Last update:
01-Dec-2010

OBJECTIVE The enlistment of young males in the Armed Forces is associated with specific epidemiological characteristics, such as crowding and physical and emotional distress that facilitate the rapid spread of respiratory pathogens. The influenza A(H1N1)n outbreak that occurred in September 2009 in a naval recruitment center in Attica, Greece is presented, and the usefulness of chemoprevention among the permanent personnel is discussed.

METHOD On September 1st 2009, 882 males presented for enlistment and training at the "Kanellopoulos" naval recruitment base. Of the 882 recruits, 497 were immediately transferred to the Poros recruitment center in order to avoid crowding and 385 stayed at the naval base. A retrospective analysis of the characteristics of the influenza A(H1N1)n outbreak was conducted in order to evaluate the usefulness of chemoprevention for the permanent personnel of the recruitment center. The pharyngeal exudate specimens were tested by real time polymerase chain reaction (RTPCR) for influenza A (H1N1)n.

RESULTS The total number of patients with flu-like symptoms was 68 (17.66% of the recruits of the naval base), of which 14 were transferred to the Athens Naval Hospital due to comorbidities; 13 of the transferred patients were confirmed to be suffering from influenza A(H1N1)n. The patients' main symptoms were fever, fatigue, body aches, cough, sore throat, shivering and diarrhea. The mean age of the patients was 23 years, the highest temperature 39.5°C and the mean duration of hospitalization 7 days. The disease severity was characterized as mild to moderate. None from the permanent personnel of the naval base presented with influenza symptoms.

CONCLUSIONS The influenza outbreak studied provides a useful example of the appropriate management for similar outbreaks in the future. On the understanding that the personnel is informed in good time about the disease and strict preventive measures are taken, the use of oseltamivir chemoprevention is not recommended among the permanent personnel of a recruitment center where influenza A(H1N1)n is confirmed.

Key words: Chemoprevention, Influenza A(H1N1)n, Oseltamivir, Outbreak, Training center.