Influenza and School-Based Influenza-Like Illness Surveillance: A Pilot Initiative in Maryland

Crawford, Geoffrey B.; Mckelvey, Sara; Crooks, Janet; Siska, Karen; Russo, Kelly; Chan, Jinlene

doi:10.1177/003335491112600416

Cited by 11 publications

(8 citation statements)

References 18 publications

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“…Aerosolization is an important mechanism for spread of IAV 25 . Since children are significantly burdened by influenza and play a key role in transmission 5,29,35,36 , we established a protocol through which IAV densities could be monitored in a school setting. Viral densities were compared to theoretical IAV exposure thresholds, above which students are expected to become infected.…”

Section: Discussionmentioning

confidence: 99%

Airborne Influenza A Virus Exposure in an Elementary School

Coleman

Sigler

2020

Sci Rep

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Influenza contributes significantly to childhood morbidity and mortality. Given the magnitude of the school-aged child population, a sizeable proportion of influenza virus transmission events are expected to occur within school settings. However, influenza virus activity in schools is not wellunderstood, likely due to our limited ability to accurately monitor for respiratory viruses without disrupting the school environment. In this study, we evaluated the use of a bioaerosol sampling method to noninvasively detect and quantify airborne influenza A virus (IAV) densities in a public elementary school. Air samples were collected from multiple locations in the school, two days per week, throughout an eight-week sampling period during influenza season. Real-time RT-PCR targeting the IAV M gene revealed detectable IAV on five occasions in densities ranging from 2.0 × 10 −1 to 1.9 × 10 4 . No significant differences in IAV densities were related to student presence/absence. The majority of IAVassociated particles were ≤4 μm in diameter, and theoretical calculations indicate infectious thresholds after minutes of exposure. Our study represents the first identification and quantification of airborne influenza virus in an elementary school, and the results suggest that airborne IAV has the potential to circulate in schools during influenza season, in large enough doses known to cause infection.Monitoring pathogen exposures in the environment is a longstanding practice to predict and investigate the incidence and spread of infectious diseases. Schools, in particular, have been identified as sources of influenza outbreaks 1-4 , and monitoring influenza-like illness in the school-aged population is a current strategy for predicting communal influenza 5 . In both seasonal and pandemic influenza outbreaks, schoolchildren are often the first to become ill 1,4,6 . Furthermore, modeling studies suggest that the highest incidence of respiratory infection is among school-aged children and young adults who contribute significantly to the spread of infections during the early stages of emerging respiratory epidemics 7 . In some communities, school-centric data, such as the number of student absences (total and those due to illness) and school nurse visits, are recorded and used for early detection of influenza outbreaks 5 . However, due to the inconsistency of self-reported data, the use of student health reports to predict influenza outbreaks is not a standardized practice. Therefore, the development of an effective method to monitor influenza virus in schools is necessary to enhance efforts to manage student and community health.Human behaviors and their environments influence respiratory virus disease susceptibility, severity, and transmissibility 8 , especially among children. Specifically, the high incidence of influenza in children is thought to be related to interactions with schoolmates and siblings 6 , as pathogen transmission is directly related to host proximity and density 9 . Influenza virus is transmitted through (i) di...

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Section: Discussionmentioning

confidence: 99%

Airborne Influenza A Virus Exposure in an Elementary School

Coleman

Sigler

2020

Sci Rep

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“…Various syndromic surveillance indicators have been collected and analyzed, including the number of ambulance dispatches, emergency department (ED) or ambulatory care clinic visits, cases of influenza-like illness and patients’ chief complaint, as well as indicators which may be associated with communicable disease syndromes, such as over-the-counter medicine and product sales [ 8 , 10 , 11 ]. Some public health departments have also collected school-based data, such as all-cause student absenteeism rates [ 12 – 17 ], gastrointestinal (GI) illness [ 13 ], and school nurse visits for influenza-like illness (ILI) [ 13 , 18 , 19 ], and compared it to other community pre-diagnostic criteria [ 8 , 10 , 13 , 14 , 20 ]. Research indicates that some school-based syndromic surveillance indicators may be as accurate as other surveillance data in early event identification [ 14 , 16 , 18 , 19 ].…”

Section: Introductionmentioning

confidence: 99%

“…Some public health departments have also collected school-based data, such as all-cause student absenteeism rates [ 12 – 17 ], gastrointestinal (GI) illness [ 13 ], and school nurse visits for influenza-like illness (ILI) [ 13 , 18 , 19 ], and compared it to other community pre-diagnostic criteria [ 8 , 10 , 13 , 14 , 20 ]. Research indicates that some school-based syndromic surveillance indicators may be as accurate as other surveillance data in early event identification [ 14 , 16 , 18 , 19 ]. For example, student absenteeism and nurse visits for ILI have been correlated with the numbers of cases of ILI seen in local EDs or the community.…”

Section: Introductionmentioning

confidence: 99%

“…In the past, school syndromic surveillance has primarily been used to help inform school closure decisions [ 13 , 17 , 19 , 21 ] and to augment existing data collected from EDs [ 13 , 16 , 18 , 20 ] rather than used in isolation for early event identification. Some syndromic surveillance programs have been implemented solely on an ad hoc basis.…”

Section: Introductionmentioning

confidence: 99%

“…Some syndromic surveillance programs have been implemented solely on an ad hoc basis. For example, two school syndromic surveillance programs were reported as only being used during the 2009 H1N1 pandemic [ 16 , 18 ]. Because school absenteeism data has the potential to inform both local policies and public health actions within communities, it is important to understand the current practices and attitudes towards syndromic surveillance in schools.…”

Section: Introductionmentioning

confidence: 99%

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Missouri K-12 school collection and reporting of school-based syndromic surveillance data: a cross sectional study

et al. 2015

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BackgroundSchool participation in collecting and reporting syndromic surveillance (SS) data to public health officials and school nurses’ attitudes regarding SS have not been assessed.MethodsAn online survey was sent to Missouri Association of School Nurses members during the 2013/2014 school year to assess whether K-12 schools were collecting and reporting SS data. Z-scores were used to assess collection versus reporting of SS indicators. Logistic regressions were used to describe factors predicting nurses’ collection and reporting of SS indicators: all-cause absenteeism, influenza-like illness and gastrointestinal illness. Univariate predictors were assessed with Chi-Squares.ResultsIn total, 133 school nurses participated (33.6 % response rate). Almost all (90.2 %, n = 120) collect at least one SS indicator; half (49.6 %, n = 66) report at least one. Schools are collecting more SS data than they are reporting to the health department (p < .05 for all comparisons). Determinants of school nurses’ collection of SS data included perceived administrative support, and knowledge of collecting and analyzing SS data. The strongest predictive factors for reporting SS data were the perception that the health department was interested in SS data and being approached by the health department to collect SS data.ConclusionSchools are collecting SS indicators at a relatively high rate, yet less than half of the data is reported to public health officials. Findings from this study indicate that public health officials can increase access to school-based SS data by approaching schools about collecting and reporting this important data.

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Role and Strategies of Surveillance Networks in Handling Emerging and Reemerging Viral Infections

Castillo‐Salgado

2013

Viral Infections and Global Change

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Influenza and School-Based Influenza-Like Illness Surveillance: A Pilot Initiative in Maryland

Cited by 11 publications

References 18 publications

Airborne Influenza A Virus Exposure in an Elementary School

Airborne Influenza A Virus Exposure in an Elementary School

Missouri K-12 school collection and reporting of school-based syndromic surveillance data: a cross sectional study

Role and Strategies of Surveillance Networks in Handling Emerging and Reemerging Viral Infections

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