title: The role of heterogeneity in contact timing and duration in network models of influenza spread in schools.
abstract: Influenza poses a significant health threat to children, and schools may play a critical role in community outbreaks. Mathematical outbreak models require assumptions about contact rates and patterns among students, but the level of temporal granularity required to produce reliable results is unclear. We collected objective contact data from students aged 5-14 at an elementary school and middle school in the state of Utah, USA, and paired those data with a novel, data-based model of influenza transmission in schools. Our simulations produced within-school transmission averages consistent with published estimates. We compared simulated outbreaks over the full resolution dynamic network with simulations on networks with averaged representations of contact timing and duration. For both schools, averaging the timing of contacts over one or two school days caused average outbreak sizes to increase by 1-8%. Averaging both contact timing and pairwise contact durations caused average outbreak sizes to increase by 10% at the middle school and 72% at the elementary school. Averaging contact durations separately across within-class and between-class contacts reduced the increase for the elementary school to 5%. Thus, the effect of ignoring details about contact timing and duration in school contact networks on outbreak size modelling can vary across different schools.
authors.affiliation: Department of Internal Medicine, University of Utah, Salt Lake City, UT 84132, USA Department of Mathematics, University of Utah, Salt Lake City, UT 84112, USA VA Salt Lake City Health Care System, Salt Lake City, UT 84108, USA damon.toth@hsc.utah.edu.
authors.forename: Damon J A
authors.initials: DJ
authors.lastname: Toth
authors.affiliation: Department of Internal Medicine, University of Utah, Salt Lake City, UT 84132, USA VA Salt Lake City Health Care System, Salt Lake City, UT 84108, USA.
authors.forename: Molly
authors.initials: M
authors.lastname: Leecaster
authors.affiliation: Department of Internal Medicine, University of Utah, Salt Lake City, UT 84132, USA VA Salt Lake City Health Care System, Salt Lake City, UT 84108, USA.
authors.forename: Warren B P
authors.initials: WB
authors.lastname: Pettey
authors.affiliation: Department of Internal Medicine, University of Utah, Salt Lake City, UT 84132, USA Department of Pathology, University of Utah, Salt Lake City, UT 84112, USA VA Salt Lake City Health Care System, Salt Lake City, UT 84108, USA Department of Biomedical Informatics, University of Utah, Salt Lake City, UT 84108, USA.
authors.forename: Adi V
authors.initials: AV
authors.lastname: Gundlapalli
authors.affiliation: Division of Global Migration and Quarantine, Centers for Disease Control and Prevention, Atlanta, GA 30333, USA.
authors.forename: Hongjiang
authors.initials: H
authors.lastname: Gao
authors.affiliation: Division of Global Migration and Quarantine, Centers for Disease Control and Prevention, Atlanta, GA 30333, USA.
authors.forename: Jeanette J
authors.initials: JJ
authors.lastname: Rainey
authors.affiliation: Division of Global Migration and Quarantine, Centers for Disease Control and Prevention, Atlanta, GA 30333, USA.
authors.forename: Amra
authors.initials: A
authors.lastname: Uzicanin
authors.affiliation: Department of Internal Medicine, University of Utah, Salt Lake City, UT 84132, USA VA Salt Lake City Health Care System, Salt Lake City, UT 84108, USA Department of Biomedical Informatics, University of Utah, Salt Lake City, UT 84108, USA.
authors.forename: Matthew H
authors.initials: MH
authors.lastname: Samore
mesh_terms: D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D004196:Disease Outbreaks; D005260:Female; D006801:Humans; D007251:Influenza, Human / Q000453:epidemiology* / Q000635:transmission*; D008297:Male; D008954:Models, Biological; D012574:Schools; D014589:Utah / Q000453:epidemiology
keywords: contact network; epidemiology; influenza; mathematical model; schools