Influenza outbreak in a correctional facility

Risk Factors Associated with Subclinical Human Infection with Avian Influenza A (H5N1) Virus—Cambodia, 2006

“…Although we were not able to isolate H5N1 viruses from these environmental specimens, experimental studies have shown that avian influenza A viruses can remain detectable in water and wet feces for up to 4 -6 days at 37°C [16,17]. Avian-to-human transmission of H5N1 virus is thought to occur through aerosolized virus inhalation into the respiratory tract or by inoculation of the nose, mouth, or conjunctival mucosa through self-transfer from contaminated hands, because H5N1 viruses replicate primarily in the human respiratory tract [18,19]. However, there is evidence to suggest that H5N1 viruses can penetrate via the gastrointestinal tract, suggesting that ingestion of contaminated food (e.g., ingestion of H5N1 virus-infected duck blood or uncooked or undercooked poultry or poultry products) or ingestion of water contaminated with H5N1 virus-infected feces could be potential infectious sources [20 -23].…”

Influenza control in Australian prison settings: Cost ‐ benefit analysis of major strategies

“…about 50 health staff), occurring once every 10 years. We also assume attack rates for these periodic outbreaks to be similar to that documented in the 2000 prison hospital outbreak (Awofeso et al, 2001).…”

“…It has been shown that the rate of progression of influenza epidemics in confined settings is affected by levels of herd immunity (Gross et al, 1988;Jefferson, Bianco, & Demicheli, 2002), poor match between vaccine, and circulating virus(es), and infection of immunosuppressed hosts (Carter, Renzullo, Helgerson, Martin, & Jekel, 1990). The rate of progression is also affected by the mobility of inmates/residents and staff, and spread by visitors and health care staff to inmates/residents (Awofeso et al, 2001). Well-timed and appropriately matched vaccination has been shown to significantly reduce morbidity and mortality, particularly in groups at high risk of infection (Demicheli, Rivetti, Deeks, & Jefferson, 2001).…”

“…Apart from a documented influenza outbreak in an Australian correctional facility in 2000 (Awofeso et al, 2001), the only other reported prison influenza outbreak was the October 2002 outbreak in a North Florida (United States) prison, which was estimated to have affected at least 100 inmates and two staff (Wright et al, 2002). In contrast, there are many documented influenza outbreaks in other ''closed'' environments, such as nursing homes (Guy et al, 2004;Ikeda & Drabkin, 1992;, ships (Earhart et al, 2001;Ferson et al, 2000), and confined workplaces such as oil rigs and barracks (Johnston, Krause, Miller, & Barclay 1997;Laurel et al, 2001).…”

Prisons show prophylaxis for close contacts may indeed help in next flu pandemic

“…Documented outbreaks of flu in prisons have been rare since then 3. However, our modelling studies and the limited experience with managing such a prison outbreak indicate that quarantining clinically ill inmates in their cells or a health facility and giving antiviral prophylaxis to inmates and frontline staff in the same “wing” of the prison in which the outbreak occurred provide a more favourable cost benefit than annual mass vaccination, or a “do nothing” approach 3…”