Abstract
BackgroundChanges in children’s contact patterns between termtime and school holidays affect the transmission of several respiratory-spread infections. Transmission of varicella zoster virus (VZV), the causative agent of chickenpox, has also been linked to the school calendar in several settings, but temporal changes in the proportion of young children attending childcare centres may have influenced this relationship.MethodsWe used two modelling methods (a simple difference equations model and a Time series Susceptible Infectious Recovered (TSIR) model) to estimate fortnightly values of a contact parameter (the per capita rate of effective contact between two specific individuals), using GP consultation data for chickenpox in England and Wales from 1967–2008.ResultsThe estimated contact parameters were 22–31% lower during the summer holiday than during termtime. The relationship between the contact parameter and the school calendar did not change markedly over the years analysed.ConclusionsIn England and Wales, reductions in contact between children during the school summer holiday lead to a reduction in the transmission of VZV. These estimates are relevant for predicting how closing schools and nurseries may affect an outbreak of an emerging respiratory-spread pathogen.
Highlights
Chickenpox is caused by varicella zoster virus (VZV), which is spread primarily by the respiratory route
Several modelling studies have found that, similar to measles [2,3,4,5,6], VZV transmission is reduced during school holidays compared to termtime [5,6,7]
Estimates of the contact parameters using the simple mass action model The contact parameter estimated using the simple mass action model was in general lowest during the summer holiday, but seasonal patterns differed between years (Figure 2)
Summary
Chickenpox is caused by varicella zoster virus (VZV), which is spread primarily by the respiratory route. Several modelling studies have found that, similar to measles [2,3,4,5,6], VZV transmission is reduced during school holidays compared to termtime [5,6,7]. Two of these studies used historical data, from early 20th Century Denmark [5] or from 1928–1973 in the USA [6]. Transmission of varicella zoster virus (VZV), the causative agent of chickenpox, has been linked to the school calendar in several settings, but temporal changes in the proportion of young children attending childcare centres may have influenced this relationship
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