Simulating school closure strategies to mitigate an influenza epidemic.
Simulating school closure strategies to mitigate an influenza epidemic.
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DOI：
10.1097/phh.0b013e3181ce594e
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发表时间：
2010-05
期刊：
影响因子：
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通讯作者：
Burke DS
中科院分区：
文献类型：
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作者：
Lee BY;Brown ST;Cooley P;Potter MA;Wheaton WD;Voorhees RE;Stebbins S;Grefenstette JJ;Zimmer SM;Zimmerman RK;Assi TM;Bailey RR;Wagener DK;Burke DS
关于在流感大流行期间关闭学校作为缓解战略的影响，仍然存在大量争论。正在进行的2009年H1N1流感大流行提供了一个无与伦比的机会，可以用最新的模拟来测试干预措施。为了在2009年H1N1流感大流行期间协助阿勒格尼县卫生局，匹兹堡大学传染病模型研究小组使用宾夕法尼亚州阿勒格尼县的基于代理的计算机模拟模型(ABM)来探索不同学校关闭策略对缓解不同繁殖率(R0)的流感疫情的影响。整个学校系统的关闭并不比个别学校的关闭更有效。任何类型的学校关闭可能需要在疫情的大部分时间内(即至少8周)保持，才能对总体血清学发病率产生显著影响。事实上，相对较短的学校停课(即两周或更短时间)实际上可能会在疫情中期将易感学生送回学校，从而略微增加总体发病率。改变触发学校停课的疾病阈值似乎对学校停课的有效性没有实质性影响，这表明学校停课的短暂延误不应引起担忧。学校关闭本身可能无法平息疫情，但如果持续至少8周，可能会将疫情高峰期推迟长达一周，从而提供更多时间来实施第二次更有效的干预措施，如接种疫苗。
There remains substantial debate over the impact of school closure as a mitigation strategy during an influenza pandemic. The ongoing 2009 H1N1 influenza pandemic has provided an unparalleled opportunity to test interventions with the most up-to-date simulations. To assist the Allegheny County Health Department during the 2009 H1N1 influenza pandemic, the University of Pittsburgh Models of Infectious Disease Agents Study group employed an agent-based computer simulation model (ABM) of Allegheny County, Pennsylvania, to explore the effects of various school closure strategies on mitigating influenza epidemics of different reproductive rates (R0). Entire school system closures were not more effective than individual school closures. Any type of school closure may need to be maintained throughout most of the epidemic (ie, at least 8 weeks) to have any significant effect on the overall serologic attack rate. In fact, relatively short school closures (ie, 2 weeks or less) may actually slightly increase the overall attack rate by returning susceptible students back into schools in the middle of the epidemic. Varying the illness threshold at which school closures are triggered did not seem to have substantial impact on the effectiveness of school closures, suggesting that short delays in closing schools should not cause concern. School closures alone may not be able to quell an epidemic but, when maintained for at least 8 weeks, could delay the epidemic peak for up to a week, providing additional time to implement a second more effective intervention such as vaccination.