| Title | Influenza A (H1N1) and School Hygiene | |
| Authors | Rengina Vorou1, Fotoula Babatsikou2 and Alexandros Chalkias3
1. Hellenic Center for Diseases Control and Prevention, Ministry of Health and Social Solidarity, Athens, Hellas 2. Nursing Department A’ and 3. Department of Public Hygiene, Technological Educational Institution (TEI) of Athens, Egaleo, Athens, Hellas |
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| Citation | Vorou, R., Babatsikou, F., Chalkias, A.: Influenza A (H1N1) and School Hygiene, Epitheorese Klin. Farmakol. Farmakokinet. 23(3): 117-124 (2009) | |
| Publication Date | Accepted for publication (Final Version): July 1, 2009 | |
| Full Text Language | English | |
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| Keywords | Influenza A (H1N1) 2009, school hygiene, school closure. | |
| Other Terms | review article | |
| Summary | Aside from antiviral treatment and the pandemic influenza A (H1N1) 2009 virus vaccine the role of which is indispensable in an influenza pandemic, the use of hygiene measures within school premises has a critical role in the delay of the evolution of the pandemic with concomitant reduction of serious illness and deaths, and societal disruption among citizens. Influenza A (H1N1) 2009 shares the same mode of transmission, spectrum of clinical presentations, surveillance case definitions, and infectious period with seasonal influenza while severe disease occurs mainly in individuals with known risk factors, and more than seasonal influenza in the 5-55 year old age group. School-aged children are not in the high priority groups for immunization against influenza A/H1N1 2009 vaccine as of yet. The epidemiology of the current pandemic in schools is presented, followed by a review of the literature regarding the hygiene measures in schools, from Kindergarten to the 12th year of education in high school, grouped into those applied on individual base, environmental cleaning and ventilation, reporting and outbreak recommendations, selective school closure, and a stricter version of these should a pandemic with more severe circumstances emerges during the 2009-2010 flu period. Respiratory etiquette, alternate use of elbow for younger children, avoidance of sharing of cups, and eating utensils, correct hand washing technique being the exclusive method when hands visibly soiled, and alcohol based hand rubs safely disposed of, monitoring of children and staff, isolation in separate room when symptomatic at school, and at home despite use of antivirals, constitute the individual base hygiene measures, while routine disinfection of contaminated surfaces at least daily, and the good ventilation constitute the environmental precautions. Instead, official sick leave and return to school documentation and personal protected equipment are not indicated in school setting. Recording and reporting of cases of ILI and above expected levels absenteeism, should be subsided by a multidisciplinary forum convention under the coordination of local public health in order that selective school closure and the less costly class suspensions are decided timely. Students should be discouraged to congregate elsewhere and reduce the benefit from selective school closure. The conclusions derived from the measures taken in affected countries since April 2009, historical data from 1918-1919 pandemic and simulation studies are: (i) Reactive school closure as a result of school absenteeism and/or staff shortages, should more severe circumstances of this pandemic emerge, will be acceptable by the public. (ii) Proactive closure implemented early before severe illness occurs in the community to decrease the spread of flu, will not be widely acceptable, unless, under circumstances of severe disease, delineation of authority among all relevant stakeholders and transparent communication between Public Health officials and population exist. (iii) Selective school closure is indicated under current circumstances. School operation is considered to have optimal impact on the pandemic evolution as it educates children and families about this, supports the economy and social infrastructures allowing parents to work, and provides the structured environment for the efficient administration of vaccines to this highly important age group of the community. (iv) Sanitary measures are characterized by a transient protective nature and their use should be sustained. This pandemic sets their role as indispensable and provides an exercise for strict and sustained implementation of hygiene measures, the importance of which, was relatively underestimated in schools, after the laudable advances of Medicine and Health during last century. | |
