ArticleClinical infectious diseases : an official publication of the Infectious Diseases Society of America2009
Clinical and epidemiologic characteristics of an outbreak of novel H1N1 (swine origin) influenza A virus among United States military beneficiaries.
Article in Clinical infectious diseases : an official publication of the Infectious Diseases Society of America, 2009. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 46 papers, 4 of them syntheses that pooled it.
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Who cites it
46 citing papers in PubMed, 4 syntheses or guidelines pooled it, 100 citations in OpenAlex.
- Pooled it
- Attack rates assessment of the 2009 pandemic H1N1 influenza A in children and their contacts: a systematic review and meta-analysis.PloS one · 2012Pooled it
- Systematic review of clinical and epidemiological features of the pandemic influenza A (H1N1) 2009.Influenza and other respiratory viruses · 2011Pooled it
- A meta-analysis of point-of-care laboratory tests in the diagnosis of novel 2009 swine-lineage pandemic influenza A (H1N1).Diagnostic microbiology and infectious disease · 2011Pooled it
- Trial
- A theoretical epidemiological investigation into the transmission of respiratory infectious diseases during group meals among military personnel based on an individual-based model.Frontiers in public health · 2025Article
- Computational investigations of the immune response to repeated influenza infections and vaccinations.Royal Society open science · 2021Article
- Article
- Evidence in a Cluster Randomized Controlled Trial of Increased 2009 Pandemic Risk Associated With 2008-2009 Seasonal Influenza Vaccine Receipt.Clinical infectious diseases : an official publication of the Infectious Diseases Society of America · 2019Article
- Serial Vaccination and the Antigenic Distance Hypothesis: Effects on Influenza Vaccine Effectiveness During A(H3N2) Epidemics in Canada, 2010-2011 to 2014-2015.The Journal of infectious diseases · 2017Article
- Non-neutralizing antibodies induced by seasonal influenza vaccine prevent, not exacerbate A(H1N1)pdm09 disease.Scientific reports · 2016Article
- A Perfect Storm: Impact of Genomic Variation and Serial Vaccination on Low Influenza Vaccine Effectiveness During the 2014-2015 Season.Clinical infectious diseases : an official publication of the Infectious Diseases Society of America · 2016Article
- Kinetics methods for clinical epidemiology problems.Proceedings of the National Academy of Sciences of the United States of America · 2015Article
- Fc receptors in antibody-dependent enhancement of viral infections.Immunological reviews · 2015Review
- Respiratory Infections in the U.S. Military: Recent Experience and Control.Clinical microbiology reviews · 2015Review
- Article
- Retrospective analysis of demographic and clinical factors associated with etiology of febrile respiratory illness among US military basic trainees.BMC infectious diseases · 2014Article
- Assessing the impact of public health interventions on the transmission of pandemic H1N1 influenza a virus aboard a Peruvian navy ship.Influenza and other respiratory viruses · 2014Article
- Clinical diagnosis of pandemic A(H1N1) 2009 influenza in children with negative rapid influenza diagnostic test by lymphopenia and lower C-reactive protein levels.Influenza and other respiratory viruses · 2014Article
- Different prognosis in hospitalized patients with influenza one season after the pandemic H1N1 influenza of 2009-2010 in Spain.Influenza and other respiratory viruses · 2013Article
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Authors and funding
11 authors at 5 institutions in 1 country.
Funding
Abstract
backgroundA novel swine-origin influenza A (H1N1) virus was identified in March 2009 and subsequently caused worldwide outbreaks. The San Diego region was an early focal point of the emerging pandemic. We describe the clinical and epidemiologic characteristics of this novel strain in a military population to assist in future outbreak prevention and control efforts.
methodsWe performed an epidemiologic evaluation of novel H1N1 virus infections diagnosed in San Diego County among 96,258 local US military beneficiaries. The structured military medical system afforded the ability to obtain precise epidemiologic information on the impact on H1N1 virus infection in a population. The novel H1N1 virus was confirmed using real-time reverse transcriptase polymerase chain reaction (rRT-PCR).
resultsFrom 21 April through 8 May 2009, 761 patients presented with influenza-like illness and underwent rRT-PCR testing. Of these patients, 97 had confirmed novel H1N1 virus infection, with an incidence rate of 101 cases per 100,000 persons. The median age of H1N1 patients with H1N1 virus infection was 21 years (interquartile range, 15-25 years). Fever was a universal symptom in patients with H1N1 virus infection; other symptoms included cough (present in 96% of patients), myalgia or arthralgia (57%), and sore throat (51%). Sixty-eight (70%) of our patients had an identifiable epidemiologic link to another confirmed patient. The largest cluster of cases of H1N1 virus infection occurred on a Navy ship and involved 32 (8%) of 402 crew members; the secondary attack rate was 6%-14%. The rapid influenza testing that was used during this outbreak had a sensitivity of 51% and specificity of 98%, compared with rRT-PCR. Only 1 patient was hospitalized, and there were no deaths.
conclusionsA novel H1N1 influenza A virus caused a significant outbreak among military beneficiaries in San Diego County, including a significant cluster of cases onboard a Navy ship. The outbreak described here primarily affected adolescents and young adults and resulted in a febrile illness without sequelae.
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