Effects of School Closure on Incidence of Pandemic Influenza in Alberta, Canada
Effects of School Closure on Incidence of Pandemic Influenza in Alberta, Canada
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DOI：
10.7326/0003-4819-156-3-201202070-00005
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发表时间：
2012-02-07
影响因子：
39.2
通讯作者：
Dushoff, Jonathan
中科院分区：
文献类型：
--
作者：
Earn, David J. D.;He, Daihai;Dushoff, Jonathan
背景：通过社会距离措施（如关闭学校）控制大流行性流感是大流行规划中一个有争议的方面。然而，对这些措施实际影响大流行进展的程度的调查一直受到限制。目的：研究2009年加拿大阿尔伯塔大流行性H1N1（pH 1 N1）流感发病率与学校关闭或天气变化之间的相关性，并估计学校关闭和天气变化对pH 1 N1传播的影响。设计：将pH 1 N1确诊病例的模式与学校日历和天气模式进行比较后，采用数学传播模型拟合数据。背景：加拿大阿尔伯塔，2009年4月19日至2010年1月2日。数据来源：2009年病毒学检测结果、2006年人口普查数据、2009年每日温度和湿度数据以及2009年校历。年龄-从提交给阿尔伯塔省公共卫生实验室的35510份标本的完整数据库中，2009年4月19日至2010年1月2日期间，卫生部进行病毒学检测。结果：学校学期的结束和重新开始对第一波流感病例的衰减和第二波流感病例的开始有重要影响。数学模型表明，关闭学校使学龄儿童的传播减少了50%以上，这是中断传播的关键因素。这些模型还表明，天气的季节性变化对流行病的时间模式有重大影响。局限性：数据可能代表了所有病毒感染的一小部分样本。数学模型简化的假设，以使模拟和分析可行。结论：分析数据从不受限制的病毒学检测在流感大流行提供了令人信服的证据表明，关闭学校可以有巨大的影响，大流行性流感的传播。关闭学校似乎是减缓大流行性流感在具有类似于加拿大的社会接触网络的国家传播的有效策略。
Background: Control of pandemic influenza by social-distancing measures, such as school closures, is a controversial aspect of pandemic planning. However, investigations of the extent to which these measures actually affect the progression of a pandemic have been limited.Objective: To examine correlations between the incidence of pandemic H1N1 (pH1N1) influenza in Alberta, Canada, in 2009 and school closures or weather changes, and to estimate the effects of school closures and weather changes on pH1N1 transmission.Design: Mathematical transmission models were fit to data that compared the pattern of confirmed pH1N1 cases with the school calendar and weather patterns.Setting: Alberta, Canada, from 19 April 2009 to 2 January 2010.Data Sources: 2009 virologic test results, 2006 census data, 2009 daily temperature and humidity data, and 2009 school calendars.Measurements: Age-specific daily counts of positive results for pH1N1 from the complete database of 35 510 specimens submitted to the Alberta Provincial Laboratory for Public Health for virologic testing from 19 April 2009 to 2 January 2010.Results: The ending and restarting of school terms had a major effect in attenuating the first wave and starting the second wave of pandemic influenza cases. Mathematical models suggested that school closure reduced transmission among school-age children by more than 50% and that this was a key factor in interrupting transmission. The models also indicated that seasonal changes in weather had a significant effect on the temporal pattern of the epidemic.Limitations: Data probably represent a small sample of all viral infections. The mathematical models make simplifying assumptions in order to make simulations and analysis feasible.Conclusion: Analysis of data from unrestricted virologic testing during an influenza pandemic provides compelling evidence that closing schools can have dramatic effects on transmission of pandemic influenza. School closure seems to be an effective strategy for slowing the spread of pandemic influenza in countries with social contact networks similar to those in Canada.