School absenteeism among school-aged children with medically attended acute viral respiratory illness during three influenza seasons, 2012-2013 through 2014-2015

Abstract

Background: Acute respiratory illnesses (ARIs) are common in school-aged children, but few studies have assessed school absenteeism due to specific respiratory viruses.

Objective: To evaluate school absenteeism among children with medically attended ARI due to common viruses.

Methods: We analyzed follow-up surveys from children seeking care for acute respiratory illness who were enrolled in the influenza vaccine effectiveness study at Marshfield Clinic during the 2012-2013 through 2014-2015 influenza seasons. Archived influenza-negative respiratory swabs were retested using multiplex RT-PCR to detect 16 respiratory virus targets. Negative binomial and logistic regression models were used to examine the association between school absence and type of respiratory viruses; endpoints included mean days absent from school and prolonged (>2 days) absence. We examined the association between influenza vaccination and school absence among children with RT-PCR-confirmed influenza.

Results: Among 1027 children, 2295 days of school were missed due to medically attended ARIs; influenza accounted for 39% of illness episodes and 47% of days missed. Mean days absent were highest for influenza (0.96-1.19) and lowest for coronavirus (0.62). Children with B/Yamagata infection were more likely to report prolonged absence than children with A/H1N1 or A/H3N2 infection [OR (95% CI): 2.1 (1.0, 4.5) and 1.7 (1.0, 2.9), respectively]. Among children with influenza, vaccination status was not associated with prolonged absence.

Conclusions: School absenteeism due to medically attended ARIs varies by viral infection. Influenza B infections accounted for the greatest burden of absenteeism.

Keywords: absenteeism; children; influenza.

Figure 1

Distribution of cases by week of onset and influenza season

Figure 2

Adjusted^a mean days absent and prolonged absence by viral infection.

1. ^aAdjusted for age and health status in negative binomial regression models and age in logistic regression models. Panel A excludes participants with adenovirus and coinfections. Panel B excludes children who were vaccinated within 14 d of illness onset or were not considered adequately vaccinated according to the Advisory Committee on Immunization Practices