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Postexposure prophylaxis with oseltamivir in outbreak control of pH1N1 influenza onboard a naval warship: An observational study

1 MO, Western Fleet, Department of Community Medicine, HQWNC, Mumbai, Maharashtra, India
2 Professor & Sr Adv, Department of Community Medicine, HQWNC, Mumbai, Maharashtra, India
3 Associate Professor, Department of Community Medicine, AFMC, Pune, Maharashtra, India
4 Associate Professor, Department of Microbiology, AFMC, Pune, Maharashtra, India
5 FMO, HQ Western Fleet, Mumbai, Maharashtra, India

Correspondence Address:
Kavita B Anand,
Associate Professor, Department of Microbiology, AFMC, Pune, Maharashtra
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Source of Support: None, Conflict of Interest: None

DOI: 10.4103/jmms.jmms_19_20

Background: Control measures such as maintenance of social distancing, hand hygiene, respiratory hygiene, regular disinfection, and keeping a high index of suspicion for probable cases form the basis of containing a pH 1N1 outbreak onboard a Naval ship. As per the present guidelines, though a quadrivalent vaccine is recommended for health-care workers in close contact, anti-flu postexposure prophylaxis strategies have been predicted to be effective in some mathematical models. Chemoprophylaxis with oseltamivir was assumed to be an effective measure to control the outbreak onboard ship while at sea. Materials and Methods: A total of 275 asymptomatic individuals were started on oral oseltamivir prophylaxis on board from day 17 onward for a duration of 10 days and side effects of the medication were noted. Results: With chemoprophylaxis of the entire crew with oseltamivir, the number of positive cases per day reduced. The outbreak cleared within 3 days of initiation of chemoprophylaxis. Active surveillance was continued for 14 days since the last positive case. Conclusion: In an afloat setting, with a rapidly spreading outbreak of airborne disease, mass chemoprophylaxis with oral oseltamivir along with aggressive public health control measures were found to have contained the spread with only mild side effects which were reported.

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