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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author 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
author_facet 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
author_sort Fiona Els
collection DOAJ
description 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
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series Journal of Interventional Epidemiology and Public Health
spelling doaj-art-721a4ac3f33d45e1a2d9c1d2f9da61ad2025-08-20T03:21:31ZengAfrican Field Epidemiology NetworkJournal of Interventional Epidemiology and Public Health2664-28242024-08-0173https://doi.org/10.37432/jieph.2024.7.3.131An influenza outbreak in a South African mine, following the relaxation of COVID-19 pandemic restrictions, September – December 2021Fiona Els0Mariana Khoza1Inge Kleinhans2Hetani Mdose3Sibongile Walaza4Cheryl Cohen5Anne von Gottberg6Fahima Moosa7Mignon du Plessis8Nicole Wolter9Chijioke Nkemjika Umunnakwe10Zinhle Makatini11Genevie Ntshoe12Andronica Moipone Shonhiwa13Nevashan Govender14Hugo Tempelman15Lourens Duvenhage16Charles Mandivenyi17 Marlence Freda Ngobeni18Jackie Kleynhans19Centre for Respiratory Diseases and Meningitis, National Institute for Communicable Diseases (NICD) of the National Health Laboratory Service (NHLS), Johannesburg, South Africa; South African Field Epidemiology Training Programme (SAFETP), Division of Public Health Surveillance and Response (DPHSR), NICD of the NHLS, Johannesburg, South Africa; School of Health Systems and Public Health, Faculty of Health Sciences, University of Pretoria, Pretoria, South AfricaOutbreak Response Unit (ORU), DPHSR, NICD of the NHLS, Johannesburg, South Africa; Department of Community Health, School of Public Health, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South AfricaOutbreak Response Unit (ORU), DPHSR, NICD of the NHLS, Johannesburg, South Africa; Department of Community Health, School of Medicine, Sefako Makgatho Health Sciences University, Pretoria, South Africa South African Field Epidemiology Training Programme (SAFETP), Division of Public Health Surveillance and Response (DPHSR), NICD of the NHLS, Johannesburg, South AfricaCentre for Respiratory Diseases and Meningitis, National Institute for Communicable Diseases (NICD) of the National Health Laboratory Service (NHLS), Johannesburg, South Africa; School of Public Health, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South AfricaCentre for Respiratory Diseases and Meningitis, National Institute for Communicable Diseases (NICD) of the National Health Laboratory Service (NHLS), Johannesburg, South Africa; School of Public Health, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South AfricaCentre for Respiratory Diseases and Meningitis, National Institute for Communicable Diseases (NICD) of the National Health Laboratory Service (NHLS), Johannesburg, South Africa;School of Pathology, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg Centre for Respiratory Diseases and Meningitis, National Institute for Communicable Diseases (NICD) of the National Health Laboratory Service (NHLS), Johannesburg, South Africa;School of Pathology, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg Centre for Respiratory Diseases and Meningitis, National Institute for Communicable Diseases (NICD) of the National Health Laboratory Service (NHLS), Johannesburg, South Africa;School of Pathology, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg Centre for Respiratory Diseases and Meningitis, National Institute for Communicable Diseases (NICD) of the National Health Laboratory Service (NHLS), Johannesburg, South Africa;School of Pathology, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg Ndlovu Research Centre, Ndlovu Laboratories, Dennilton, Limpopo, South AfricaNational Health Laboratory Service, Charlotte Maxeke Johannesburg Academic Hospital; Ndlovu Department of Virology, Faculty of Health Sciences, University of Witwatersrand, South AfricaSchool of Health Systems and Public Health, Faculty of Health Sciences, University of Pretoria, Pretoria, South Africa; Outbreak Response Unit (ORU), DPHSR, NICD of the NHLS, Johannesburg, South AfricaOutbreak Response Unit (ORU), DPHSR, NICD of the NHLS, Johannesburg, South AfricaOutbreak Response Unit (ORU), DPHSR, NICD of the NHLS, Johannesburg, South AfricaNdlovu Research Centre, Ndlovu Laboratories, Dennilton, Limpopo, South Africa; Department of Community Health, School of Public Health, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa; University of Utrecht, NetherlandsNdlovu Research Centre, Ndlovu Laboratories, Dennilton, Limpopo, South AfricaWorld Health Organization, Pretoria, South Africa; Limpopo Department of Health, Polokwane, South AfricaLimpopo Department of Health, Polokwane, South AfricaCentre for Respiratory Diseases and Meningitis, National Institute for Communicable Diseases (NICD) of the National Health Laboratory Service (NHLS), Johannesburg, South Africa; School of Public Health, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South AfricaIntroduction: 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 interventionshttps://www.afenet-journal.net/content/article/7/40/full/influenzaminerespiratory diseasesouth africaoutbreakrisk factors
spellingShingle 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
An influenza outbreak in a South African mine, following the relaxation of COVID-19 pandemic restrictions, September – December 2021
Journal of Interventional Epidemiology and Public Health
influenza
mine
respiratory disease
south africa
outbreak
risk factors
title An influenza outbreak in a South African mine, following the relaxation of COVID-19 pandemic restrictions, September – December 2021
title_full An influenza outbreak in a South African mine, following the relaxation of COVID-19 pandemic restrictions, September – December 2021
title_fullStr An influenza outbreak in a South African mine, following the relaxation of COVID-19 pandemic restrictions, September – December 2021
title_full_unstemmed An influenza outbreak in a South African mine, following the relaxation of COVID-19 pandemic restrictions, September – December 2021
title_short An influenza outbreak in a South African mine, following the relaxation of COVID-19 pandemic restrictions, September – December 2021
title_sort influenza outbreak in a south african mine following the relaxation of covid 19 pandemic restrictions september december 2021
topic influenza
mine
respiratory disease
south africa
outbreak
risk factors
url https://www.afenet-journal.net/content/article/7/40/full/
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