| References | 1. Human infection with new influenza A (H1N1) virus: WHO Consultation on suspension of classes and restriction of mass gatherings to mitigate the impact of epidemics caused by influenza A (H1N1). Wkly Epidemiol. Rec.84(27): 269-271 (2009)
2. CDC. Update: Novel Influenza A (H1N1) Virus Infection – Mexico, March-May 2009. MMWR Morb. Mortal. Wkly Rep. 58: 585-589 (2009) 3. Garcia-Garcia L., Valdespino-Gomez J.L., Lazcano-Ponce E., et al.: Partial protection of seasonal trivalent inactivated vaccine against novel pandemic influenza A/H1N1 2009: case-control study in Mexico City. BMJ 339: b3928 (2009) doi:10.1136/bmj.b3928 4. Use of influenza A (H1N1) 2009 monovalent vaccine recommendations of the Advisory Committee on Immunization Practices (ACIP), 2009. MMWR 58(RR10): 1-8. (2009) 5. CDC. Update: Novel Influenza A (H1N1) Virus Infections – Worldwide, May 6, 2009. MMWR 58(17): 453-488 (2009) 6. Kelly H., Grant K.: ECDC Interim Risk Assessment. Pandemic (H1N1) 2009 influenza. MMWR 33: 918-921 (2009) 7. Hahni S., Donker T., Meijer A., Timen A., van Steenbergen J., Osterhaus A., van der Sande M., Koopmans M., Wallinga J., Coutinho R., the Dutch NewInfluenza A(H1N1)v Investigation Team. Epidemiology and control of influenza A(H1N1)vin the Netherlands: the first 115 cases. Euro Surveill. 14(27): pii=19267 (2009) 8. Glass L.M., Glass R.J.: Social contact networks for the spread of pandemic influenza in children and teenagers. BMC Public Health 8: 61 (2008) 9. Mikolajczyk R.T., Akmatov M.K., Rastin S., Kretzschmar M.: Social contacts of school children and the transmission of respiratory-spread pathogens. Epidemiol. Infect. 136: 813-822 (2008) Epub 2007 Jul 18. 10. CDC: Swine-origin influenza A (H1N1) virus infections in a school – New York City,April 2009. MMWR Morb. Mortal. Wkly Rep. 58(17): 470-472 (2009) 11. Cruz-Pacheco G., Duran L., Esteva L., Minzoni A.A., Lopez-Cervantes M., Panayotaros P., Ahued Ortega A., Villasepor Ruvz I.: Modelling of the influenza A(H1N1)v outbreak in Mexico City, April-May 2009, with control sanitary measures. Euro Surveill. 14(26): pii=19254 (2009) 12. Health Protection Agency; Health Protection Scotland; National Public Health Service for Wales; HPA Northern Ireland Swine influenza investigation teams. Epidemiology of new influenza A (H1N1) virus infection, United Kingdom, April-June 2009. Euro Surveill. 14(22): pii: 19232 (2009) 13. Koliou M., Soteriades E.S., Toumasi M.M., Demosthenous A., Hadjidemetriou A.: Epidemiological and clinical characteristics of influenza A(H1N1)v infection in children: The first 45 cases in Cyprus, June-August 2009. Euro Surveill. 14(33): pii=19312 (2009) 14. Kar-Purkayastha I., Ingram C., Maguire H., Roche A.; The importance of school and social activities in the transmission of influenza A(H1N1)v: England, April-June 2009. Euro Surveill. 14(33): pii=19311 (2009) 15. CDC: Novel Influenza A (H1N1) virus infections among health-care personnel – United States, April–May 2009 Novel Influenza A (H1N1). MMWR 58(23): 641 (2009) 16. ECDC: Managing schools during the current pandemic (H1N1) 2009 – Reactive and proactive school closures in Europe. http://ecdc.europa.eu/en/activites/sciadvice/Lists/ECDC%20Reviews 17. TECHNICAL REPORT: Guide to public health measures to reduce the impact of influenza pandemics in Europe – The ECDC menu. http://ecdc.europa.eu/en/publications/Publications/0906_TER_Public_Health_Measures_for_Influenza_Pandemics.pdf 18. CDC. Technical Report for State and Local Public Health Officials and Child Care and Early Childhood Providers on CDC Guidance on Helping Child Care and Early Childhood