Implementation of non-pharmaceutical interventions by New York City public schools to prevent 2009 influenza A.
BACKGROUND
Children are important transmitters of influenza in the community and a number of non-pharmaceutical interventions (NPIs), including hand washing and use of hand sanitizer, have been recommended to mitigate the transmission of influenza, but limited information is available regarding schools' ability to implement these NPIs during an influenza outbreak. We evaluated implementation of NPIs during fall 2009 in response to H1N1 pandemic influenza (pH1N1) by New York City (NYC) public schools.


METHODS
From January 25 through February 9, 2010, an online survey was sent to all the 1,632 NYC public schools and principals were asked to participate in the survey or to designate a school nurse or other school official with knowledge of school policies and characteristics to do so.


RESULTS
Of 1,633 schools, 376(23%) accessed and completed the survey. Nearly all respondents (99%) implemented at least two NPIs. Schools that had a Flu Response Team (FRT) as a part of school emergency preparedness plan were more likely to implement the NPI guidelines recommended by NYC public health officials than schools that did not have a FRT. Designation of a room for isolating ill students, for example, was more common in schools with a FRT (72%) than those without (53%) (p<0.001).


CONCLUSIONS
Implementing an NPI program in a large school system to mitigate the effects of an influenza outbreak is feasible, but there is potential need for additional resources in some schools to increase capacity and adherence to all recommendations. Public health influenza-preparedness plans should include school preparedness planning and FRTs.
Epidemic Intelligence Services, Centers for Disease Control and Prevention, Atlanta, GA, USA. sagolory@cdc.gov
Simon G
SG
Agolory
Oxiris
O
Barbot
Francisco
F
Averhoff
Don
D
Weiss
Elisha
E
Wilson
Joseph
J
Egger
Jeffery
J
Miller
Ikechukwu
I
Ogbuanu
Sabrina
S
Walton
Emily
E
Kahn
D000293:Adolescent; D003142:Communication; D003625:Data Collection / Q000706:statistics & numerical data; D006266:Health Education / Q000706:statistics & numerical data; D006284:Health Plan Implementation / Q000706:statistics & numerical data*; D006801:Humans; D006920:Hygiene; D053118:Influenza A Virus, H1N1 Subtype / Q000502:physiology; D007251:Influenza, Human / Q000453:epidemiology / Q000517:prevention & control* / Q000628:therapy* / Q000821:virology; D020407:Internet; D009519:New York City / Q000453:epidemiology; D058028:Research Report; D012499:Sanitation / Q000706:statistics & numerical data; D012574:Schools / Q000706:statistics & numerical data*