Substantial Impact of School Closure on the Transmission Dynamics during the Pandemic Flu H1N1-2009 in Oita, Japan

Abstract

BackgroundSchool closure is considered as an effective measure to prevent pandemic influenza. Although Japan has implemented many class, grade, and whole school closures during the early stage of the pandemic 2009, the effectiveness of such a school closure has not been analysed appropriately. In addition, analysis based on evidence or data from a large population has yet to be performed. We evaluated the preventive effect of school closure against the pandemic (H1N1) 2009 and examined efficient strategies of reactive school closure.Materials and MethodsData included daily reports of reactive school closures and the number of infected students in the pandemic in Oita City, Japan. We used a regression model that incorporated a time delay to analyse the daily data of school closure based on a time continuous susceptible-exposed-infected-removed model of infectious disease spread. The delay was due to the time-lag from transmission to case reporting. We simulated the number of students infected daily with and without school closure and evaluated the effectiveness.ResultsThe model with a 3-day delay from transmission to reporting yielded the best fit using R 2 (the coefficient of determination). This result suggests that the recommended period of school closure is more than 4 days. Moreover, the effect of school closure in the simulation of school closure showed the following: the number of infected students decreased by about 24% at its peak, and the number of cumulative infected students decreased by about 8.0%.ConclusionsSchool closure was an effective intervention for mitigating the spread of influenza and should be implemented for more than 4 days. School closure has a remarkable impact on decreasing the number of infected students at the peak, but it does not substantially decrease the total number of infected students.

Japanese Surveillance Systems and Treatment for Influenza

“…This rule is applied not only to elementary schools but also to children’s day care centers, nursing schools, junior high schools, and high schools. Then those schools must report the number of absent students diagnosed with influenza as well as closures (class, grade, or school) to the local Education Board in each municipality [34]. …”

“…In many cases, a class is closed when the number of absences due to ILI exceeds 10–20 %. Several groups evaluated the most optimal duration of class closure, and it was suggested that school closure lasting more than 4 or 5 days is effective to mitigate the spread of influenza [34–37]. …”

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