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Targeted school closings may help prevent widespread flu transmission
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Region-focused and gradual school closure policies, which target schools with high levels of influenza, may prevent widespread outbreaks of pandemic influenza and decrease the cost burden associated with current response policies, according to research in PLOS Computational Biology.
“School closure is a nonpharmaceutical intervention, considered for the mitigation of influenza epidemics and pandemics, whose impact and cost-effectiveness are still disputed,” Laura Fumanelli, PhD, of the Bruno Kessler Foundation in Trento, Italy, and colleagues wrote.
Laura Fumanelli
The researchers performed a model-based analysis, which simulated influenza spread, to evaluate the effectiveness of four types of school closure policies. These included national closure, closing all schools within a country; countywide closure, closing all schools within a high-risk county; reactive school-by-school closure, closing schools when absenteeism exceeds a given limit; and gradual closure, first closing classrooms, then grades, then entire schools. Closure types were considered based on feasibility, utilizing absenteeism and national influenza-like illness monitoring systems. The researchers based their model on the 2009 A/H1N1 influenza pandemic in the United Kingdom.
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Modeling results showed that gradual and countywide closure policies were the most effective at mitigating transmission of influenza during heightened periods. The researchers said closure periods of 1 week separated by closures of variable duration were optimal at breaking the chain of transmission.
“We found that, under specific constraints on the average number of weeks lost per student, reactive school-by-school, gradual, and countywide closure give comparable outcomes in terms of optimal infection attack rate reduction, peak incidence reduction or peak delay,” the researchers wrote.
Fumanelli and colleagues also found that gradual and countywide closure policies would entail the lowest social costs of all closure types because they involved fewer students and therefore less coordination with parents and public officials. The investigators said these results suggest that closure policies could be less costly than traditional influenza response policies.
“Our results suggest that health care policymakers may consider school closure as a countermeasure during influenza outbreaks, if put in the condition to properly evaluate the severity of the disease and the subsequent level of effort that a country should be ready to afford,” Fumanelli and colleagues wrote. – by David Costill
Disclosure: The researchers report no relevant financial disclosures.
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