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. 2019 Jan:147:e127.
doi: 10.1017/S0950268818003424.

School sessions are correlated with seasonal outbreaks of medically attended respiratory infections: electronic health record time series analysis, Wisconsin 2004-2011

J L Temte  1 , J G Meiman  1 , R E Gangnon  2
Affiliations

School sessions are correlated with seasonal outbreaks of medically attended respiratory infections: electronic health record time series analysis, Wisconsin 2004-2011

J L Temte et al. Epidemiol Infect. 2019 Jan.

Abstract

Increased social contact within school settings is thought to be an important factor in seasonal outbreaks of acute respiratory infection (ARI). To better understand the degree of impact, we analysed electronic health records and compared risks of respiratory infections within communities while schools were in session and out-of-session. A time series analysis of weekly respiratory infection diagnoses from 28 family medicine clinics in Wisconsin showed that people under the age of 65 experienced an increased risk of ARI when schools were in session. For children aged 5-17 years, the risk ratio for the first week of a school session was 1.12 (95% confidence interval (CI) 0.93-1.34), the second week of a session was 1.39 (95% CI 1.15-1.68) and more than 2 weeks into a session was 1.43 (95% CI 1.20-1.71). Less significant increased risk ratios were also observed in young children (0-4 years) and adults (18-64 years). These results were obtained after modelling for baseline seasonal variations in disease prevalence and controlling for short-term changes in ambient temperature and relative humidity. Understanding the mechanisms of seasonality make it easier to predict outbreaks and launch timely public health interventions.

Keywords: Influenza; respiratory infections; transmission.

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Conflict of interest statement

All authors have reported no conflict of interest. All authors have signed the ICMJE Form for Disclosure of Potential Conflicts of Interest.

Figures

Fig. 1.
Fig. 1.
ARI counts by age group (July 2008 through June 2011). Arrows in panel for children, ages 5–17 years, indicates start of the academic year.
Fig. 2.
Fig. 2.
Relative risks of ARI (95% CI), children ages 5–17 years.
See this image and copyright information in PMC

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