| Title | Hygiene measures during influenza A (H1N1) school outbreaks | |
| Authors | Rengina Vorou1, Fotoula Babatsikou2, Alexandros Chalkias3 and Stavroula Galani4
1. Hellenic Center for Diseases Control and Prevention, Ministry of Health and Social Solidarity, Athens, Hellas 2. Nursing Department A, 3. Department of Public Hygiene, 4. Department of Basic Medical Sciences, Technological Educational Institution (TEI) of Athens, Egaleo, Athens, Hellas |
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| Citation | Vorou, R., Babatsikou, F., Chalkias, A. and Galani, S.: Hygiene measures during influenza A (H1N1) school outbreaks, Epitheorese Klin. Farmakol. Farmakokinet. 24(1): 5-12 (2010) | |
| Publication Date | Accepted for publication (Final Version): April 10, 2010 | |
| Full Text Language | English | |
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| Keywords | Influenza A (H1N1) 2009, Influenza A (H1N1) 2009 school outbreaks, School Hygiene, school closure, influenza A (H1N1) surveillance. | |
| Other Terms | review article | |
| Summary | Influenza virus is a leading cause of acute respiratory infection worldwide and an important respiratory pathogen in young children, with the greatest morbidity and hospitalization rates in young infants. The emergence of novel swine-origin influenza A H1N1 in April of 2009 was followed by the declaration of the first pandemic since 1968 by the World Health Organization. The majority of cases including severe cases, are reported in individuals younger than 65 years of age (age range 5-24 years), more severe disease occurs in the 5-55 year old age group compared to those resulting from seasonal influenza and almost half of cases occur in children below 18 years old. Patients receiving antiviral medications continue shedding the virus, thus transmitting the infection. Randomized clinical trials in infants and children starting at 6 months of age provided evidence that the pandemic influenza A (H1N1) 2009 vaccine was immunogenic and the vaccine related adverse events were mild to moderate, similar to those of seasonal vaccine and with no noticeable differences between vaccine and placebo groups. Among all settings the schools and other venues of students’ social activities account for the greater proportion of the expansion of the infection in the community. A review of the school outbreaks, the hygiene measures implemented and their effectiveness is attempted. In urban settings i.e. in Mexico, in New York, in Australia, in the United Kingdom, in Japan, school outbreaks of influenza A (H1N1) 2009 virus occurred relatively early, before wider transmission in the community with broader age distribution had ensued. The public health interventions were scheduled according to the epidemiological characteristics of the pandemic. As of yet there are no reviews reporting the vaccination coverage and the protection this conferred in school age children worldwide. Consequently, the sustained use of hygiene measures, the latter being characterized by their transient protective nature, within school premises, before and after school closure, have had a critical role in the delay of the spread of the pandemic among the school age children. Hygiene measures and relevant training were modified according to the type of school; nursery/day care, elementary, junior, senior high school. Training was offered via communication and subsided by mass media campaigns to parents, guardians, students, children and staff. School closure has been decided in all aforementioned outbreaks but in Hawaii and in local rather than national level with the exception of Mexico where there was nationwide school closure for two weeks. The selective school closure of particular schools was decided after careful estimation of the transmission rate in the premises and consultation with local public health authorities. The delineation of authority among all relevant stakeholders and the transparent communication between Public Health officials and population under circumstances of severe disease, set school closure is an easier decision. Proactive school closure in national or local level were applied in Mexico and Japan respectively and kept as alternate in the majority of countries. All the above mentioned outbreaks triggered initiation of enhanced active surveillance of ILI, uncomplicated and complicated respiratory illness in students and staff members, as well as among household contacts when circumstances allowed this. School operation was considered to have optimal impact on the pandemic evolution as it educated children and families about pandemic and hygiene measures, supported the economy and the social infrastructures, and facilitated influenza A (H1N1) 2009 surveillance, outbreak detection and recognition of the circulation of the virus in the community. Children need factual age appropriate information and reasonable mass media attendance about the potential seriousness of disease and concrete instruction about prevention of the infection. Further epidemiological studies are needed to determine the degree to which Influenza A (H1N1)v infection spreads in the community during and after school outbreaks, and analyze the impact of school dismissal on peak mortality and overall mortality rates. The latter has been speculated to be slightly reduced or not affected at al in existing simulation studies. | |
| References | 1. Neuzil K.M., Mellen B.G., Wright P.F., Mitchel E.F.,Jr, Griffin M.R.: The effect of influenza on hospitalizations, outpatient visits, and courses of antibiotics in children. N. Engl. J. Med. 342: 225-231 (2000). PubMed PMID: 10648763.
