title: Use of nonpharmaceutical interventions to reduce transmission of 2009 pandemic influenza A (pH1N1) in Pennsylvania public schools.
abstract: BACKGROUND
  School-based recommendations for nonpharmaceutical interventions (NPIs) were issued in response to the threat of 2009 pandemic influenza A (pH1N1). The implementation and effectiveness of these recommendations has not been assessed.
  
  
  METHODS
  In November 2009, a Web-based survey of all Pennsylvania public schools was conducted to assess the use of recommended NPIs.
  
  
  RESULTS
  Overall, 1040 (31%) of 3351 schools participated in the survey. By fall 2009, 820 (84%) of 979 respondents reported that their school had an influenza plan in place, a 44% higher proportion than in the spring 2009 (p < .01). Most schools communicated health messages (eg, staying home when sick), implemented return to school requirements, and made hand sanitizer available. Schools with a spring influenza plan (N = 568) were less likely to report substantial influenza-like illness (ILI) during the fall wave of influenza than the 299 schools without a spring influenza plan (63% vs 71%, p = .02). This association persisted after controlling for schools with substantial ILI in the spring.
  
  
  CONCLUSIONS
  The reported use of NPIs in participating Pennsylvania public schools improved substantially from spring to fall and was generally consistent with issued recommendations. The proactive implementation of a number of NPIs and the early implementation of communication and education initiatives might have cumulatively reduced the impact of pH1N1 in some schools.
authors.affiliation: Epidemic Intelligence Service, Centers for Disease Control and Prevention, 1600 Clifton Road, MS-E92, Atlanta, GA 30333, USA. jrmiller@cdc.gov
authors.forename: Jeffrey R
authors.initials: JR
authors.lastname: Miller
authors.forename: Vanessa L
authors.initials: VL
authors.lastname: Short
authors.forename: Henry M
authors.initials: HM
authors.lastname: Wu
authors.forename: Kirsten
authors.initials: K
authors.lastname: Waller
authors.forename: Paul
authors.initials: P
authors.lastname: Mead
authors.forename: Emily
authors.initials: E
authors.lastname: Kahn
authors.forename: Beth A
authors.initials: BA
authors.lastname: Bahn
authors.forename: Jon W
authors.initials: JW
authors.lastname: Dale
authors.forename: Muazzam
authors.initials: M
authors.lastname: Nasrullah
authors.forename: Sabrina E
authors.initials: SE
authors.lastname: Walton
authors.forename: Veronica
authors.initials: V
authors.lastname: Urdaneta
authors.forename: Stephen
authors.initials: S
authors.lastname: Ostroff
authors.forename: Francisco
authors.initials: F
authors.lastname: Averhoff
mesh_terms: D000293:Adolescent; D002648:Child; D018562:Disease Transmission, Infectious / Q000517:prevention & control*; D005260:Female; D006235:Hand Disinfection; D006266:Health Education / Q000706:statistics & numerical data; D006284:Health Plan Implementation / Q000706:statistics & numerical data; D006801:Humans; D006920:Hygiene; D015994:Incidence; D053118:Influenza A Virus, H1N1 Subtype / Q000472:pathogenicity*; D007251:Influenza, Human / Q000453:epidemiology* / Q000635:transmission*; D008297:Male; D058873:Pandemics / Q000517:prevention & control*; D010414:Pennsylvania / Q000453:epidemiology; D012574:Schools