The impact of school holidays on the social mixing patterns of school children

Abstract

School holidays are recognised to be of great epidemiological importance for a wide range of infectious diseases; this is postulated to be because the social mixing patterns of school children - a key population group - change significantly during the holiday period. However, there is little direct quantitative evidence to confirm this belief. Here, we present the results of a prospective survey designed to provide a detailed comparison of social mixing patterns of school children during school terms and during the school holidays. Paired data were collected, with participants recording their social contacts once during term time and once during the holiday period. We found that the daily number of recorded encounters approximately halved during the holidays, and that the number of close contact encounters fell by approximately one third. The holiday period also saw a change in the age structure of children's social contacts, with far fewer contacts of their own age, but an increase in the number of encounters with adults, particularly older adults. A greater amount of mixing between children at different schools was recorded during the holiday. We suggest, therefore, that whilst infections may spread rapidly within schools during term time, in the holiday period there are increased opportunities for transmission to other schools and other age groups.

Incidence and risk factors for influenza-like-illness in the UK: online surveillance using Flusurvey

“…The decline in incidence is coincident with Christmas holidays, and the resurgence of cases in this age group in the new year, after schools had reopened, is similar to other data [7,19-21]. The observation that incidence in the 19-45 year olds lagged behind the youngest age group, suggests that under 18s may have brought the illness back to their families.…”

The Effects of School Closures on Influenza Outbreaks and Pandemics: Systematic Review of Simulation Studies

“…Contact studies have found that school closures reduce contact between children substantially but have much less effect on adults' contact behaviour [51], [63], [64]. In a UK study, children's contacts were reduced overall during school holidays, but the number of contacts they made with adults increased [62]. The assumptions made in the modelling studies were therefore generally consistent with empirical data, but incorporating additional contact data into transmission models, as they become available, may increase the reliability of model predictions.…”

“…For example, it has been estimated that if such contacts increased 1·5 times more during a pandemic closure than during school holidays, then the benefits of school closure would be minimal [13]. This limitation arises partly because there are relatively few data regarding the effects of school closures, particularly reactive closures, on contact patterns [51], [52], [62]–[65] (although several studies estimated the effects of school closures on contact patterns using either empirical data or modelling techniques [13]–[17]). Existing data typically refer to face-to-face conversational contacts, which appear to be a good proxy for transmission of respiratory infections including influenza [66], although further studies are needed of the precise nature of contacts which are sufficient to allow transmission [67].…”

Targeted vaccination in healthy school children – Can primary school vaccination alone control influenza?

“…Studies have shown that the daily number of age-dependent contacts for children can vary between term-time and holidays or weekends [42][43][44]. The inclusion of additional contact matrices in the model would improve the accuracy of the mathematical model in estimating the daily number of contacts sufficient for influenza transmission between children and their contacts.…”