Effective school actions for mitigating seasonal influenza outbreaks in Niigata, Japan.
Effective school actions for mitigating seasonal influenza outbreaks in Niigata, Japan.
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DOI：
10.1371/journal.pone.0074716
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发表时间：
2013
期刊：
影响因子：
3.7
通讯作者：
Suzuki H
中科院分区：
文献类型：
--
作者：
Sugisaki K;Seki N;Tanabe N;Saito R;Sasaki A;Sasaki S;Suzuki H
自1950年S根据《学校卫生法》，日本在季节性流感暴发期间实施了各种学校行动。然而，关闭的有效持续时间、范围和时间仍未确定。我们对日本新泻地区2004-2005至2007-2008学年连续四个流感季节小学停课与流感暴发控制的关系进行了回顾性研究。在72所学校的1061个班级中，61所学校记录了624例流感爆发。为应对流感暴发，共有62例学生停课，定义为学生因流感或流感样疾病缺勤率超过10%。在这些个案中，有28宗在学生缺勤率达到10%后的第二天进行停课，另有34宗则开始其他类型的停课。与其他类型的停课相比，为期两天的停课在一周内结束的疫情病例数量明显更多(分别为82.1%和20.6%)。根据疫情开始的季节、年级、星期几和疫情开始当天的缺勤率调整的多变量模型证实了两天停课与一周内疫情中断之间的显著关联(OR，3.18%；95%CI，1.12-9.07%；p = 0.030)。我们的结果表明，在缺勤率达到10%后的第二天进行为期两天的停课是缓解小学流感爆发的有效方法。
Japan has implemented various school actions during seasonal influenza outbreaks since the 1950's under the School Health Law. However, the effective duration, extent, and timing of closures remain unresolved. We conducted a retrospective study on the relationship between elementary class closures and influenza outbreak control during four consecutive influenza seasons from the 2004-2005 to 2007-2008 school years in Joetsu, Niigata, Japan. Among a total of 1,061 classes of 72 schools, 624 cases of influenza outbreaks were documented among 61 schools. Class closures were carried out in a total of 62 cases in response to influenza outbreak, which was defined as a student absentee rate of greater than 10% due to influenza or influenza-like illness. Of these cases, two-day class closures were conducted the day after reaching a 10% student absentee rate in 28 cases and other types of closures were initiated in 34 cases. A markedly higher number of outbreak cases ended within one week for two-day class closures compared to the other types of closures (82.1% vs. 20.6%, respectively). The significant association between two-day class closures and interruption of an outbreak within one week was confirmed using a multivariable model adjusted for the season, grade, day of the week of an outbreak start, and absentee rate on the day of an outbreak start (OR, 3.18; 95% CI, 1.12–9.07; p = 0.030). Our results suggest that a two-day class closure carried out the day after reaching a 10% absentee rate is an effective approach for mitigating influenza outbreaks in elementary schools.
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