Evidenced-based tool for triggering school closures during influenza outbreaks, Japan.

DOI: 10.3201/eid1511.090798
Suggested citation for this article: Sasaki A, Gatewood A, Ozonoff A, Suzuki H, Tanabe N, Seki N, et al. Evidenced-based tool for triggering school closures during influenza outbreaks, Japan. Emerg Infect Dis. 2009 Nov; [Epub ahead of print]
Evidence-based Tool for Triggering School Closures during Influenza Outbreaks, Japan
Asami Sasaki, Anne Gatewood, Al Ozonoff, Hiroshi Suzuki, Naohito Tanabe, Nao Seki, Reiko Saito, and John S. Brownstein
Author affiliations: Harvard School of Public Health, Boston, Massachusetts, USA (A. Sasaki); University of Niigata Prefecture, Niigata, Japan (A. Sasaki); Children’s Hospital, Boston (A. Gatewood, J.S. Brownstein); Harvard Medical School, Boston (A. Gatewood, J.S. Brownstein); Boston University School of Public Health, Boston (A. Ozonoff); and Niigata University Graduate School of Medical and Dental Sciences, Niigata (H. Suzuki, M. Tamabe, N. Seki, R. Saito)
Guidelines available to school administrators to support school closure decisions during influenza outbreaks are usually not evidence-based. Using empirical data on absentee rates of elementary school students in Japan, we developed a simple and practical algorithm for determining the optimal timing of school closures for control of influenza outbreaks.
Influenza pandemic preparedness and seasonal influenza control programs have focused on vaccine development and antiviral drugs, which are only partially effective and not always available to all persons at risk (1–3). Nonpharmaceutical interventions, such as social distancing, represent additional key tools for mitigating the impact of outbreaks. Because children are a major factor in the transmission of influenza within communities and among households, school closure may be a valuable social distancing method (4,5).
Japan has a unique system of monitoring school absenteeism and of instituting school closures during influenza outbreaks. Individual classes, specific grade levels, or the entire school may be closed; final decision-making authority is given to school principals. However, as in the United States and other countries, there are no regulations to support these decisions (6)

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