SciMetrika, LLC, Durham, NC 27713, USA.
J Sch Health. 2012 Mar;82(3):123-30. doi: 10.1111/j.1746-1561.2011.00675.x.
The effects of individual school dismissal on influenza transmission have not been well studied. During the spring 2009 novel H1N1 outbreak, New York City implemented an individual school dismissal policy intended to limit influenza transmission at schools with high rates of influenza-like illness (ILI).
Active disease surveillance data collected by the New York City Health Department on rates of ILI in schools were used to evaluate the impact. Sixty-four schools that met the Health Department's criteria for considering dismissal were included in the analysis. Twenty-four schools that met criteria subsequently dismissed all classes for approximately 1 school week. A regression model was fit to these data, estimating the effect of school dismissal on rates of in-school ILI following reconvening, adjusting for potential confounders.
The model estimated that, on average, school dismissal reduced the rate of ILI by 7.1% over the entire average outbreak period. However, a large proportion of in-school ILI occurred before dismissal criteria were met. A separate model estimated that school absenteeism rates were not significantly affected by dismissal.
Results suggest that individual school dismissal could be considered in situations where schools have a disproportionate number of high-risk students or may be unable to implement recommended preventive or infection control measures. Future work should focus on developing more sensitive indicators of early outbreak detection in schools and evaluating the impact of school dismissal on community transmission.
个别学校停课对流感传播的影响尚未得到充分研究。在 2009 年春季新型 H1N1 爆发期间，纽约市实施了一项个别学校停课政策，旨在限制流感发病率高的学校的流感传播。
利用纽约市卫生局收集的关于学校流感样疾病（ILI）发病率的主动疾病监测数据进行评估。符合卫生局考虑停课标准的 64 所学校被纳入分析。24 所符合标准的学校随后停课约一周。对这些数据进行回归模型拟合，估计在重新开学后学校停课对校内ILI 发生率的影响，同时调整潜在的混杂因素。
模型估计，平均而言，在整个平均爆发期间，学校停课使ILI 发生率降低了 7.1%。然而，在达到停课标准之前，有很大一部分校内ILI 已经发生。另一个模型估计，学校的缺课率并没有因停课而显著受到影响。
结果表明，在学校有大量高风险学生或无法实施建议的预防或感染控制措施的情况下，可以考虑个别学校停课。未来的工作应重点开发更敏感的学校早期爆发检测指标，并评估学校停课对社区传播的影响。
