title: Reactive School Closure During Increased Influenza-Like Illness (ILI) Activity in Western Kentucky, 2013: A Field Evaluation of Effect on ILI Incidence and Economic and Social Consequences for Families.
abstract: Background.School closures are an important mitigation strategy during influenza pandemic: if implemented early in a local outbreak, they can slow the disease spread in the surrounding community. During seasonal influenza epidemics, school closures may occur reactively, after the disease is already widespread in the community. Such reactive closures are often too late to reduce influenza transmission. However, they can provide data to determine under which circumstances they might be effective in reducing influenza-like illness (ILI) transmission.Methods.We conducted a household survey in a school district in Kentucky. District A closed after high student absenteeism due to influenza-like illness (ILI), whereas adjacent Districts B and C remained open. We collected data on self-reported ILI among household members in these 3 districts 2 weeks before the District A closure, during closure, and 2 weeks after reopening, and we evaluated economic and social consequences of school closure on student households in District A. The difference-in-differences method was applied to compare changes in ILI rates from before to after closure between districts.Results.Estimated average daily ILI rate decreased less in District A than in District B or C for the entire sample and when stratified by age groups (0-5 years old, 6-18 years old, and above 18 years old). Twenty-five percent of District A households reported ≥1 closure-related economic or social difficulty.Conclusions.Closing schools after a widespread ILI activity in District A did not reduce ILI transmission but caused difficulties for some households.
authors: Division of Epidemiology and Health Planning, Kentucky Department for Public Health, Frankfort; Epidemic Intelligence Service Officer.
authors: Elizabeth S
authors: ES
authors: Russell
authors: Division of Global Migration and Quarantine.
authors: Yenlik
authors: Y
authors: Zheteyeva
authors: Division of Global Migration and Quarantine.
authors: Hongjiang
authors: H
authors: Gao
authors: Division of Global Migration and Quarantine.
authors: Jianrong
authors: J
authors: Shi
authors: Division of Global Migration and Quarantine.
authors: Jeanette J
authors: JJ
authors: Rainey
authors: Division of Epidemiology and Health Planning, Kentucky Department for Public Health, Frankfort; Office of Public Health Preparedness and Response, Centers for Disease Control and Prevention, Atlanta, Georgia.
authors: Douglas
authors: D
authors: Thoroughman
authors: Division of Global Migration and Quarantine.
authors: Amra
authors: A
authors: Uzicanin
keywords: influenza; school closure; school dismissal; schools