Tuesday, October 20, 2009

Air Force Academy Outbreak Reviewed

 

 

# 3854

 

 

Over the July 4th weekend, Air Force Academy cadets were exposed to the H1N1 swine flu at a Barbeque and fireworks display.  More than 100 developed symptoms in the 48 to 72 hours that followed. 

 

Occurring among such a tightly monitored group, this outbreak gives us a terrific opportunity to look at the spread, treatment, and course of illness of this H1N1 virus. 

 

Maggie Fox, ace Health and Science reporter for Reuters, brings us the details.   Follow the link to read it in its entirety.

 

 

July 4 swine flu outbreak shows pattern of virus

Tue Oct 20, 2009 12:00am EDT

* Nearly one in five still have virus after getting better

* Quick isolation halted spread

* Tamiflu of little help in healthy young patients

By Maggie Fox, Health and Science Editor

WASHINGTON, Oct 20 (Reuters) - More than 100 new cadets at the U.S. Air Force Academy got infected with swine flu at July 4 barbecue and fireworks display but quick isolation measures got it under control within two weeks, researchers reported on Tuesday.

 

The outbreak provided a unique opportunity to study the virus closely and Dr. Catherine Takacs Witkop and colleagues say they discovered some surprising things. Among them:

  • Nearly a quarter, or 24 percent, of patients still had virus in their noses seven days after getting sick, including 19 percent who had been well for at least 24 hours
  • Tamiflu, the drug used to treat influenza, did not help any of the previously healthy young men and women get better any quicker.
  • Most cadets were sick for five days or longer
  • Eleven percent of the cadets became infected.

(Continue . . . )

 

A few things of note. 


This outbreak was brought under control, according to the doctors treating the cadets, by invoking strict isolation policies

 

Sick cadets were moved to a single dormitory, and remained in isolation until they were free of symptoms for 24 hours, or for 7 days after symptoms first appeared, whichever was longer.

 

Most cadets were sick longer than 5 days, and nasal washes showed the virus still present 24 hours after symptoms abated in nearly 20% of victims. 

 

Whether these cadets were still infectious, absent symptoms of coughing and sneezing, is unknown.


The use of Tamiflu among healthy, fit, young cadets who experienced moderate illness (none were hospitalized, none died) showed no tangible benefit. Antivirals, it would appear, are of greatest value for those with severe symptoms.

 

All of which would seem to reinforce some of what we already knew. 

 

If you get sick, STAY HOME.   Don’t infect others.   Remember the sage advice offered by @CarolDn  (see Take The Pledge)

 

If you get sick, pledge to yourself: "This germ stops with me" Don't pass it forward.

 

That more than 10% of the attendees of this Barbeque came down with the virus within 72 hours speaks to the infectiousness of H1N1.  Which is why it is so important to stay home if you are sick. 


For the overwhelming majority of healthy, fit adults this virus produces a moderate, miserable, but survivable illness.  But note that more than half of these cadets were sick longer than 5 days.

 

So if you are an employer, or a teacher, don’t be surprised if this virus causes at least a week’s absence.  And that would be for uncomplicated illnesses.

 

As we gain more experience with this virus, we will undoubtedly see more studies of this sort, giving us a better idea of how this virus spreads, and reacts, in the population.


The health and level of fitness at the Air Force Academy, along with responsive medical care, no doubt helped to limit the impact of this virus on these cadets.  

 

Fortunately, even in the general population, roughly 99% of those infected recover without incident. 

 

But for the remaining 1%, H1N1 can prose a more serious threat. To those with pre-existing conditions like asthma, diabetes, and pregnancy, of course. 

 

But even among the healthy and fit.

 

And right now, we don’t have a reliable way of knowing, in advance, who will do well with this virus, and who won’t.