Asian Influenza: Isolated Outbreak Within a Large Closed Population

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Abstract
Acute febrile illness occurring in 16 patients on the same day signaled and epidemic that involved 64 of 275 persons (23% attack rate). The outbreak was identified as due to Asian influenza by isolation of the virus from nasopharyngeal swabs from 4 patients and sharp antibody rises in paired acute and convalescent sera. The occurrence of Asian influenza in a population repeatedly vaccinated was a surprise. The nucleus of the outbreak was found to be recent admissions to the hospital who had not been vaccinated and who had no demonstrable antibodies against Asian influenza. Disease indistinguishable from that occurring in other patients was observed in a patient with an already existent antibody titer that is ordinarily regarded as protective. Further, some patients failed to show any demonstrable antibody titer rises in response to natural disease. It is suggested that demonstrable antibodies do not fully reflect the patient''s response to infection or his immunologic status. Patients newly admitted to closed populations should be vaccinated at the time of admission in order to serve maximally the purposes of preventive medicine.