Closure of schools during an influenza pandemic

• Published in: The Lancet infectious diseases Vol. 9; no. 8; pp. 473 - 481
• Main Authors: Cauchemez, Simon, Ferguson, Neil M, Wachtel, Claude, Tegnell, Anders, Saour, Guillaume, Duncan, Ben, Nicoll, Angus
• Format: Journal Article
• Language: English
• Published: London Elsevier Ltd 01.08.2009; Lancet Publishing Group; Elsevier Limited
• Subjects: Biological and medical sciences; Disease Outbreaks - prevention & control; Disease transmission; Global Health; Health policy; Human viral diseases; Humans; Infectious Disease; Infectious diseases; Influenza A Virus, H1N1 Subtype; Influenza, Human - epidemiology; Influenza, Human - prevention & control; Medical sciences; Pandemics; Public health; Public Policy; Schools; Schools - organization & administration; Viral diseases; Viral diseases of the respiratory system and ent viral diseases; Infection; Viral disease; Influenza; School environment
• ISSN: 1473-3099; 1474-4457; 1474-4457
• DOI: 10.1016/S1473-3099(09)70176-8

In response to WHO raising the influenza pandemic alert level from phase five to phase six, health officials around the world are carefully reviewing pandemic mitigation protocols. School closure (also called class dismissal in North America) is a non-pharmaceutical intervention that is commonly suggested for mitigating influenza pandemics. Health officials taking the decision to close schools must weigh the potential health benefits of reducing transmission and thus case numbers against high economic and social costs, difficult ethical issues, and the possible disruption of key services such as health care. Also, if schools are expected to close as a deliberate policy option, or just because of high levels of staff absenteeism, it is important to plan to mitigate the negative features of closure. In this context, there is still debate about if, when, and how school closure policy should be used. In this Review, we take a multidisciplinary and holistic perspective and review the multiple aspects of school closure as a public health policy. Implications for the mitigation of the swine-origin influenza A H1N1 pandemic are also discussed.