Programs Respond to Influenza during the 2009-2010 Influenza Season. September 4, 2009. http://cdc.gov/H1N1flu/childcare/technical.htm 19. CDC Guidance on Helping Child Care and Early Childhood Programs Respond to Influenza during the 2009–2010 Influenza Season. September 4, 2009 http://www.cdc.gov/H1N1flu/childcare/guidance.htm 20. Action steps for schools to prevent the spread of flu. August 7, 2009. http://www.cdc.gov/H1N1flu/schools/toolkit/actionsteps.htm 21. Individual and community based measures to help prevent transmission of influenza Like Illness (ILI) in the Community, Including the Pandemic Influenza (H1N1) 2009 Virus. http://phac-aspc.ca/alert-alerte/h1n1/hp-ps-info_health-sante-eng.php 22. CDC: Interim Infection Control Recommendations. http://www.cdc.gov/h1n1flu/guidelines_infection_control.htm#B 23. World Health Organization (WHO). New Influenza A (H1N1) virus: global epidemiological situation, June 2009. Wkly Epidemiol. Rec. 84(25): 249-257 (2009) 24. Nicoll A., Coulombier D.: Europe’s initial experience with pandemic (H1N1) 2009 – mitigation and delaying policies and practices. Euro Surveill. 14(29): pii=19279 (2009) http://www.eurosurveillance.org/ViewArticle 25. Centers for Disease Control and Prevention (CDC). Finelli L. Influenza Surveillance. ACIP Meeting 24-25 June 2009. Available from: http://www.cdc.gov/vaccines/recs/ACIP/downloads/mtg-slides-jun09/15-2inf.pdf 26. Shimada T, Gu Y, Kamiya H, Komiya N, Odaira F, Sunagawa T, Takahashi H, Toyokawa T, Tsuchihashi Y, Yasui Y, Tada Y, Okabe N. Epidemiology of influenza A(H1N1)v virus infection in Japan, May-June 2009. Euro Surveill. 14(24): pii=19244 (2009) 27. Munayco C.V., G mez J., Laguna-Torres V.A., Arrasco J., Kochel T.J., Fiestas V., Garcia J., Perez J., Torres I., Condori F., Nishiura H., Chowell G.: Epidemiological and transmissibility analysis of influenza A(H1N1)v in a southern hemisphere setting: Peru. Euro Surveill. 14(32): pii=19299 (2009) 28. Fraser C., Donnelly C.A,. Cauchemez S., Hanage W.P., et al.: Pandemic potential of a strain of influenza A (H1N1): early findings. Science 324: 1557-1561 (2009) 29. Odaira F., Takahashi H., Toyokawa T., Tsuchihashi Y., Kodama T., Yahata Y., Sunagawa T., Taniguchi K., Okabe N.: Assessment of secondary attack rate and effectiveness of antiviral prophylaxis among household contacts in an influenza A(H1N1)v outbreak in Kobe, Japan, May-June 2009. Euro Surveill. 14(35): pii=19320 (2009) 30. Human infection with new influenza A (H1N1) virus: clinical observations from a school-associated outbreak in Kobe, Japan, May 2009. Wkly Epidemiol. Rec. 84(24): 237-44 (2009) 31. Aledort J.E., Lurie N., Wasserman J., Bozzette S.A.: Non-pharmaceutical public health interventions for pandemic influenza: an evaluation of the evidence base. BMC Public Health 7: 208 (2007) 32. Howard Markel; Harvey B. Lipman; J. Alexander Navarro; et al.: Nonpharmaceutical interventions implemented by US Cities during the 1918-1919 influenza pandemic. JAMA 298: 644-654 (2007) 33. Centers for Disease Control and Prevention: CDC guidance for state and local public health officials and school administrators for school (K–12) responses to influenza during the 2009–2010 school year [ebook]. Atlanta (GA): CDC; 2009 Aug 7 [cited 2009 Aug 25]. Available from: http://www.cdc.gov/h1n1flu/schools/schoolguidance.htm 34. Stern A.M., Cetron M.S., Markel H.: Closing The Schools: Lessons From The 1918-19U.S. Influenza Pandemic. Health Aff. (Millwood). 2009 Sep 29. 35. Sypsa V., Hatzakis A.: School closure is currently the main strategy to mitigate influenza A (H1N1)v: A modeling study. Euro Surveill. 14(24): pii=19240 (2009) 36. Koonin L.M., Cetron M.S.: School closure to reduce influenza transmission. Comment on: Emerg Infect Dis. 2008 Oct;14(10):1660-2. Emerg. Infect. Dis. 15(1): 137-138 (2009) author reply 138. 37. Cowling B.J., Lau E.H.Y., Lam C.L.H., Cheng C.K.Y., Kovar J., Chan K.H., et al.: Effects of school closures, 2008 winter influenza season, Hong Kong. Emerg. Infect. Dis. J. Home 14(10): Oct. 2008 [serial on the Internet] http://www.cdc.gov/EID/conyent/14/10/1660.htm |
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