season: effect on school absenteeism, parental absenteeism from work, and secondary illness in families. Archives of Pediatric and Adolescent Medicine 2002; 156: 986991.

16.RJ Glass , Targeted social distancing design for pandemic influenza. Emerging Infectious Diseases 2006; 12: 16711681.

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