School closure may be effective in reducing transmission of respiratory viruses in the community
School closure may be effective in reducing transmission of respiratory viruses in the community
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DOI：
10.1017/s0950268809002556
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发表时间：
2009-10-01
影响因子：
4.2
通讯作者：
Steinberg, D. M.
中科院分区：
文献类型：
--
作者：
Heymann, A. D.;Hoch, I.;Steinberg, D. M.
控制大流行性流感的拟议措施包括关闭学校，但尚未调查其有效性。我们研究了2000年以色列全国小学罢课对流感样疾病发病率的影响。在这项对170万名首选提供者组织成员的历史观察性研究中，我们分析了1998-2002年冬季初级保健就诊的诊断。我们计算了每周流感样诊断与非呼吸道诊断的比率，并为学龄儿童，儿童家庭成员和所有其他年龄>12岁的人拟合回归模型。对于每个人群，流感样诊断与非呼吸道诊断的比率下降最快的时间发生在罢工开始后2周。每周流感样诊断与非呼吸道诊断的比率的变化在罢工年与其他年份相比，在统计学上具有显著性（P = 0.0074）。在1999年，没有学龄儿童的成年人也出现了较小的下降（P = 0.037）。光明节对1998年、1999年和2001年学龄儿童的比率有负面影响（分别为P = 0.008、0.006和0.045），1999年对成人组和2001年对没有学龄儿童的成人组有统计学意义。在流感大流行中，学校关闭应被视为遏制战略的一部分。
Proposed measures to contain pandemic influenza include school closure, although the effectiveness of this has not been investigated. We examined the effect of a nationwide elementary school strike in Israel in 2000 on the incidence of influenza-like illness. In this historical observational study of 1.7 million members of a preferred provider organization, we analysed diagnoses from primary-care visits during the winter months in 1998-2002. We calculated the weekly ratio of influenza-like diagnoses to non-respiratory diagnoses, and fitted regression models for school-aged children, children's household members, and all other individuals aged >12 years. For each population the steepest drop in the ratio of influenza-like diagnoses to non-respiratory diagnoses occurred in the strike year 2 weeks after the start of the strike. The changes in the weekly ratio of influenza-like diagnoses to non-respiratory diagnoses were statistically significant (P = 0.0074) for school children for the strike year compared to other years. A smaller decrease was also seen for the adults with no school-aged children in 1999 (P = 0.037). The Chanukah holiday had a negative impact on the ratio for school-aged children in 1998, 1999 and 2001 (P = 0.008, 0.006 and 0.045, respectively) and was statistically significant for both adult groups in 1999 and for adults with no school-aged children in 2001. School closure should be considered part of the containment strategy in an influenza pandemic.