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Effect of winter school breaks on influenza-like illness, Argentina, 2005-2008.

Garza RC, Basurto-Dávila R, Ortega-Sanchez IR, Carlino LO, Meltzer MI, Albalak R, Balbuena K, Orellano P, Widdowson MA, Averhoff F - Emerging Infect. Dis. (2013)

Bottom Line: The largest decrease was among children 5-14 years of age during the week after the break (37% lower IRR).Among adults, effects were weaker and delayed.Two-week winter school breaks significantly decreased visits to a health care provider for ILI among school-aged children and nonelderly adults.

View Article: PubMed Central - PubMed

Affiliation: Office of Public Health Preparedness and Response, Centers for Disease Control and Prevention, 1600 Clifton Rd NE, Mailstop D14, Atlanta, GA 30333, USA. RGarza@cdc.gov

ABSTRACT
School closures are used to reduce seasonal and pandemic influenza transmission, yet evidence of their effectiveness is sparse. In Argentina, annual winter school breaks occur during the influenza season, providing an opportunity to study this intervention. We used 2005-2008 national weekly surveillance data of visits to a health care provider for influenza-like illness (ILI) from all provinces. Using Serfling-specified Poisson regressions and population-based census denominators, we developed incidence rate ratios (IRRs) for the 3 weeks before, 2 weeks during, and 3 weeks after the break. For persons 5-64 years of age, IRRs were <1 for at least 1 week after the break. Observed rates returned to expected by the third week after the break; overall decrease among persons of all ages was 14%. The largest decrease was among children 5-14 years of age during the week after the break (37% lower IRR). Among adults, effects were weaker and delayed. Two-week winter school breaks significantly decreased visits to a health care provider for ILI among school-aged children and nonelderly adults.

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Related in: MedlinePlus

Estimated deviation from predicted incidence rates for influenza-like illness relative to winter break, by week and age group, Argentina, 2005–2008. Dashed lines show the 95% CI for the incidence rate ratios of age group 5–14 years because this is the age group of interest and because it simplifies the display of these results. Statistical significance for the other age groups is shown in Table 2.
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Figure 2: Estimated deviation from predicted incidence rates for influenza-like illness relative to winter break, by week and age group, Argentina, 2005–2008. Dashed lines show the 95% CI for the incidence rate ratios of age group 5–14 years because this is the age group of interest and because it simplifies the display of these results. Statistical significance for the other age groups is shown in Table 2.

Mentions: Except for the age groups <5 and ≥65 years, lower incidence rates for ILI visits (i.e., IRR<1) were estimated for all groups for at least 1 of the weeks during or after winter school break, but this effect varied by age group in strength and timing relative to the start of the break (Table 2). Statistically significant IRRs for the age group 15–24 years occurred during the 2 weeks after the winter break. Among adults, 25–44 years of age, significant deviations from seasonal trends in ILI visits were observed for the second week (IRR = 0.83, p = 0.009) after the winter break. Among all age groups, incidence of ILI visits returned to regular seasonal patterns 3 weeks after the end of the winter break (Figure 2; Table 2).


Effect of winter school breaks on influenza-like illness, Argentina, 2005-2008.

Garza RC, Basurto-Dávila R, Ortega-Sanchez IR, Carlino LO, Meltzer MI, Albalak R, Balbuena K, Orellano P, Widdowson MA, Averhoff F - Emerging Infect. Dis. (2013)

Estimated deviation from predicted incidence rates for influenza-like illness relative to winter break, by week and age group, Argentina, 2005–2008. Dashed lines show the 95% CI for the incidence rate ratios of age group 5–14 years because this is the age group of interest and because it simplifies the display of these results. Statistical significance for the other age groups is shown in Table 2.
© Copyright Policy
Related In: Results  -  Collection

Show All Figures
getmorefigures.php?uid=PMC3713818&req=5

Figure 2: Estimated deviation from predicted incidence rates for influenza-like illness relative to winter break, by week and age group, Argentina, 2005–2008. Dashed lines show the 95% CI for the incidence rate ratios of age group 5–14 years because this is the age group of interest and because it simplifies the display of these results. Statistical significance for the other age groups is shown in Table 2.
Mentions: Except for the age groups <5 and ≥65 years, lower incidence rates for ILI visits (i.e., IRR<1) were estimated for all groups for at least 1 of the weeks during or after winter school break, but this effect varied by age group in strength and timing relative to the start of the break (Table 2). Statistically significant IRRs for the age group 15–24 years occurred during the 2 weeks after the winter break. Among adults, 25–44 years of age, significant deviations from seasonal trends in ILI visits were observed for the second week (IRR = 0.83, p = 0.009) after the winter break. Among all age groups, incidence of ILI visits returned to regular seasonal patterns 3 weeks after the end of the winter break (Figure 2; Table 2).

Bottom Line: The largest decrease was among children 5-14 years of age during the week after the break (37% lower IRR).Among adults, effects were weaker and delayed.Two-week winter school breaks significantly decreased visits to a health care provider for ILI among school-aged children and nonelderly adults.

View Article: PubMed Central - PubMed

Affiliation: Office of Public Health Preparedness and Response, Centers for Disease Control and Prevention, 1600 Clifton Rd NE, Mailstop D14, Atlanta, GA 30333, USA. RGarza@cdc.gov

ABSTRACT
School closures are used to reduce seasonal and pandemic influenza transmission, yet evidence of their effectiveness is sparse. In Argentina, annual winter school breaks occur during the influenza season, providing an opportunity to study this intervention. We used 2005-2008 national weekly surveillance data of visits to a health care provider for influenza-like illness (ILI) from all provinces. Using Serfling-specified Poisson regressions and population-based census denominators, we developed incidence rate ratios (IRRs) for the 3 weeks before, 2 weeks during, and 3 weeks after the break. For persons 5-64 years of age, IRRs were <1 for at least 1 week after the break. Observed rates returned to expected by the third week after the break; overall decrease among persons of all ages was 14%. The largest decrease was among children 5-14 years of age during the week after the break (37% lower IRR). Among adults, effects were weaker and delayed. Two-week winter school breaks significantly decreased visits to a health care provider for ILI among school-aged children and nonelderly adults.

Show MeSH
Related in: MedlinePlus