Two Aircraft Carriers’ Perspectives: A Comparative of Control Measures in Shipboard H1N1 Outbreaks

The USS George Washington (GW) and the USS Ronald Reagan (RR), 2 US Navy aircraft carriers, experienced almost simultaneous outbreaks of novel H1N1 influenza A in the summer of 2009. We compared the respective epidemic control measures taken and subsequent lessons learned. Data were collated from bo...

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Bibliographic Details
Published in:Disaster medicine and public health preparedness 2013-02, Vol.7 (1), p.29-35
Main Authors: Harwood, Jared L., LaVan, Joseph T., Brand, George J.
Format: Article
Language:English
Subjects:
Adult
Aircraft carriers
Antiviral Agents - therapeutic use
Biological and medical sciences
Clinical Protocols
Disease
Disease Outbreaks - prevention & control
Drug therapy
Epidemics
Female
Human viral diseases
Humans
Illnesses
Immunization
Infection Control - methods
Infectious diseases
Influenza A Virus, H1N1 Subtype
Influenza, Human - prevention & control
Influenza, Human - transmission
Male
Masks
Medical personnel
Medical sciences
Middle Aged
Military Personnel
Miscellaneous
Original Research
Oseltamivir - therapeutic use
Pandemics
Ports
Public health
Public health. Hygiene
Public health. Hygiene-occupational medicine
Quarantine
Ships
Swine flu
Time Factors
Viral diseases
Viral diseases of the respiratory system and ent viral diseases
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Summary:The USS George Washington (GW) and the USS Ronald Reagan (RR), 2 US Navy aircraft carriers, experienced almost simultaneous outbreaks of novel H1N1 influenza A in the summer of 2009. We compared the respective epidemic control measures taken and subsequent lessons learned. Data were collated from both outbreaks to assess various elements including attack rate, isolation/quarantine protocols, and treatment methods. The respective duration of each outbreak was compared with survival curve analysis. The number of personnel affected in each outbreak was compared using χ2 analysis. Differences were found in the protocols used on the 2 ships. The GW treated about two-thirds of the patients with oseltamivir through day 14 and quarantined all patients meeting case definition throughout the outbreak. Face masks were used throughout. The RR used oseltamivir and quarantined many fewer patients (through days 5 and 3, respectively). No face masks were used after day 5. The outbreaks were similar in duration (GW = 25 days, RR = 27 days, P = .38), but the RR had significantly more cases (n = 253 vs 142, P < .0001). A portion of each group had samples that were confirmed H1N1 by polymerase chain reaction. GW's protocol, including aggressive oseltamivir treatment of two-thirds of the cases and quarantine throughout the duration decreased the overall number of personnel affected, likely reducing the overall control reproduction number. Both outbreaks were similar in duration. Even though the GW expended significantly more resources than the RR, if the 2009 pandemic H1N1 strain had been as clinically severe as the 1918 pandemic, a more stringent treatment protocol may have been the only way to prevent significant operational impact.
ISSN:1935-7893
1938-744X
DOI:10.1001/dmp.2012.53