Influence of School Closure on the Incidence of Viral Respiratory Diseases Among Children and on Health Care Utilization

Heymann, Anthony; Chodick, Gabriel; Reichman, Brian; Kokia, Ehud; J, Laufer

doi:10.1097/01.inf.0000128778.54105.06

Cited by 129 publications

(127 citation statements)

References 15 publications

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“…Had the school holidays not taken place, it is reasonable to suppose that there would have been a single large wave of influenza cases. School holidays have also been linked to a reduction in incidence of ILI in France [20] and Israel [22]. A review of school closures in relation to influenza can be found in Cauchemez et al [1].…”

Section: Introductionmentioning

confidence: 99%

The influence of school holiday timing on epidemic impact

Eames

2013

Epidemiol. Infect.

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SUMMARYThe impact of reactive school closure on an epidemic is uncertain, since it is not clear how an unplanned closure will affect social mixing patterns. The effect of school holidays on social mixing patterns is better understood. Here, we use mathematical models to explore the influence of the timing of school holidays on the final size and peak incidence of an influenza-like epidemic. A well-timed holiday can reduce the impact of an epidemic, in particular substantially reducing an epidemic's peak. Final size and peak incidence cannot both be minimized: a later holiday is optimal for minimizing the final size, while an earlier holiday minimizes peak incidence. Using social mixing data from the UK, we estimated that, had the 2009 influenza epidemic not been interrupted by the school summer holidays, the final size would have been about 20% larger and the peak about 170% higher.

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Section: Introductionmentioning

confidence: 99%

The influence of school holiday timing on epidemic impact

Eames

2013

Epidemiol. Infect.

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“…In addition to school closure, the risk of transmission may be reduced further by giving prophylactic treatment with antivirals like oseltamivir that are active against influenza viruses. However, it is difficult to predict how effective these measures will be during a real outbreak and the evidence is limited [3,4]. Even though children stay away from school, they may still meet in large groups outside school and the effectiveness of antiviral prophylaxis is dependent on compliance with taking the medication.…”

Section: Introductionmentioning

confidence: 99%

Compliance and side effects of prophylactic oseltamivir treatment in a school in South West England

Wallensten

Oliver

Lewis³

et al. 2009

Eurosurveillance

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School closure along with mass prophylactic oseltamivir treatment of pupils have been used in England and elsewhere to contain school outbreaks of influenza A(H1N1)v. We evaluated the protective effect, compliance with and side effects of oseltamivir chemoprophylactic treatment with a ten-day course of 1x 75mg given to 11-12-year-old pupils in one school year in a secondary school in South West England closed for ten days in response to a symptomatic laboratory-confirmed pupil. We distributed a questionnaire to pupils in the affected school year in class after the school had re-opened. Questions included symptoms of flu-like illness, compliance with chemoprophylaxis and side effects. All present on the day, 248 (93.2%) participated. Compliance with chemoprophylaxis was high, 77% took the full course, 91% took at least seven days. Fifty-one percent experienced symptoms such as feeling sick (31.2%), headaches (24.3%) and stomach ache (21.1%). Although some children were ill with flu-like symptoms, those tested did not have A(H1N1)v infection. Compliance with oseltamivir chemoprophylaxis was high, although likely side effects were common. The burden of side effects needs to be considered when deciding on mass oseltamivir chemoprophylaxis in children especially given that the symptoms of A(H1N1)v influenza are generally mild.

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“…Similarly, a large study of military recruits found that a structured top-down program of hand-washing at least five times daily nearly halved the incidence of acute respiratory illnesses, while recruits who washed hands less frequently reported more episodes of acute respiratory illnesses (OR 1.5, 95% CI 1.2 to 1.8) [11]. Interestingly, promoting hand-washing and using soap to wash hands were both associated with significantly reduced school absenteeism [12]. Teachers generally agree that a hand-washing program is easy to implement among primary students: step (1) wet hands, (2) lather fingers, (3) lather palms and backs of hands, (4) rinse, and (5) dry with a clean towel [13].…”

Section: Discussionmentioning

confidence: 99%

“…Similarly, an Israeli study of 186,094 children (between six and twelve years of age) reported temporary, preventative school closures resulted in a (a) 42% decreased morbidity from respiratory tract infections, (b) 28% decrease in visits to physicians and/or emergency department, and (c) 35% reduction in the purchase of medications [12].…”

Section: Discussionmentioning

confidence: 99%

Brief communication (Original). Effectiveness of influenza control using nonpharmaceutical interventions at primary schools in Nakhon Phanom Province, Northeast Thailand

2014

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Background:The world is entering the post-outbreak period of the 2009 A H1N1 strain of the influenza virus. The strain is expected to continue spreading, as seasonal influenza viruses do each year. The majority of children have relatively low immunity and engage in activities at school where opportunities abound for exposure to and spreading of diseases. Objectives: We compared the effectiveness of influenza prevention by using non-pharmaceutical measures in primary schools. Methods: This study was conducted at two medium-sized primary schools in Nakhon Phanom province, Thailand. Multistage sampling was used to select students from Grades 4 to 6. The study group consisted of 230 students from the 2 schools and the control group 224 students from the 2 schools. The research included (a) 8 h of instruction on influenza-like illnesses and their prevention integrated into health promotion and physical education classes and (b) building understanding among parents and in the community. Data were analyzed for frequencies, percentages, and multiple logistic regression. Results: Non-pharmaceutical influenza interventions reduced the rate of influenza-like illnesses by 77% (AOR = 0.23, 95% CI: 0.15"0.36). Students who did not receive the influenza-like prevention and control training had a morbidity of 54.9%; whereas those who received the training had a morbidity of 23.5%. Overall, the group receiving the educational model saw a 57% reduction in its morbidity compared with the control group. The students in the intervention group who washed their hands for 20 seconds three or more times per day had a morbidity of 38.9%, which resulted in an overall reduction in morbidity of 36.4%. The morbidity rate of students who missed school because they were ill was 39.5%. When comparing training methods, the hand-washing group saw morbidity reduced by 34.7%, while simply receiving news and information from public health officials resulted in only a 29.2% reduction in morbidity. Overall, the group receiving the disease prevention and control training was able to reduce morbidity by 58.7%. Conclusion: Influenza prevention education among students was integrated into the health education curriculum. Children were taught hand-washing and respiratory etiquette (i.e., covering the nose and face when sneezing, coughing, and nose-blowing). Cartoon media were used as visual teaching aids. The results from this program helped to decrease the number of cases of influenza-like illness and morbidity among students and families.

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Influence of School Closure on the Incidence of Viral Respiratory Diseases Among Children and on Health Care Utilization

Cited by 129 publications

References 15 publications

The influence of school holiday timing on epidemic impact

The influence of school holiday timing on epidemic impact

Compliance and side effects of prophylactic oseltamivir treatment in a school in South West England

Brief communication (Original). Effectiveness of influenza control using nonpharmaceutical interventions at primary schools in Nakhon Phanom Province, Northeast Thailand

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