Can closing schools stop the flu?

Email|Link|Comments (0)Posted by Elizabeth Cooney July 20, 2009 08:53 PM As they prepare for a fall flu season that could bring two nasty strains, Boston health officials are studying whether school closings helped to stop the spread of swine flu during the spring. Dr. Anita Barry, director of the infectious disease bureau at the Boston Public Health Commission, said the agency is still analyzing case reports from private and public schools that closed after abseentism rates soared. They expect to have answers in a month that will tell them if closing schools broke the chain of transmission of swine flu, known by its scientific name H1N1. The Boston review continues even as an article appearing today in a special issue of the British medical journal The Lancet Infectious Diseases concludes that closing schools early in a pandemic can reduce the number of cases at its peak, but cases might rise later when they reopened, leading to the same totals had schools not been shuttered. This flattening in the number of cases was observed in epidemics dating from 1918 through 2008. The social and economic costs of prolonged closing may be high, measured in lost income for parents who must miss work as well as in disruptions in the healthcare system when its workers also have to stay home, Simon Cauchemez of Imperial College London Stargames and co-authors wrote. "The H1N1 pandemic could become more severe, and so the current cautious approach of not necessarily recommending school closure in Europe and North America might need reappraisal in the autumn," the authors said. But "there are still many uncertainties about the health, economic, and social implications of closing schools to mitigate an influenza pandemic." The novel flu strain has disproportionately sickened young people since it emerged in April. In Massachusetts, almost two-thirds of confirmed cases were found in people under age 18, reflecting similar figures worldwide. Barry said the commission estimates there were 23,000 cases in the city, or about 4 percent of the population, based on mathematical models derived from tracking visits to hospital emergency rooms. When it comes to transmitting infectious diseases, children make ideal agents. They are both more likely to catch viruses and to spread them, having less immunity than adults and being more likely to gather in close quarters at school. They're contagious longer and carry higher amounts of virus, too. In Boston, the H1N1 outbreak taxed hospitals in May and doctors' offices in June, Dr. Marvin Harper, an infectious disease specialist at Children's Hospital Boston, said. But a surge in cases occurring in the winter months could overwhelm the healthcare system. In his view, the value of school closings depends on whether the disease is already spreading across the population. An H1N1 vaccine is not expected to be ready before the end of the year and it will likely be set aside for the most vulnerable people first. "If more of the cases are being spread by kids outside of school than in school, then closing schools really isn't going to have that much effect," he said. "The point of [the Lancet] article is if you are going to close a school, you need to do it early and not late." Barry of the Boston Public Health Commission said one thing is certain. "This is the year for people to get their seasonal flu vaccine and get it early," she said. "You don't want to get [infected] twice, because you can get seasonal flu and H1N1 if you're really unlucky." For More Information: http://www.boston.com/news/health/blog/2009/07/when_it_comes_t.html & Reel King