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When should flu trigger a school shutdown?
Date:11/4/2009

Boston, Mass. -- As flu season approaches, parents around the country are starting to face school closures. But how bad should an influenza outbreak be for a school to shut down? A study led by epidemiologists John Brownstein, PhD, and Anne Gatewood Hoen, PhD of the Children's Hospital Boston Informatics Program, in collaboration Asami Sasaki of the University of Niigata Prefecture (Niigata, Japan), tapped a detailed set of Japanese data to help guide decision making by schools and government agencies. The analysis was published by the Centers for Disease Control and Prevention in the November issue of Emerging Infectious Diseases.

"Currently many U.S. schools don't have specific or consistent algorithms for deciding whether to shut down," says Brownstein. "They don't always use quantitative data, and it may be a political or fear-based decision rather than a data-based one."

Sasaki, Hoen and Brownstein analyzed flu absenteeism data from a Japanese school district with 54 elementary schools. Tracking four consecutive flu seasons (2004-2008), they asked what pattern of flu absenteeism was best for detecting a true school outbreak -- balanced against the practical need to keep schools open if possible.

"You'd want get a school closed before an epidemic peaks, to prevent transmission of the virus, but you also don't want to close a school unnecessarily," explains Brownstein. "We also wanted an algorithm that's not too complex, that could be easily implemented by schools."

A school outbreak was defined as a daily flu absentee rate of more than 10 percent of students. After comparing more than two dozen possible scenarios for closing a school, the analysis suggested three optimal scenarios:

  1. A single-day influenza-related absentee rate of 5 percent
  2. Absenteeism of 4 percent or more on two consecutive days
  3. Absenteeism of 3 percent or more on three consecutive days

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Contact: James Newton
james.newton@childrens.harvard.edu
617-919-3110
Children's Hospital Boston
Source:Eurekalert

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