The influence of school holiday timing on epidemic impact

Eames, Ken T. D.

doi:10.1017/s0950268813002884

Cited by 30 publications

(26 citation statements)

References 29 publications

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“…Previous work on school holidays during the flu season suggested that a "late holiday" (e.g., occurs later in the epidemic period) reduces total epidemic size while an early holiday reduces the magnitude of the epidemic peak [35]. We observed a temporary dip in flu transmission immediately following the holiday period, which corresponds to other reports of holiday-related slowing of child transmission [21,22].…”

Section: Discussionsupporting

confidence: 83%

Contact, travel, and transmission: The impact of winter holidays on influenza dynamics in the United States

Ewing

Lee

Bansal

2016

Preprint

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Background: The seasonality of influenza is thought to vary depending on changes in environmental factors, human contact, and travel patterns. During winter holidays, when children are out of school, typical patterns of potential disease-causing contact and travel change. The aim of this research is to understand the impact of winter school holidays on age-specific and spatial flu transmission, and the resulting size and spread of the epidemic. We hypothesize that reduced contacts among children during school holidays will lower their infection rates, infection rates among adults will subsequently decrease as fewer children are sick, and increased travel during the holidays will hasten the spread of flu across the country.Methods: Using aggregated medical claims data from physician offices and hospitals in the United States, we examined influenza dynamics before, during, and after the winter holidays from 2001 to 2009. We quantified the changes to transmission and characterized holiday-associated changes to epidemic trajectories among children and adults in a spatial context. Informed by this empirical evidence, we used a deterministic, age-specific spatial metapopulation model to compare models with and without holiday-associated behavioral changes to understand the effects of holidays on flu season trajectories and spatial spread. Results:In analyzing eight seasons of medical claims data, we observed a mean 15% drop in the effective reproductive number immediately after Christmas. Rates of influenza-like illness among children experienced a sharp dip and recovery during and after the holidays, while adults experienced more gradual dips and recoveries during these periods. The model results demonstrated that both child and adult flu incidence dipped during the holiday period, but trends among adults lagged those in children. The peaks of the child and adult flu epidemics were delayed when the holiday was introduced, but the attack rate did not change significantly for either age group. In the medical claims data and the model-generated data with the holiday, the spatial synchrony of epidemic trajectories before and after the holiday remained similar. In the model-generated data without the holiday, however, epidemic trajectories became spatially asynchronous.Conclusions: Our work suggests that winter holidays delay the epidemic peaks and increase the spatial synchrony of natural trajectories for seasonal influenza in the United States every year. These findings have implications for the design of influenza intervention strategies, such as the proper timing and duration of school closures, and the spatial and demographic reallocation of vaccines.

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Section: Discussionsupporting

confidence: 83%

Contact, travel, and transmission: The impact of winter holidays on influenza dynamics in the United States

Ewing

Lee

Bansal

2016

Preprint

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“…A relatively small number of reinfections were identified in February, which coincided with the school holiday season, reducing contact opportunities among susceptible children. These results agreed with those of Eames et al [35], who suggested the association between holidays and disease epidemics.…”

Section: Discussionsupporting

confidence: 93%

Epidemiological characteristics of hand, foot and mouth disease reinfection in Guangzhou, Southern China from 2012 to 2017

Zhong

Wang

Chen

et al. 2019

Preprint

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Background: Hand, foot and mouth disease (HFMD) is a common infectious disease that occurs mostly in infants and children. Reinfection is not uncommon because of the limited cross-protection from infections of different enterovirus. This study was to investigate the epidemiological characteristics and its influential factors of HFMD reinfection in Guangzhou. Methods: Data on HFMD patients aged ≤5 years from 2012 to 2017 were extracted from surveillance system. Descriptive epidemiology method was adopted to analyze the characteristics of populations and time. Influential factors of reinfection were assessed using the logistic regression model. Results: Of 369,054 HFMD patients, 11,321 patients were classified as reinfection, corresponding to a rate of 3.07%. The reinfection rate in male was higher than in female (χ2=60.11, P<0.001). The reinfection rate in patients ≤1 year was 3.86%, which showed a downward trend with age (Z=37.37, Ptrend<0.001). The highest reinfection rate was observed in the scattered children (3.38%), followed by nursery care children and others (χ2=514.75, P<0.001). Besides, higher risk of reinfection was detected among those who were male, lower age group and other enteroviruses infection compared with their respective counterparts. Seasonality was illustrated according to the number of reinfections peaked from April to July. Time intervals curves revealed the number of reinfections gradually increased after 13 months from the initial infection. Conclusions: These results indicated that male ≤4 years, especially those lived scattered and infected with other enteroviruses were more likely to be reinfection. Administrations need to be alert to signs of HFMD reinfection. Effective interventions should be imposed on these high-risk children in time.

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“…The closure provided increased time to prepare a response and learn more about the disease, but the overall epidemic was very similar to what would have happened without the closure. In contrast, evidence suggests that summer holidays altered the final outcome of the pandemic (at least in the UK), significantly reducing the total number of infections by splitting the epidemic into two smaller peaks [13].…”

Section: Introductionmentioning

confidence: 99%

The timing of one-shot interventions for epidemic control

Lauro

Kiss

Miller

2020

Preprint

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The apparent early success in China's large-scale intervention to control the COVID-19 epidemic has led to interest in whether other countries can replicate it as well as concerns about a resurgence of the epidemic if or when China relaxes the interventions. In this paper we look at the impact of a single short-term intervention on an epidemic. We see that if an intervention cannot be sustained long-term, it has the greatest impact if it is imposed once infection levels have become large enough that there is an appreciable number of infections present. For minimising the total number infected it should start close to the peak so that there is no rebound once the intervention is stopped, while to minimise the peak prevalence, it should start earlier, allowing two peaks of comparable size rather than one very large peak. In populations with distinct subgroups, synchronized interventions are less effective than targeting the interventions in each sub-population separately.We do not attempt to clearly determine what makes an intervention sustainable or not. We believe that is a policy question. If an intervention is sustainable, it should be kept in place. Our intent is to offer insight into how best to time an intervention whose impact on society is too great to maintain.

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The influence of school holiday timing on epidemic impact

Cited by 30 publications

References 29 publications

Contact, travel, and transmission: The impact of winter holidays on influenza dynamics in the United States

Contact, travel, and transmission: The impact of winter holidays on influenza dynamics in the United States

Epidemiological characteristics of hand, foot and mouth disease reinfection in Guangzhou, Southern China from 2012 to 2017

The timing of one-shot interventions for epidemic control

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