Tanabe Yoshimi, Kurita Junko, Nagasu Natsuki, Sugawara Tamie, Ohkusa Yasushi
Health, Longevity, and Welfare Division, Department of Health and Social Services of Ibaraki Prefectual Office.
The Graduate School of Health Sciences, Ibaraki Prefectural University of Health Sciences.
Tohoku J Exp Med. 2019 Mar;247(3):173-178. doi: 10.1620/tjem.247.173.
Infection control in nursery schools and schools is important for community health and the health of children. In Japan, caregivers of children or students usually report the absence due to illness to their attending nurseries or schools, including symptoms and diagnosed diseases. The (Nursery) School Absenteeism Surveillance System, (N)SASSy, covers about 60% of schools and 40% of nurseries in Japan. In this paper, we evaluated the benefits of (N)SASSy as an infection control measure by a public health center. Mito Public Health Center (MPHC) covers 58 nurseries and 186 schools, as of May 2015, and called the nurseries and/or schools to confirm the situation, in case of aberration detected through (N)SASSy. The outcome was defined as the proportion of cluster avoidance by advice from MPHC. A cluster was identified, when the number of patients at the same facility with the same symptom or diagnosed disease was greater than ten during the prior seven days. During the study period (April 2015-March 2016), MPHC advised 85 times, and clusters were avoided 82 times (96.5%). The proportion of cluster avoidance was 100% for fever, enterohemorrhagic Escherichia coli infection, respiratory syncytial virus infection, or streptococcal pharyngitis infection. The proportion of cluster avoidance for diarrhea, vomiting or gastroenteritis infection, mumps, hand-foot-mouth disease (HFMD), and influenza was 78.8, 50.0, 20.0, and 6.7%, respectively. In conclusion, advice from a public health center given by phone based on information from (N)SASSy will be helpful for reducing the number of clusters of infectious diseases, except for HFMD and influenza.
幼儿园和学校的感染控制对社区健康和儿童健康至关重要。在日本，儿童或学生的照顾者通常会向其就读的幼儿园或学校报告因病缺勤情况，包括症状和确诊疾病。（幼儿园）学校缺勤监测系统（N）SASSy覆盖了日本约60%的学校和40%的幼儿园。在本文中，我们评估了公共卫生中心将（N）SASSy作为一种感染控制措施的益处。截至2015年5月，水户公共卫生中心（MPHC）覆盖了58所幼儿园和186所学校，并在通过（N）SASSy检测到异常情况时，致电幼儿园和/或学校以确认情况。结果定义为通过MPHC的建议避免聚集性发病的比例。当同一机构内同一症状或确诊疾病的患者数量在过去七天内超过十人时，即确定为聚集性发病。在研究期间（2015年4月至2016年3月），MPHC提供了85次建议，其中82次（96.5%）避免了聚集性发病。对于发热、肠出血性大肠杆菌感染、呼吸道合胞病毒感染或链球菌性咽炎感染，避免聚集性发病的比例为100%。对于腹泻、呕吐或肠胃炎感染、腮腺炎、手足口病（HFMD）和流感，避免聚集性发病的比例分别为78.8%、50.0%、20.0%和6.7%。总之，基于（N）SASSy信息通过电话提供的公共卫生中心建议，将有助于减少传染病聚集性发病的数量，但手足口病和流感除外。
