The Relationship Between School Holidays and Transmission of Influenza in England and Wales
The Relationship Between School Holidays and Transmission of Influenza in England and Wales
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DOI：
10.1093/aje/kww083
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发表时间：
2016-11-01
影响因子：
5
通讯作者：
Mangtani, Punam
中科院分区：
文献类型：
--
作者：
Jackson, Charlotte;Vynnycky, Emilia;Mangtani, Punam
关闭学校通常被认为是一种流感控制措施，但其对传播的影响知之甚少。我们使用两种方法来估计学校假期如何影响接触参数（足以传播感染的人均接触率），使用英格兰和威尔士（1967-2000）的初级保健数据。首先，我们拟合了一个年龄结构的易感染性恢复模型，每年的数据估计的比例变化的接触参数在学校假期期间相比，termtime。其次，我们计算了假期和termtime之间的接触参数的百分比差异从每周的接触参数值，直接从简单的质量作用模型估计。在适当情况下，使用随机效应荟萃分析合并估计值。从数据拟合来看，5-14岁儿童在假期期间与学期期间接触参数的差异范围从36%减少到17%增加;估计值对于荟萃分析来说过于异质。基于简单的集体行动模型，接触参数是17%（95%置信区间：10，25），在假期期间比termtime。结果是稳健的假设比例的感染报告和个人谁是易感的流感季节开始时。我们的结论是，学校关闭可能会减少流感爆发期间的传播。
School closure is often considered as an influenza control measure, but its effects on transmission are poorly understood. We used 2 approaches to estimate how school holidays affect the contact parameter (the per capita rate of contact sufficient for infection transmission) for influenza using primary care data from England and Wales (1967-2000). Firstly, we fitted an age-structured susceptible-infectious-recovered model to each year's data to estimate the proportional change in the contact parameter during school holidays as compared with termtime. Secondly, we calculated the percentage difference in the contact parameter between holidays and termtime from weekly values of the contact parameter, estimated directly from simple mass-action models. Estimates were combined using random-effects meta-analysis, where appropriate. From fitting to the data, the difference in the contact parameter among children aged 5-14 years during holidays as compared with termtime ranged from a 36% reduction to a 17% increase; estimates were too heterogeneous for meta-analysis. Based on the simple mass-action model, the contact parameter was 17% (95% confidence interval: 10, 25) lower during holidays than during termtime. Results were robust to the assumed proportions of infections that were reported and individuals who were susceptible when the influenza season started. We conclude that school closure may reduce transmission during influenza outbreaks.