How much would closing schools reduce transmission during an influenza pandemic?
How much would closing schools reduce transmission during an influenza pandemic?
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DOI：
10.1097/ede.0b013e31812713b4
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发表时间：
2007-09-01
期刊：
影响因子：
5.4
通讯作者：
Barnes, Belinda
中科院分区：
文献类型：
--
作者：
Glass, Kathryn;Barnes, Belinda
背景：在决定是否在流感大流行期间关闭学校时，当局必须权衡可能的好处与预期的社会破坏。虽然学校已经关闭以减缓流感的传播，但关于对疾病传播的影响的证据有限。方法：为了评估在各种大流行情况下关闭学校的效益，我们使用了一个与过去流感大流行的发病率相适应的疾病传播随机数学模型。我们将这些益处与其他针对儿童的干预措施所取得的效果进行了比较。结果：关闭学校可以显著减少儿童之间的传播，但在大多数情况下，对所有个体（成人和儿童）的平均传播率只有中等影响。如果学校在2%的儿童感染之前关闭，那么关闭学校的大部分好处就可以实现；如果干预措施推迟到20%的儿童被感染，则收效甚微。对所有学龄儿童进行免疫接种只比关闭学校略为改善，这表明学校是儿童之间传播的重要场所。成人和儿童的相对感染率很好地说明了关闭学校可能带来的好处，对儿童感染率高的感染影响最大。结论：关闭学校在减少儿童之间的传播方面是有效的，但对更广泛人群的平均传播率只有中等影响，除非儿童受到不成比例的影响。
Background: When deciding whether to close schools during an influenza pandemic, authorities must weigh the likely benefits against the expected social disruption. Although schools have been closed to slow the spread of influenza, there is limited evidence as to the impact on transmission of disease. Methods: To assess the benefits of closing schools for various pandemic scenarios, we used a stochastic mathematical model of disease transmission fitted to attack rates from past influenza pandemics. We compared these benefits with those achieved by other interventions targeted at children. Results: Closing schools can reduce transmission among children considerably, but has only a moderate impact on average transmission rates among all individuals (both adults and children) under most scenarios. Much of the benefit of closing schools can be achieved if schools are closed by the time that 2% of children are infected; if the intervention is delayed until 20% of children are infected, there is little benefit. Immunization of all school children provides only a slight improvement over closing schools, indicating that schools are an important venue for transmission between children. Relative attack rates in adults and children provide a good indication of the likely benefit of closing schools, with the greatest impact seen for infections with high attack rates in children. Conclusions: Closing schools is effective at reducing transmission between children but has only a moderate effect on average transmission rates in the wider population unless children are disproportionately affected.