Abstract
IntroductionChildren are important transmitters of influenza in the community and a number of non-pharmaceutical interventions (NPIs), including hand washing and use of hand sanitizer, have been recommended to mitigate the transmission of influenza, but limited information is available regarding schools' ability to implement these NPIs during an influenza outbreak. We evaluated implementation of NPIs during fall 2009 in response to H1N1 pandemic influenza (pH1N1) by New York City (NYC) public schools.MethodsFrom January 25 through February 9, 2010, an online survey was sent to all the 1,632 NYC public schools and principals were asked to participate in the survey or to designate a school nurse or other school official with knowledge of school policies and characteristics to do so.ResultsOf 1,633 schools, 376(23%) accessed and completed the survey. Nearly all respondents (99%) implemented at least two NPIs. Schools that had a Flu Response Team (FRT) as a part of school emergency preparedness plan were more likely to implement the NPI guidelines recommended by NYC public health officials than schools that did not have a FRT. Designation of a room for isolating ill students, for example, was more common in schools with a FRT (72%) than those without (53%) (p<0.001).ConclusionsImplementing an NPI program in a large school system to mitigate the effects of an influenza outbreak is feasible, but there is potential need for additional resources in some schools to increase capacity and adherence to all recommendations. Public health influenza-preparedness plans should include school preparedness planning and FRTs.
Highlights
Children are important transmitters of influenza in the community and a number of non-pharmaceutical interventions (NPIs), including hand washing and use of hand sanitizer, have been recommended to mitigate the transmission of influenza, but limited information is available regarding schools’ ability to implement these NPIs during an influenza outbreak
In New York City (NYC), the first case of pH1N1 was confirmed in a high school student on April 23, 2009, a week after the first cases in the United States were diagnosed in two children in California [14,15,16]
Centers for Disease Control and Prevention (CDC)-recommended NPIs include hand washing and/or use of hand sanitizer, immediate isolation of students with influenza-like illness (ILI), routine cleaning of surfaces that students and staff touch frequently, teaching proper hand washing and respiratory etiquette in schools, and the use of face masks by persons exposed to patients with suspected influenza [20]
Summary
Children are important transmitters of influenza in the community and a number of non-pharmaceutical interventions (NPIs), including hand washing and use of hand sanitizer, have been recommended to mitigate the transmission of influenza, but limited information is available regarding schools’ ability to implement these NPIs during an influenza outbreak. We evaluated implementation of NPIs during fall 2009 in response to H1N1 pandemic influenza (pH1N1) by New York City (NYC) public schools. In New York City (NYC), the first case of pH1N1 was confirmed in a high school student on April 23, 2009, a week after the first cases in the United States were diagnosed in two children in California [14,15,16]. CDC-recommended NPIs include hand washing and/or use of hand sanitizer, immediate isolation of students with influenza-like illness (ILI), routine cleaning of surfaces that students and staff touch frequently, teaching proper hand washing and respiratory etiquette in schools, and the use of face masks by persons exposed to patients with suspected influenza [20]
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