Implementation of community influenza centers and vaccination campaign in protecting healthcare workers and control of pandemic (H1N1) 2009 in Taipei City, Taiwan

摘要

Dear Editor, We read with interest the article by Maltezou et al. on vaccination coverage against vaccine-preventable diseases among healthcare workers (HCWs) in Greece. HCWs are at high risk of acquiring emerging infections while caring for patients, as has been shown with SARS and influenza epidemics. In Taiwan, the first case of the pandemic (H1N1) 2009 influenza was identified in May, 2009. The strategy was shift from containment to mitigation in late June, 2009. There were sporadic clusters since August 2009, as the influenza spread throughout a family-school-community transmission cascade, the upsurge outbreak in the community was identified in the beginning of September 2009. As the whole community saturated with sufficiently numbers of influenza patients, severe or complicated cases accumulated and patients began to visit the hospitals, which further exaggerating the viral transmission and the nosocomial outbreak ensued. In Taipei City, 119 non-HCW civilians were diagnosed with pandemic (H1N1) 2009 infection and hospitalized due to complications of influenza. Meanwhile, despite implementation of the augmented infection control program, the incidence of H1N1 infections among HCWs increased as the numbers of hospitalized patients with complicated influenza increased in late August and September 2009 (Fig. 1). In response to the epidemic, Taipei Department of Health launched 212 community influenza centers (CICs) in mid-September 2009. It included 34 special influenza outpatient clinics in the hospitals and 178 volunteer general practitioners from the clinics. They received logistic support for the diagnosis of the pandemic (H1N1) 2009 virus and oseltamivir for its treatment. They had been installed with infection control measures including alcoholic disinfectant dispensers to facilitate hand hygiene. Each CIC received a certificate designating the facility as a CIC so that civilians could easily recognize the site for medical aid. All patients visiting the CICs with influenza-like illnesses (ILIs) were diagnosed with influenza A virus infection as revealed by positive reactions to rapid antigen tests or epidemiological linking and treated accordingly. Those with complications of influenza required hospitaliza-tion were referred to hospitals for further management. Throughout the whole course, there was no pandemic (H1N1) 2009 infection among HCWs serving in the CICs.