Estimating the impact of school closure on social mixing behaviour and the transmission of close contact infections in eight European countries

Abstract

BackgroundMathematical modelling of infectious disease is increasingly used to help guide public health policy. As directly transmitted infections, such as influenza and tuberculosis, require contact between individuals, knowledge about contact patterns is a necessary pre-requisite of accurate model predictions. Of particular interest is the potential impact of school closure as a means of controlling pandemic influenza (and potentially other pathogens).MethodsThis paper uses a population-based prospective survey of mixing patterns in eight European countries to study the relative change in the basic reproduction number (R0 - the average number of secondary cases from a typical primary case in a fully susceptible population) on weekdays versus weekends and during regular versus holiday periods. The relative change in R0 during holiday periods and weekends gives an indication of the impact collective school closures (and prophylactic absenteeism) may have during a pandemic.ResultsSocial contact patterns differ substantially when comparing weekdays to the weekend and regular to holiday periods mainly due to the reduction in work and/or school contacts. For most countries the basic reproduction number decreases from the week to weekends and regular to holiday periods by about 21% and 17%, respectively. However for other countries no significant decrease was observed.ConclusionWe use a large-scale social contact survey in eight different European countries to gain insights in the relative change in the basic reproduction number on weekdays versus weekends and during regular versus holiday periods. The resulting estimates indicate that school closure can have a substantial impact on the spread of a newly emerging infectious disease that is transmitted via close (non sexual) contacts.

The H1N1 Virus and Mexican Baseball Attendance

“…Chowell et al (2011) estimate that social distancing in Mexico in response to H1N1 reduced the spread of infection by roughly 1/3, which matches results in other contexts (Wu et al 2010, Hens et al 2009. Two works on gatherings in economics support these findings from epidemiology.…”

Simulating school closure policies for cost effective pandemic decision making

“…The possible closure triggers were a range of SAP thresholds (prevalence in children ages [5][6][7][8][9][10][11][12][13][14][15][16][17][18], based on the assumption that prevalence in this age group can be Figure 1 School closure policy pathway for high transmission scenarios. The full tree for the 0.5% school-age prevalence closure trigger is shown.…”

“…A number of studies have quantified the impact of school closures on cumulative attack rates, but have not evaluated the social and economic costs of such policies [6,[8][9][10][11][12]. Some of these studies demonstrate school closures can have a significant impact on the basic reproduction number and on the overall spread of disease [4-7, 10, 13, 14].…”

The influence of school holiday timing on epidemic impact

“…While there are few studies that have measured the impact of disease-related school closure on contact patterns [16,17], the impact of school holidays on contact patterns is better documented. Studies have shown that school pupils make considerably fewer social contacts each day during holiday periods than they do during term time [21,[23][24][25], and have predicted that the change in social contact patterns would lead to a reduction in the basic reproduction number of an influenza-like illness (ILI) of around 20-35% [21,25].…”