2. Glezen W.P.: Considerations of the risk of influenza in children and indications for prophylaxis. Rev. Infect. Dis. 12: 408-420 (1980) 3. Swine influenza A (H1N1) infection in two children: Southern California, March-April 2009. MMWR Morb Mortal Wkly rep. 58: 400-402 (2009) 4. Jain S., Kamimoto L., Bramley A.M., Schmitz A.M., Benoit S.R., Louie J., Sugerman D.E., Druckenmiller J.K., Ritger K.A., Chugh R., Jasuja S., Deutscher M., Chen S., Walker J.D., Duchin J.S., Lett S., Soliva S., Wells E.V., Swerdlow D., Uyeki T.M., Fiore A.E., Olsen S.J., Fry A.M., Bridges C.B., Finelli L.: 2009 Pandemic Influenza A (H1N1) Virus Hospitalizations Investigation Team. Hospitalized patients with 2009 H1N1influenza in the United States, April-June 2009. N. Engl. J. Med. 361: 1935-1944 (2009) 5. 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) 6. 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) 7. 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. 8. 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) 9. 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) 10. 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) 11. CDC. Update: Novel Influenza A (H1N1) Virus Infection – Mexico, March-May 2009. MMWR Morb. Mortal. Wkly Rep. 58: 585-589 (2009) 12. Cases mount through Australia: 5 June 2009. http://health.gov.au/internet/healthemergency/publishing.nsf/Content/news-069 13. 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) 14. 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): 237-244 (2009) 15. Center for Disease Control and Prevention: Outbreak of 2009 Pandemic Influenza A (H1N1) at a School, Hawaii, May 2009. MMWR January 8, 2010 / 58(51&52): 1440-1444 16. Guinard A., Grout L., Durand C., Schwoebel V.: Outbreakof influenza A(H1N1)v without travel history in a school in the Toulouse district, France, June 2009. Euro Surveill. 2009; 14(27):pii=19265. Available online: http://www.eurosurveillance.org/ViewArticle.aspx?Articleld=19265 17. 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) 18. Kelly H., Grant K.: ECDC Interim Risk Assessment. Pandemic (H1N1) 2009 influenza. MMWR 33: 918-921 (2009) 19. 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) 20. ECDC: Managing schools during the current pandemic (H1N1) 2009 – Reactive and proactive school closures in Europe. http://ecdc.europa.eu/en/activities/sciadvice/Lists/ECDC%20Reviews 21. Technical Report: Guide to public health measures toreduce 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 22. 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://www.cdc.gov/H1N1flu/childcare/technical.htm 23. 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 24. Action steps for schools to prevent the spread of flu. August 7, 2009. http://www.cdc.gov/H1N1flu/schools/toolkit/actionsteps.htm 25. CDC. Update: Novel Influenza A (H1N1) Virus Infections – Worldwide, May 6, 2009. MMWR 58(17): 453-488 (2009) 26. Hahnι 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) 27. CDC: Interim Infection Control Recommendations. http://www.cdc.gov/h1n1flu/guidelines_infection_control.htm#B 28. World Health Organization (WHO): Human infection with new Influenza A (H1N1) virus: clinical observations from Mexico and other affected coubtries, May 2009. Wkly Epidemiol. Rec. 84(21): 184-189 (2009) 29. Individual and community based measures to help prevent transmission of influenza Like Ilness (ILI) in the Community, Including the Pandemic Influenza (H1N1) 2009 Virus. http://www.phac-aspc.ca/alert-alerte/h1n1/hp-ps-info_health-sante-eng.php 30. World Health Organization (WHO). New Influenza A (H1N1) virus: global epidemiological situation, June 2009. Wkly Epidemiol. Rec. 84(25): 249-257 (2009) 31. 