Implications of Non-Pharmaceutical Interventions for Mitigating Influenza in Schools and the Role of Co-Infection in the University Setting.

Epidemiology;Infectious disease;Public Health;Health Sciences;Epidemiological Science

Davis, Brian MichaelMonto, Arnold S ;

University of Michigan

关键词: Epidemiology;    Infectious disease;    Public Health;    Health Sciences;    Epidemiological Science;   

Others  :  https://deepblue.lib.umich.edu/bitstream/handle/2027.42/120891/bridavis_1.pdf?sequence=1&isAllowed=y

瑞士|英语

来源: The Illinois Digital Environment for Access to Learning and Scholarship

【 摘 要 】

The 2009 influenza A (H1N1) pandemic resulted in a renewed focus on non-pharmaceutical interventions (NPI) due to a delay in the development of an appropriate vaccine. Having determined that co-occurrence with either bacterial or viral pathogens may influence susceptibility to acute respiratory illness (ARI), we conducted one methodological review of co-occurrence as well as three novel studies, using available data from NPI studies in the community setting. We sought to examine risk factors for co-occurrence and to assess associations between school closures and influenza-like illness (ILI), a type of ARI.This research furthers knowledge regarding common respiratory agents, providing estimates of the prevalence of common viruses and bacteria as well as co-occurrence in a college-aged population. Additionally, we utilized surveillance data from the state of Michigan to provide a quantitative analysis of the effects of school closure. Our findings indicated a high prevalence of human coronaviruses during the season of interest among otherwise healthy adults with ARI, with coronavirus infected students having a decrease in symptomatic cough and chills over the 6-day illness episode measured, and runny nose increasing. A second finding of an association between viral infection and Streptococcus pneumoniae colonization suggests that ARI symptoms in young adults can be indicative of a viral and bacterial co-occurrence, and the screening for both can provide a better understanding of the causes of ARI. The finding suggested that a variety of underlying infectious agents cause ARI among young adults living in residence halls, suggesting this environment is conducive to ARI transmission. Finally, this dissertation found a minimal effect of reactive school closures on community levels of ILI during the 2009 H1N1 influenza A pandemic. While this finding does not disprove the effectiveness of school closure as an NPI, it does suggest that reactive school closures may not be effective once illness is already in the community. We discuss implications from these findings in order to better understand and address issues related to ARI in the real-world setting.