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Developing guidelines for school closure interventions to be used during a future influenza pandemic.
BMC Infect Dis. 2010 Jul 27; 10:221.BI

Abstract

BACKGROUND

The A/H1N1 2009 influenza pandemic revealed that operational issues of school closure interventions, such as when school closure should be initiated (activation trigger), how long schools should be closed (duration) and what type of school closure should be adopted, varied greatly between and within countries. Computer simulation can be used to examine school closure intervention strategies in order to inform public health authorities as they refine school closure guidelines in light of experience with the A/H1N1 2009 pandemic.

METHODS

An individual-based simulation model was used to investigate the effectiveness of school closure interventions for influenza pandemics with R0 of 1.5, 2.0 and 2.5. The effectiveness of individual school closure and simultaneous school closure were analyzed for 2, 4 and 8 weeks closure duration, with a daily diagnosed case based intervention activation trigger scheme. The effectiveness of combining antiviral drug treatment and household prophyaxis with school closure was also investigated.

RESULTS

Illness attack rate was reduced from 33% to 19% (14% reduction in overall attack rate) by 8 weeks school closure activating at 30 daily diagnosed cases in the community for an influenza pandemic with R0 = 1.5; when combined with antivirals a 19% (from 33% to 14%) reduction in attack rate was obtained. For R(0) > or = 2.0, school closure would be less effective. An 8 weeks school closure strategy gives 9% (from 50% to 41%) and 4% (from 59% to 55%) reduction in attack rate for R(0) = 2.0 and 2.5 respectively; however, school closure plus antivirals would give a significant reduction (approximately 15%) in over all attack rate. The results also suggest that an individual school closure strategy would be more effective than simultaneous school closure.

CONCLUSIONS

Our results indicate that the particular school closure strategy to be adopted depends both on the disease severity, which will determine the duration of school closure deemed acceptable, and its transmissibility. For epidemics with a low transmissibility (R(0) < 2.0) and/or mild severity, individual school closures should begin once a daily community case count is exceeded. For a severe, highly transmissible epidemic (R(0) > or = 2.0), long duration school closure should begin as soon as possible and be combined with other interventions.

Authors+Show Affiliations

School of Computer Science and Software Engineering, University of Western Australia, Perth, Australia.No affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article

Language

eng

PubMed ID

20659348

Citation

Halder, Nilimesh, et al. "Developing Guidelines for School Closure Interventions to Be Used During a Future Influenza Pandemic." BMC Infectious Diseases, vol. 10, 2010, p. 221.
Halder N, Kelso JK, Milne GJ. Developing guidelines for school closure interventions to be used during a future influenza pandemic. BMC Infect Dis. 2010;10:221.
Halder, N., Kelso, J. K., & Milne, G. J. (2010). Developing guidelines for school closure interventions to be used during a future influenza pandemic. BMC Infectious Diseases, 10, 221. https://doi.org/10.1186/1471-2334-10-221
Halder N, Kelso JK, Milne GJ. Developing Guidelines for School Closure Interventions to Be Used During a Future Influenza Pandemic. BMC Infect Dis. 2010 Jul 27;10:221. PubMed PMID: 20659348.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Developing guidelines for school closure interventions to be used during a future influenza pandemic. AU - Halder,Nilimesh, AU - Kelso,Joel K, AU - Milne,George J, Y1 - 2010/07/27/ PY - 2010/03/24/received PY - 2010/07/27/accepted PY - 2010/7/28/entrez PY - 2010/7/28/pubmed PY - 2010/9/25/medline SP - 221 EP - 221 JF - BMC infectious diseases JO - BMC Infect Dis VL - 10 N2 - BACKGROUND: The A/H1N1 2009 influenza pandemic revealed that operational issues of school closure interventions, such as when school closure should be initiated (activation trigger), how long schools should be closed (duration) and what type of school closure should be adopted, varied greatly between and within countries. Computer simulation can be used to examine school closure intervention strategies in order to inform public health authorities as they refine school closure guidelines in light of experience with the A/H1N1 2009 pandemic. METHODS: An individual-based simulation model was used to investigate the effectiveness of school closure interventions for influenza pandemics with R0 of 1.5, 2.0 and 2.5. The effectiveness of individual school closure and simultaneous school closure were analyzed for 2, 4 and 8 weeks closure duration, with a daily diagnosed case based intervention activation trigger scheme. The effectiveness of combining antiviral drug treatment and household prophyaxis with school closure was also investigated. RESULTS: Illness attack rate was reduced from 33% to 19% (14% reduction in overall attack rate) by 8 weeks school closure activating at 30 daily diagnosed cases in the community for an influenza pandemic with R0 = 1.5; when combined with antivirals a 19% (from 33% to 14%) reduction in attack rate was obtained. For R(0) > or = 2.0, school closure would be less effective. An 8 weeks school closure strategy gives 9% (from 50% to 41%) and 4% (from 59% to 55%) reduction in attack rate for R(0) = 2.0 and 2.5 respectively; however, school closure plus antivirals would give a significant reduction (approximately 15%) in over all attack rate. The results also suggest that an individual school closure strategy would be more effective than simultaneous school closure. CONCLUSIONS: Our results indicate that the particular school closure strategy to be adopted depends both on the disease severity, which will determine the duration of school closure deemed acceptable, and its transmissibility. For epidemics with a low transmissibility (R(0) < 2.0) and/or mild severity, individual school closures should begin once a daily community case count is exceeded. For a severe, highly transmissible epidemic (R(0) > or = 2.0), long duration school closure should begin as soon as possible and be combined with other interventions. SN - 1471-2334 UR - https://www.unboundmedicine.com/medline/citation/20659348/Developing_guidelines_for_school_closure_interventions_to_be_used_during_a_future_influenza_pandemic_ L2 - https://bmcinfectdis.biomedcentral.com/articles/10.1186/1471-2334-10-221 DB - PRIME DP - Unbound Medicine ER -