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 32. Centers for Disease Control and Prevention (CDC). Finelli L. Influenza Surveillance. ACIP Meeting 24-25 June 2009. Available from: http://cdc.gov/vaccines/recs/ACIP/downloads/mtg-slides-jun09/15-2-inf.pdf 33. Halasa N.B.: Update on the 2009 pandemic influenza A H1N1 in children. Curr. Opin. Pediatr. 22: 83-87 (2010) 34. Munayco C.V., G[1]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) 35. 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) 36. 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) 37. 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) 38. CDC: Recommendations for the amount of time persons with influenza-like illness should be away from others. Available at: http://www.cdc.gov/h1n1flu/guidance/exclusion.htm 39. Carrat F., Vergu E., Ferguson N.M., Lemaitre M., Cauchemez S., Leach S., et al.: Timelines of infection and disease in human influenza: a review of volunteer challenge studies. Am. J. Epidemiol. 167: 775-785 (2008) 40. Kamigaki T., Hitoshi Oshitani H.: Epidemiological characteristics and low case fatality rate of pandemic (H1N1) 2009 in Japan. PLoSCurr. Influenza 20: RRN1139 (2009) 41. 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) 42. Nolan T., McVernon J., Skeljo M., Richmond P., Wadia U., Lambert S., Nissen M., Marshall H., Booy R., Heron L., Hartel G., Lai M., Basser R., Gittleson C., Greenberg M.: Immunogenicity of a monovalent 2009 influenza A (H1N1) vaccine in infants and children: a randomized trial. JAMA 303: 37-46 (2010) 43. Plennevaux E., Sheldon E., Blatter M., Reeves-Hoche M.K., Denis M.: Immune response after a single vaccination against 2009 influenza A H1N1 in USA: a preliminary report of two randomised controlled phase 2 trials. Lancet 375(9708): 9-11 (2010) 44. Zhu F.C., Wang H., Fang H.H., Yang J.G., Lin X.J., Liang X.F., Zhang X.F., Pan H.X., Meng F.Y., Hu Y.M., Liu W.D., Li C.G., Li W., Zhang X., Hu J.M., Peng .WB., Yang B.P., Xi P., Wang H.Q., Zheng J.S.: A novel influenza A (H1N1) vaccine in various age groups. N. Engl. J. Med. 361: 2414-23 (2009) 45. 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/school/schoolguidance.htm 46. 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) 47. 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 48. 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 49. Markel H., Lipman H.B., Navarro J.A, Sloan A., Michalsen J.R., Stern A.M., Cetron M.S.: Nonpharmaceutical interventions implemented by US Cities during the 1918-1919 influenza pandemic. JAMA 298: 644-654 (2007) Comment in: JAMA. 2007 Nov 21;298(19):2260-1; author reply 2261. JAMA. 2007 Nov 21;298(19)2260; author reply 2261. 50. 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. 51. Johal S.S.: Psychosocial impacts of quarantine during disease outbreaks and interventions that may help to relieve strain. N. Z. Med. J. 122: 47-52 (009) 52. Managing your anxietyabout H1N1 flu (swine flu). http://www.apa.org/helpcenter/h1n1-flu.aspx 53. Vorou R., Babatsikou F., Chalkias A.: Influenza A (H1N1) and School Hygiene. Rev. Clin. Pharmacol. Pharmacokinet., Int. Ed. 23:117-124 (2009) |
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| Relative Papers | Influenza A (H1N1) and School Hygiene
Rengina Vorou, Fotoula Babatsikou, Alexandros Chalkias |
Online ISSN 1011-6575
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