title: Transmission characteristics of different students during a school outbreak of (H1N1) pdm09 influenza in China, 2009.
abstract: Many outbreaks of A(H1N1)pdm09 influenza have occurred in schools with a high population density. Containment of school outbreaks is predicted to help mitigate pandemic influenza. Understanding disease transmission characteristics within the school setting is critical to implementing effective control measures. Based on a school outbreak survey, we found almost all (93.7%) disease transmission occurred within a single grade, only 6.3% crossed grades. Transmissions originating from freshmen exhibited a star-shaped network; other grades exhibited branch- or line-shaped networks, indicating freshmen have higher activity and are more likely to cause infection. R0 for freshmen, calculated as 2.04, estimated as 2.76, was greater than for other grades (P < 0.01). Without intervention, the estimated number of cases was much greater when the outbreak was initiated by freshmen than by other grades. Furthermore, the estimated number of cases required to be under quarantine and isolation for freshmen was less than that of equivalent other grades. So we concluded that different grades have different transmission mode. Freshmen were the main facilitators of the spread of A(H1N1)pdm09 influenza during this school outbreak, so control measures (e.g. close contact isolation) priority used for freshmen would likely have effectively reduced spread of influenza in school settings.
authors.affiliation: 1] Institute of Disease Control and Prevention, Academy of Military Medical Sciences, 20 Dong-Da-Jie Street, Fengtai District, Beijing 100071, China [2].
authors.forename: Ligui
authors.initials: L
authors.lastname: Wang
authors.affiliation: 1] Institute of Disease Control and Prevention, Academy of Military Medical Sciences, 20 Dong-Da-Jie Street, Fengtai District, Beijing 100071, China [2].
authors.forename: Chenyi
authors.initials: C
authors.lastname: Chu
authors.affiliation: 1] Institute of Disease Control and Prevention, Academy of Military Medical Sciences, 20 Dong-Da-Jie Street, Fengtai District, Beijing 100071, China [2].
authors.forename: Guang
authors.initials: G
authors.lastname: Yang
authors.affiliation: 1] Institute of Disease Control and Prevention, Academy of Military Medical Sciences, 20 Dong-Da-Jie Street, Fengtai District, Beijing 100071, China [2].
authors.forename: Rongzhang
authors.initials: R
authors.lastname: Hao
authors.affiliation: 1] State Key Laboratory for Infectious Disease Prevention and Control, Chinese Center for Disease Control and Prevention, 5 Liu-Zi Street, ChangPing District, Beijing 102206, China [2].
authors.forename: Zhenjun
authors.initials: Z
authors.lastname: Li
authors.affiliation: 1] Key Laboratory of Complex Systems and Intelligence Science, Institute of Automation, Chinese Academy of Sciences, 95 Zhong-Guan-Cun-Dong Street, Haidian District, Beijing 100190, China [2].
authors.forename: Zhidong
authors.initials: Z
authors.lastname: Cao
authors.affiliation: Institute of Disease Control and Prevention, Academy of Military Medical Sciences, 20 Dong-Da-Jie Street, Fengtai District, Beijing 100071, China.
authors.forename: Shaofu
authors.initials: S
authors.lastname: Qiu
authors.affiliation: Institute of Disease Control and Prevention, Academy of Military Medical Sciences, 20 Dong-Da-Jie Street, Fengtai District, Beijing 100071, China.
authors.forename: Peng
authors.initials: P
authors.lastname: Li
authors.affiliation: Institute of Disease Control and Prevention, Academy of Military Medical Sciences, 20 Dong-Da-Jie Street, Fengtai District, Beijing 100071, China.
authors.forename: Zhihao
authors.initials: Z
authors.lastname: Wu
authors.affiliation: Institute of Disease Control and Prevention, Academy of Military Medical Sciences, 20 Dong-Da-Jie Street, Fengtai District, Beijing 100071, China.
authors.forename: Zhengquan
authors.initials: Z
authors.lastname: Yuan
authors.affiliation: Institute of Disease Control and Prevention, Academy of Military Medical Sciences, 20 Dong-Da-Jie Street, Fengtai District, Beijing 100071, China.
authors.forename: Yuanyong
authors.initials: Y
authors.lastname: Xu
authors.affiliation: Key Laboratory of Complex Systems and Intelligence Science, Institute of Automation, Chinese Academy of Sciences, 95 Zhong-Guan-Cun-Dong Street, Haidian District, Beijing 100190, China.
authors.forename: Dajun
authors.initials: D
authors.lastname: Zeng
authors.affiliation: Institute of Disease Control and Prevention, Academy of Military Medical Sciences, 20 Dong-Da-Jie Street, Fengtai District, Beijing 100071, China.
authors.forename: Yong
authors.initials: Y
authors.lastname: Wang
authors.affiliation: Institute of Disease Control and Prevention, Academy of Military Medical Sciences, 20 Dong-Da-Jie Street, Fengtai District, Beijing 100071, China.
authors.forename: Hongbin
authors.initials: H
authors.lastname: Song
mesh_terms: D000293:Adolescent; D000328:Adult; D002681:China / Q000453:epidemiology; D004196:Disease Outbreaks; D005260:Female; D006801:Humans; D053118:Influenza A Virus, H1N1 Subtype / Q000302:isolation & purification; D007251:Influenza, Human / Q000453:epidemiology* / Q000635:transmission / Q000821:virology; D008297:Male; D008962:Models, Theoretical; D011790:Quarantine; D012574:Schools
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