An influenza outbreak in a South African mine, following the relaxation of COVID-19 pandemic restrictions, September – December 2021

Introduction: In November 2021, two months after lifting COVID-19 restrictions, a cluster of laboratory-confirmed influenza cases was detected outside of the normal influenza season at a mine in South Africa. We aimed to determine factors associated with influenza infection. Methods: A suspe...

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Main Authors: Fiona Els, Mariana Khoza, Inge Kleinhans, Hetani Mdose, Sibongile Walaza, Cheryl Cohen, Anne von Gottberg, Fahima Moosa, Mignon du Plessis, Nicole Wolter, Chijioke Nkemjika Umunnakwe, Zinhle Makatini, Genevie Ntshoe, Andronica Moipone Shonhiwa, Nevashan Govender, Hugo Tempelman, Lourens Duvenhage, Charles Mandivenyi, Marlence Freda Ngobeni, Jackie Kleynhans
Format: Article
Language:English
Published: African Field Epidemiology Network 2024-08-01
Series:Journal of Interventional Epidemiology and Public Health
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Online Access:https://www.afenet-journal.net/content/article/7/40/full/
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Summary:Introduction: In November 2021, two months after lifting COVID-19 restrictions, a cluster of laboratory-confirmed influenza cases was detected outside of the normal influenza season at a mine in South Africa. We aimed to determine factors associated with influenza infection. Methods: A suspected influenza case was an employee presenting with acute onset of ≥1 symptom (fever, cough, rhinorrhoea, sore throat, shortness of breath, loss of smell or taste, myalgia, diarrhoea, nausea, vomiting) or any employee returning from leave or newly recruited. A confirmed influenza case was any person with laboratory-confirmed influenza. We calculated the influenza attack rate among 10 030 mine employees and assessed factors associated with influenza infection from 1 September–13 December 2021 using logistic regression. Results: There were 3,534 suspected influenza cases of which 161 tested influenza positive (influenza attack rate 1.6%, 161/10 030). Of the suspected influenza cases, 82% (2,886/3,534) were male and the mean age was 40-years. Among the confirmed cases, 87% (140/161) were male and the mean age was 39-years (IQR:31-45). Factors associated with laboratory-confirmed influenza were age 18-35-years (aOR 2.09; 95%CI 1.21-3.60) or 36-49 years (aOR 1.68, 95% CI: 1.02-2.79) vs. ≥50 years and working as an operator (aOR 3.47; 95%CI 1.23-9.75) or in engineering (aOR 3.20; 95%CI 1.03-9.98) vs. in the office. Of the 118 samples that were subtyped, 88 (74.6%) were influenza A(H1N1)pdm09. Conclusion: Out-of-season influenza outbreaks can occur in semi-closed communities. Influenza vaccines could help reduce illness and work absenteeism. Immediate recommendations included isolation of infected individuals and more personalized education to increase adherence to non-pharmaceutical interventions
ISSN:2664-2824