Household Responses to Pandemic (H1N1) 2009–related School Closures, Perth, Western Australia

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Volume 16, Number 2–February 2010
Research
Household Responses to Pandemic (H1N1) 2009–related School Closures, Perth, Western Australia
Paul V. Effler, Dale Carcione, Carolien Giele, Gary K. Dowse, Leigh Goggin, and Donna B. Mak
Author affiliations: Associate Editor, Emerging Infectious Diseases journal, Centers for Disease Control and Prevention, Atlanta, Georgia, USA (P.V. Effler); and Department of Health, Perth, Western Australia, Australia (P.V. Effler, D. Carcione, C. Giele, G.K. Dowse, L. Goggin, D.B. Mak)

Suggested citation for this article

Abstract
School closure is often purported to reduce influenza transmission, but little is known about its effect on families. We surveyed families affected by pandemic (H1N1) 2009–related school closures in Perth, Western Australia, Australia. Surveys were returned for 233 (58%) of 402 students. School closure was deemed appropriate by 110 parents (47%); however, 91 (45%) parents of 202 asymptomatic students reported taking >1 day off work to care for their child, and 71 (35%) had to make childcare arrangements because of the class closures. During the week, 172 (74%) students participated in activities outside the home on >1 occasion, resulting in an average of 3.7 out-of-home activities for each student. In our survey, activities outside the home were commonly reported by students affected by school closure, the effect on families was substantial, and parental opinion regarding school closures as a means to mitigate the outbreak of pandemic (H1N1) 2009 was divided.

On Friday, June 5, 2009, the Western Australia Department of Health received its third notification of confirmed infection with influenza A pandemic (H1N1) 2009. The patient was an elementary school student from Perth, Western Australia, Australia, who had recently returned from a sporting club excursion to Victoria, another Australian state, which had already experienced >600 cumulative confirmed cases of pandemic influenza (1).

Over the next 3 days (June 6–8), vigorous contact tracing and testing confirmed 11 more pandemic (H1N1) 2009 infections among schoolchildren; all had either visited Victoria or were close contacts of confirmed case-patients who had traveled to Victoria. These 11 children attended 3 schools located within 2 km of each other in a socioeconomically advantaged area of Western Australia's capital, Perth, which has a population of 1.7 million (2). On Sunday, June 7, in accordance with Australian public health practice at the time, the Department of Health advised the 3 schools to cancel classes for the coming week. School A, a public school, closed entirely; schools B and C, both private, cancelled classes for grade 5 and grades 5–7, respectively. The grades closed at schools B and C were those in which at least 1 student was confirmed as having pandemic (H1N1) 2009 virus infection.

School closure (i.e., either closure of school or dismissal of classes) is a nonpharmaceutical intervention often recommended for mitigating virus transmission during an influenza pandemic (3,4). However, little is known about the effect of school closures on students and families. We describe the activities of students affected by school closure, the effect of school closure on families, and parental opinions regarding school closures implemented in response to influenza A pandemic (H1N1) 2009.

Methods
Parents of all students excluded from attendance at schools A, B, and C were surveyed to ascertain the age of their child; the onset of illness, if any, in their child during the school closure period; the need for special childcare arrangements due to the closure; whether the child went out of the home during the school closure period; and parental perspectives on the consequences and appropriateness of the school closure. Parents were asked to complete a written questionnaire for their child; no personal identifiers were obtained. Surveys were distributed by schools on June 22, 2009 (10 days after school closure ended), and collected on July 3, 2009.

A case-patient was defined as a student with PCR results positive for influenza A pandemic (H1N1) 2009 virus. A contact was defined as a student who had been in a classroom with a case-patient for >4 hours or who had had another period of close physical proximity (e.g., sitting within 1 m of the case-patient for at least 15 min) during the case-patient's infectious period (i.e., 1 day before until 7 days after symptom onset). Other students affected by the closure but who did not meet case-patient or contact criteria were defined as school peers.

Influenza-like illness (ILI) was defined as an illness with fever and cough and/or sore throat. Upper respiratory infection (URI) was defined as an illness not meeting ILI criteria but exhibiting >1 of the following signs or symptoms: sore throat, cough or runny nose. Asymptomatic students were defined as contacts and peers in whom ILI or URI did not develop during the period of school closure. Ill students were defined as case-patients, contacts, and peers who developed ILI or URI during the school closure period.

Suggested Citation for this Article
Effler PV, Carcione D, Giele c, Dowse GK, Goggin L, Mak DB. Household responses to pandemic (H1N1) 2009–related school closures, Perth, Western Australia. Emerg Infect Dis [serial on the Internet]. 2010 Feb [date cited]. http://www.cdc.gov/EID/content/16/2/205.htm

DOI: 10.3201/eid1602.091372

abrir aquí para acceder al documento CDC EID completo del cual se reproduce un 25%:
http://www.cdc.gov/eid/content/16/2/205.htm