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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.

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The eleven physicians independently of the Rt-PCR result were absent from work. The authors declare that they have no conflict of interests.

A nasopharyngeal swab was obtained and tested by Rt-PCR. Within the medical facility, there are 33 resident dormitories,12 to 15 m2 each, for 76 fellows. Instituto Mexicano del Seguro Social.

Declaration of conflicts of interest: Influenza A H1N1 has been more frequent in young people, as bolftin the case of the physicians seen.

Most of the cases were inter-related, as they shared the medical office, dorms or the weekend shift, and they all occurred in a small time frame. No severe forms of the disease or complications related with the influenza were observed. Most of the sick physicians were young and healthy, and boleton 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.

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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. 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 rate of ILI in this cohort of physicians was Based on the timeline and known incubation period, it is possible that Pandemic H1N was introduced into the boleyin with limited initial spread, and that then an accelerated spread with peak in transmission occurred with the first community peak in Mexico City.

A suspected case of influenza was defined as any booetin 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.

An outbreak investigation was conducted.

All sought medical attention within 1 to 7 days of initial symptoms. The rate of infection in this group of physicians was The hematologist, non-related to the remainder of the group, examined a confirmed case of influenza A H1N1. Por cada caso de ERC incluimos a dos controles sanos.

CARTAS AL EDITOR

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. Healthcare workers HCWs are of major concern during influenza epidemics.

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The clinical picture of these young physicians was highly suggestive of Pandemic H1N1. Sixty percent of these live at the hospital dormitories 2 to 6 per room. They did report being in close contact with other physicians fellows and staff who were suffering from ILI. Crowded conditions and long working hours in teaching hospitals may increase exposure to influenza A H1N1 in medical fellows, and might have been underestimated.

One hundred and seventeen post-graduate students 76 fellows were being trained in in 14 different specialties. This report is a brief description of Pandemic H1N1 in physicians, who are key to rapid and efficient healthcare delivery during outbreaks and disasters.

Although the Infection Control Committee alerted early to healthcare workers 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. Mean case age was Three had close contact with the staff Oncologist 2nd casebecause they were consulting in the same medical office.