title: Control of an H1N1 outbreak in a correctional facility in central Taiwan.
abstract: BACKGROUND
  Controlling the outbreak of H1N1 in correctional facilities is difficult due to the inevitable close and prolonged contact between inmates. The current study reports an H1N1 outbreak in a correction facility and investigates the effectiveness of oseltamivir to control the spread of H1N1.
  
  
  METHODS
  All 2690 inmates at the prison received medical service from a single hospital. A list of patients with a diagnosis of influenza was compiled based on medical diagnoses with respiratory symptoms during the outbreak period. The outbreak was then investigated using both chart review and questionnaires.
  
  
  RESULTS
  In the 4-week outbreak period, 24.6% (663/2690) of inmates experienced influenza-associated symptoms, 50.5% (335/663) fulfilled the criteria for influenza-like illness (ILI) with fever, and the overall attack rate of ILI was 12.8%. Twelve inmates were admitted for complicated influenza, and three of them experienced respiratory failure. Oseltamivir was provided at the end of the 2nd week, and the effectiveness of oseltamivir in the 1004 inmates from seven major sections in the prison was analyzed. The ILI incidence rate reduced from 12.6 ± 4.1% between the 1st and 2nd weeks to 4.8 ± 2.4% between the 3rd and 4th weeks (p = 0.018) after the oseltamivir intervention. In the 878 uninfected inmates 47.0% (413/878) of inmates received prophylactic oseltamivir at the end of the 2nd week, the incidence of ILI was lower than those without prophylaxis (6.2% versus 2.4%; p = 0.013).
  
  
  CONCLUSIONS
  H1N1 influenza spread rapidly in the correctional facility. The use of oseltamivir may be a practical intervention to control an H1N1 outbreak an enclosed environment such as this.
authors.affiliation: Department of Internal Medicine, Taichung Veteran General Hospital, Chiayi Branch, Chiayi, Taiwan; Institute of Clinical Medicine, National Cheng Kung University Medical College, Tainan, Taiwan.
authors.forename: Wen-Cheng
authors.initials: WC
authors.lastname: Chao
authors.affiliation: Department of Internal Medicine, Taichung Veteran General Hospital, Taichung, Taiwan.
authors.forename: Po-Yu
authors.initials: PY
authors.lastname: Liu
authors.affiliation: Department of Internal Medicine, Taichung Veteran General Hospital, Chiayi Branch, Chiayi, Taiwan; Department of Respiratory Therapy, College of Health Care, China Medical University, Taichung, Taiwan. Electronic address: clwu@vghtc.gov.tw.
authors.forename: Chieh-Liang
authors.initials: CL
authors.lastname: Wu
mesh_terms: D000328:Adult; D000998:Antiviral Agents / Q000627:therapeutic use; D004196:Disease Outbreaks / Q000517:prevention & control*; D006268:Health Facilities; D006801:Humans; D053118:Influenza A Virus, H1N1 Subtype / Q000302:isolation & purification*; D007251:Influenza, Human / Q000188:drug therapy / Q000453:epidemiology* / Q000517:prevention & control*; D008297:Male; D008875:Middle Aged; D053139:Oseltamivir / Q000627:therapeutic use; D013624:Taiwan / Q000453:epidemiology
chemical_list: D000998:Antiviral Agents; D053139:Oseltamivir
keywords: H1N1; correctional facility; influenza; oseltamivir; outbreak