Phramongkutklao College of Medicine, Thailand
Ploypun Narindrarangkura graduated from Phramongkutklao College of Medicine in 2013. Now she is the faculty of Military and Community Medicine Department, Phramongkutklao College of Medicine. Her previous study was on “Prevalence and Risk Factors of Obstructive Sleep Apnea (OSA) Using Modified Berlin Questionnaire in Thai Rural Community”. She used to present this research at APMMC conference when she was a medical student. She is fascinated with research in public health and infectious disease.
Influenza is a respiratory disease in which some subtypes have high virulence. In some particular setting such as military camp, the crowded environment is prone for an outbreak, rapid onset and difficult for controlling transmission. We investigated and characterized an operationally unique outbreak of H3 influenza A in 2nd year medical cadets at Phramongkutklao College of Medicine during October 2015. Case report form of respiratory infection was performed in both ILI and non-ILI cases. Nasopharyngeal swab was performed to idenfify influenza A/B. Positive cases for influenza A were further analyzed by real-time PCR (RT-PCR) method for H3 influenza A. Total of 103, 2nd year medical cadets were enrolled into the study. There were 40 (38.8%, 95% CI; 25.6 – 44.3) of them presented with ILI in which 28 cases (70 %) were positive for influenza A. Mean age was 19.6 years (SD=0.84). 2 cases (5%) later developed pneumonia and admitted to hospital. The factors asscocited with ILI were including occuplying in platoon 2 (OR=3.54, 95% CI; 1.25-10.03, p=0.017) and staying in the barrack within 2 weeks prior to the outbreak (OR=4.23, 95% CI; 1.14 – 15.79, p=0.031) medical cadets were immunized for influenza vaccine for 39 (37.9%) before commencing military training. Attack rate of ILI was significantly higher in unvaccinated cases (44.1%) than vaccinated cases (28.2%). We tested sampels of 10 positive cases of influenza A and found that all cases were A/H3 influenza by RT-PCR. We suggested that all military personnels should be vaccinated for influenza before recruitment. Military should seperate ILI case from others to prevent an outbreak.
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