Developing guidelines for school closure interventions to be used during a future influenza pandemic

BMC Infectious Diseases

Research Article

Nilimesh Halder¹  Joel K Kelso¹  George J Milne¹ 

[1] School of Computer Science and Software Engineering, University of Western Australia, Perth, Australia;

关键词: Influenza;    Attack Rate;    Seasonal Influenza;    Influenza Pandemic;    Reproduction Number;   

DOI  :  10.1186/1471-2334-10-221

 received in 2010-03-24, accepted in 2010-07-27,  发布年份 2010

来源: Springer

【 摘 要 】

BackgroundThe 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.MethodsAn 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.ResultsIllness 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 R0 >= 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 R0 = 2.0 and 2.5 respectively; however, school closure plus antivirals would give a significant reduction (~15%) in over all attack rate. The results also suggest that an individual school closure strategy would be more effective than simultaneous school closure.ConclusionsOur 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 (R0 < 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 (R0 >= 2.0), long duration school closure should begin as soon as possible and be combined with other interventions.

【 授权许可】

Unknown   
© Halder et al; licensee BioMed Central Ltd. 2010. This article is published under license to BioMed Central Ltd. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.