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01.12.2018 | Research article | Ausgabe 1/2018 Open Access

BMC Infectious Diseases 1/2018

The impact of regular school closure on seasonal influenza epidemics: a data-driven spatial transmission model for Belgium

Zeitschrift:
BMC Infectious Diseases > Ausgabe 1/2018
Autoren:
Giancarlo De Luca, Kim Van Kerckhove, Pietro Coletti, Chiara Poletto, Nathalie Bossuyt, Niel Hens, Vittoria Colizza
Wichtige Hinweise

Electronic supplementary material

The online version of this article (doi:https://​doi.​org/​10.​1186/​s12879-017-2934-3) contains supplementary material, which is available to authorized users.

Abstract

Background

School closure is often considered as an option to mitigate influenza epidemics because of its potential to reduce transmission in children and then in the community. The policy is still however highly debated because of controversial evidence. Moreover, the specific mechanisms leading to mitigation are not clearly identified.

Methods

We introduced a stochastic spatial age-specific metapopulation model to assess the role of holiday-associated behavioral changes and how they affect seasonal influenza dynamics. The model is applied to Belgium, parameterized with country-specific data on social mixing and travel, and calibrated to the 2008/2009 influenza season. It includes behavioral changes occurring during weekend vs. weekday, and holiday vs. school-term. Several experimental scenarios are explored to identify the relevant social and behavioral mechanisms.

Results

Stochastic numerical simulations show that holidays considerably delay the peak of the season and mitigate its impact. Changes in mixing patterns are responsible for the observed effects, whereas changes in travel behavior do not alter the epidemic. Weekends are important in slowing down the season by periodically dampening transmission. Christmas holidays have the largest impact on the epidemic, however later school breaks may help in reducing the epidemic size, stressing the importance of considering the full calendar. An extension of the Christmas holiday of 1 week may further mitigate the epidemic.

Conclusion

Changes in the way individuals establish contacts during holidays are the key ingredient explaining the mitigating effect of regular school closure. Our findings highlight the need to quantify these changes in different demographic and epidemic contexts in order to provide accurate and reliable evaluations of closure effectiveness. They also suggest strategic policies in the distribution of holiday periods to minimize the epidemic impact.
Zusatzmaterial
Additional file 1 The Additional File provides additional details on the modeling approach, the calibration procedure, as well as additional validation results. (PDF 839 kb)
12879_2017_2934_MOESM1_ESM.pdf
Literatur
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