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The effects of school closures on influenza outbreaks and pandemics: systematic review of simulation studies.
PLoS One. 2014; 9(5):e97297.Plos

Abstract

BACKGROUND

School closure is a potential intervention during an influenza pandemic and has been investigated in many modelling studies.

OBJECTIVES

To systematically review the effects of school closure on influenza outbreaks as predicted by simulation studies.

METHODS

We searched Medline and Embase for relevant modelling studies published by the end of October 2012, and handsearched key journals. We summarised the predicted effects of school closure on the peak and cumulative attack rates and the duration of the epidemic. We investigated how these predictions depended on the basic reproduction number, the timing and duration of closure and the assumed effects of school closures on contact patterns.

RESULTS

School closures were usually predicted to be most effective if they caused large reductions in contact, if transmissibility was low (e.g. a basic reproduction number <2), and if attack rates were higher in children than in adults. The cumulative attack rate was expected to change less than the peak, but quantitative predictions varied (e.g. reductions in the peak were frequently 20-60% but some studies predicted >90% reductions or even increases under certain assumptions). This partly reflected differences in model assumptions, such as those regarding population contact patterns.

CONCLUSIONS

Simulation studies suggest that school closure can be a useful control measure during an influenza pandemic, particularly for reducing peak demand on health services. However, it is difficult to accurately quantify the likely benefits. Further studies of the effects of reactive school closures on contact patterns are needed to improve the accuracy of model predictions.

Authors+Show Affiliations

Department of Infectious Disease Epidemiology, London School of Hygiene and Tropical Medicine, London, United Kingdom; Statistics, Modelling and Economics Department, Public Health England, London, United Kingdom.Department of Infectious Disease Epidemiology, London School of Hygiene and Tropical Medicine, London, United Kingdom.Field Epidemiology Services, Public Health England, Birmingham, United Kingdom.West Midlands Public Health England Centre, Public Health England, Birmingham, United Kingdom.Department of Infectious Disease Epidemiology, London School of Hygiene and Tropical Medicine, London, United Kingdom; Statistics, Modelling and Economics Department, Public Health England, London, United Kingdom.

Pub Type(s)

Journal Article
Research Support, Non-U.S. Gov't
Review
Systematic Review

Language

eng

PubMed ID

24830407

Citation

Jackson, Charlotte, et al. "The Effects of School Closures On Influenza Outbreaks and Pandemics: Systematic Review of Simulation Studies." PloS One, vol. 9, no. 5, 2014, pp. e97297.
Jackson C, Mangtani P, Hawker J, et al. The effects of school closures on influenza outbreaks and pandemics: systematic review of simulation studies. PLoS One. 2014;9(5):e97297.
Jackson, C., Mangtani, P., Hawker, J., Olowokure, B., & Vynnycky, E. (2014). The effects of school closures on influenza outbreaks and pandemics: systematic review of simulation studies. PloS One, 9(5), e97297. https://doi.org/10.1371/journal.pone.0097297
Jackson C, et al. The Effects of School Closures On Influenza Outbreaks and Pandemics: Systematic Review of Simulation Studies. PLoS One. 2014;9(5):e97297. PubMed PMID: 24830407.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - The effects of school closures on influenza outbreaks and pandemics: systematic review of simulation studies. AU - Jackson,Charlotte, AU - Mangtani,Punam, AU - Hawker,Jeremy, AU - Olowokure,Babatunde, AU - Vynnycky,Emilia, Y1 - 2014/05/15/ PY - 2013/10/18/received PY - 2014/04/17/accepted PY - 2014/5/17/entrez PY - 2014/5/17/pubmed PY - 2015/1/23/medline SP - e97297 EP - e97297 JF - PloS one JO - PLoS One VL - 9 IS - 5 N2 - BACKGROUND: School closure is a potential intervention during an influenza pandemic and has been investigated in many modelling studies. OBJECTIVES: To systematically review the effects of school closure on influenza outbreaks as predicted by simulation studies. METHODS: We searched Medline and Embase for relevant modelling studies published by the end of October 2012, and handsearched key journals. We summarised the predicted effects of school closure on the peak and cumulative attack rates and the duration of the epidemic. We investigated how these predictions depended on the basic reproduction number, the timing and duration of closure and the assumed effects of school closures on contact patterns. RESULTS: School closures were usually predicted to be most effective if they caused large reductions in contact, if transmissibility was low (e.g. a basic reproduction number <2), and if attack rates were higher in children than in adults. The cumulative attack rate was expected to change less than the peak, but quantitative predictions varied (e.g. reductions in the peak were frequently 20-60% but some studies predicted >90% reductions or even increases under certain assumptions). This partly reflected differences in model assumptions, such as those regarding population contact patterns. CONCLUSIONS: Simulation studies suggest that school closure can be a useful control measure during an influenza pandemic, particularly for reducing peak demand on health services. However, it is difficult to accurately quantify the likely benefits. Further studies of the effects of reactive school closures on contact patterns are needed to improve the accuracy of model predictions. SN - 1932-6203 UR - https://www.unboundmedicine.com/medline/citation/24830407/The_effects_of_school_closures_on_influenza_outbreaks_and_pandemics:_systematic_review_of_simulation_studies_ L2 - https://dx.plos.org/10.1371/journal.pone.0097297 DB - PRIME DP - Unbound Medicine ER -