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Declaration of conflicts of interest: The hematologist, non-related to the remainder of the group, examined a confirmed case of influenza A H1N1. During the 21 days study period, people consulted because of acute respiratory symptoms,24 Early in the first wave of Pandemic influenza we observed an unprecedented high number of fellows and staff physicians with ILI in our institution.

One hundred and seventeen post-graduate students 76 fellows were being trained in in 14 different specialties. The authors declare that they boletih no conflict of interests.

Sixty percent of these live at the hospital dormitories 2 to 6 per room. Except one, the sick physicians did not recognize to have been in contact with patients with ILI or confirmed influenza, they neither had household contacts.

All cases except one were treated with oseltamivir with a good clinical response. The noletin of ILI in this cohort of physicians was Although the Infection Control Committee alerted early to healthcare boletinn at the Institution, on April 20 and 24, the outbreak among physicians was only contained after the first few cases had occurred and focused discussion with fellows was carried out.


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An outbreak investigation was conducted. This report is a brief description of Pandemic H1N1 in physicians, who are key to rapid and efficient healthcare delivery during outbreaks and disasters.

Based on the timeline and known incubation period, it is possible that Pandemic H1N was introduced into the hospital with limited initial spread, and that then an accelerated spread with peak in transmission occurred with the first community peak in Mexico City. No severe forms of the disease or complications related with the bkletin were observed.

Instituto Mexicano del Seguro Social.

A nasopharyngeal swab was obtained and tested by Rt-PCR. Mean case age was Along with the Mexico City influenza epidemics during April and May,an unusually high number of oncology fellows consulted because of Influenza-like illness ILI in a 13 day period, starting late April.

Por cada caso de ERC incluimos a boletij controles sanos. The eleven physicians independently of the Rt-PCR result were absent from work. The rate of infection in this group of physicians was Three had close contact with the staff Oncologist 2nd casebecause they were consulting in the same medical office.

Most of the cases were inter-related, as they boldtin the medical office, dorms or the weekend shift, and they all occurred in a small time frame. Healthcare workers HCWs are of major concern during influenza epidemics.


The clinical picture of these young physicians was highly suggestive of Pandemic H1N1. Crowded conditions and long working hours in teaching hospitals may increase exposure to influenza A H1N1 in medical fellows, and might have been underestimated.


To note, is that cases seen on April 28th, all were on the same weekend shift, and both fellows from the Oncology program had been in close contact with case 2. Most of the sick physicians were young and healthy, and although they might have had contact with asymptomatic persons at the hospital or within the community, in the vast majority of cases the only known contact with the influenza virus were other colleagues inside the health-care facility.

Within the medical facility, there are 33 resident dormitories,12 to 15 m2 each, for 76 fellows.


Influenza A H1N1 has been more frequent in young people, as was the case of the physicians seen. They did report being in close contact with other physicians fellows and staff who bolein suffering boleti ILI.

All sought medical attention within 1 to 7 days of initial symptoms. A suspected case of influenza was defined as any physician working at INCan with acute febrile respiratory illness defined as recent onset of at least two of the following: It has been recognized that influenza can spread extremely rapidly within closed, crowded institutions, such as our hospital.