Navigation Links
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

The scenarios #2 and #3 performed similarly, with the greatest sensitivity and specificity for predicting a flu outbreak (i.e., the fewest missed predictions and the fewest "false positives.") Both gave better results than the single-day scenario (#1). The researchers suggest that scenario #2 (with a sensitivity of 0.84 and a specificity of 0.77) might be the preferred early warning trigger, balancing the need to prevent transmission with the need to minimize unnecessary closures.

"Our method would give school administrators or government agencies a basis for timely closure decisions, by allowing them to predict the escalation of an outbreak using past absenteeism data," says Hoen. "It could be used with data from schools in other communities to provide predictions. It would leave decision-making in the hands of local officials, but provide them with a data-driven basis for making those decisions."

Japan makes a good model for studying influenza in schools because it closely monitors school absenteeism due to flu, requires testing for the flu virus in students who become ill, and has a track record of instituting partial or complete school closures during outbreaks. However, Brownstein cautions that the scenarios might play out differently in the U.S. than they would in Japan, mainly because students here aren't required to be tested for influenza as they are in Japan, so it's less certain whether they actually have the flu. Also, the vaccination status of students in this study was unknown.

Last spring, during the early days of the H1N1 influenza pandemic, the CDC recommended first a 7-day school closure, then a 14-day closure after appearance of the first suspected case. Later, as more became known about the extent of community spread and disease severity, the CDC changed the recommendation to advise against school closure unless absentee rates interfered with school function. CDC's current guidelines (http://www.cdc.gov/h1n1flu/schools/schoolguidance.htm, 10/21/09) don't provide a specific algorithm, but state that "the decision to selectively dismiss a school should be made locally," in conjunction with local and state health officials, "and should balance the risks of keeping the students in school with the social disruption that school dismissal can cause." When the decision is made to dismiss students, CDC recommends doing so for 5 to 7 calendar days.


'/>"/>

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

Related medicine news :

1. Mark McGwires Message: Cheat, Do Drugs, Cover Up When Congress Investigates, Says Ex-White House Drug Spokesman Bob Weiner; World Series Should Test Both Teams During Games
2. Should noninvasive ventilation be considered a high-risk procedure during an epidemic?
3. How should mental, neurological and substance use disorders be treated where resources are scarce?
4. K-State Veterinarian Says Owners Should Count How Many Calories Their Obese Pets Take In And Consider Several Factors When Feeding Pets For Good Health
5. National Health Care Reformers Should Pay Attention to Lawsuit Alleging that Nations Largest Insurer Routinely Denies Liver Transplants
6. Nurses Should Be Included In Health Care Debate
7. World Vision Says Asian Disasters Should Be Wake-Up Call For Global Leaders
8. Mental Illness Awareness Week: What You Should Know, Including PBS Broadcasts, Oct. 4-10
9. Breast milk should be drunk at the same time of day that it is expressed
10. Researchers believe hormone therapy should not be stopped prior to mammograms
11. Medicinal products susceptible to dose dumping should be fully tested
Post Your Comments:
*Name:
*Comment:
*Email:
(Date:3/23/2017)... ... March 23, 2017 , ... “My Journey Through Heaven”: the true-life account of ... profound faith of God’s promise of Heaven for His people. “My Journey Through Heaven” ... with his wife, three children and six grandchildren living and doing for God as ...
(Date:3/23/2017)... ... March 23, 2017 , ... “A ... God. “A Respectful Response To Atheist Manifesto” is the creation of published author ... wife, Nancy, for sixty years. He holds graduate degrees from Kent State University ...
(Date:3/23/2017)... ... March 23, 2017 , ... “More Corruption”: a simple and strong explanation of the ... of the rulers of Heaven was asked by God to write a book about Him. ... me just because I kept my commitment to the Lord God. They have not walked ...
(Date:3/22/2017)... ... ... Death anxiety is unconscious and needs understanding and non-judgmental support in a loving ... book titled “ As Good as Goodbyes Get ” (published by Balboa Press AU), ... experiencing at the bedside of patients who were dying. The book centers about questions ...
(Date:3/22/2017)... ... March 23, 2017 , ... ... solutions for drugs, biologics and consumer health products, today announced that it had ... currently taking place at the Suntec Singapore International Exhibition & Convention Centre, Singapore. ...
Breaking Medicine News(10 mins):
(Date:3/23/2017)... YORK , March 23, 2017 ... sample preparation market is expected to reach USD 7.2 billion ... of 7.1%. Sample preparation is a procedure in which a ... crucial step in most analytical procedures since the methods are ... preparation is one of the most shared procedures in the ...
(Date:3/23/2017)... Denmark , March 23, 2017 Ascendis ... its innovative TransCon technology to address significant unmet medical ... will host a conference call and webcast on Monday, ... the Endocrine Society in Orlando, Florida ... disease pipeline candidates (TransCon Growth Hormone, TransCon PTH and ...
(Date:3/23/2017)... , March 23, 2017  Cornerstone Pharmaceuticals, ... a major milestone today.  Following successful End-of-Phase ... U.S. Food and Drug Administration (FDA), the ... and regulatory path forward to conduct pivotal ... patients with acute myeloid leukemia (AML) and ...
Breaking Medicine Technology: