Association Between School Closure and Subsequent Absenteeism During a Seasonal Influenza Epidemic
Association Between School Closure and Subsequent Absenteeism During a Seasonal Influenza Epidemic
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DOI：
10.1097/ede.0b013e3181b5f3ec
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发表时间：
2009-11-01
期刊：
影响因子：
5.4
通讯作者：
Duchin, Jeffrey
中科院分区：
文献类型：
--
作者：
Rodriguez, Carla V.;Rietberg, Krista;Duchin, Jeffrey
背景：数学模型表明，关闭学校等社会疏远措施可能会减轻流感大流行期间的社区传播。由于停课会对学校和家庭造成干扰，因此在季节性流感爆发期间他们很少受雇。一种罕见的情况使我们能够研究季节性流感爆发期间学校停课与缺勤之间的关联，当时华盛顿州金县的一半公立学校在冬季休课期间关闭，而一半学校则整周或部分时间保持开放。方法：使用缺勤作为流感活动的代理，我们测试了这样的假设：放假的学校比保持开放的学校的放假后缺勤率更低。 2007 年 2 月 5 日至 3 月 9 日期间，我们在学校放假期间 (n = 256) 和上课期间 (n = 205) 进行每日回顾性和前瞻性监测。我们使用泊松分布的广义估计方程来评估休息后学校和上课学校之间的平均缺勤率是否存在差异，并根据基线缺勤率和学校随时间的重复测量进行调整。结果：结果表明，与仍在上课的学校相比，休息后学校的休息后缺勤率没有差异（相对风险 = 1.07 [95% 置信区间 = 0.96-1.20]）。这一结果适用于小学 (1.00 [0.91-1.10])，这些学校的缺勤模式被认为最能代表社区流感活动。结论：我们没有发现季节性流感爆发期间学校停课会减少随后的缺勤。然而，这一“自然实验”的局限性阻碍了我们检测是否确实存在益处的能力。
Background: Mathematical models suggest that social distancing measures, such as school closures, may mitigate community transmission during an influenza pandemic. Because closures are disruptive to schools and families, they are rarely employed during seasonal influenza outbreaks. A rare circumstance enabled us to examine the association between school closure and absenteeism during a seasonal influenza outbreak when half of King County, Washington public schools closed for a winter recess 19-23 February 2007, while half remained open for all or part of the week.Methods: Using absenteeism as a proxy for influenza activity, we tested the hypothesis that schools on break would experience lower rates of post-break absenteeism than schools remaining open. We conducted daily retrospective and prospective surveillance from 5 February-9 March 2007 in schools on break (n = 256) and in session (n = 205). We use generalized estimating equations with Poisson distribution to evaluate whether mean absenteeism after the break differed between schools on break and those in session, adjusting for baseline absenteeism and repeated measurements by schools over time.Results: Results indicate no difference in post-break absenteeism in schools on break compared with schools that remained in session (relative risk =. 1.07 [95% confidence interval = 0.96-1.20]). This result held in elementary schools (1.00 [0.91-1.10]), where absenteeism patterns are thought to be most representative of community influenza activity.Conclusion: We did not find that school closure during a seasonal influenza outbreak reduced subsequent absenteeism. However, limitations in this "natural experiment" hampered our ability to detect a benefit if one truly was present.