Preventive measures for the transmission control of influenza in primary schools in Saudi Arabia: Lessons from the recent H1N1 pandemic

Abstract

Background and Objectives: All over the world schools play an important role in the transmission of influenza within the community. The aim of the present study was to assess the preventive measures taken by primary schools in the Eastern province of Saudi Arabia, to reduce the transmission of H1N1 influenza. Materials and Methods: A cross-sectional study was conducted in ten female primary schools selected by a multistage stratified random sampling technique with proportionate allocation out of 163 public and private schools in Dammam and Khobar. All ten schools were assessed for availability of human and nonhuman resources for the prevention of H1N1 transmission, and the efficiency of preventive measures by a predesigned checklist based on the guidelines of World Health Organization, Centre for Disease Control and Prevention and Saudi Ministry of Health and by the review of school records. Two classes were randomly selected from each school for the screening of desks for influenza by rapid antigen test and confirmation of positive cases by polymerase chain reaction. The total sample size was 500 desks. Results: Optimal implementation of recommended preventive and control measures in the primary schools was observed. All desk swab samples were negative for the influenza virus. Despite the low prevalence of students immunized with the H1N1 vaccine (2.3%), the percentage of suspected and confirmed H1N1 cases was low (0.6% and 0.1% respectively). Conclusion and Recommendation: Appropriate implementation of the recommended preventive and control measures for influenza in primary schools may reduce H1NI viral transmission even without mass student immunization. Accordingly, it is recommended that only high-risk children be immunized to reduce the incidence of side-effects of the vaccine.