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Study Looks at How Children Drive Flu Outbreaks, In and Out of School

Guest post by Gina Cairney

We know how to prevent the spread of germs, keeping the flu at bay, but researchers at the University of Pittsburgh want to know how children spread the virus, why it happens, and whether school closures are effective at preventing an epidemic.

With the help of student volunteers from Borland Manor Elementary School and North Strabane Intermmediate schools in the Canon-McMillan school district, Pennsylvania, researchers from the university are taking a closer look this week at how children spread the flu, reports the Pittsburgh Tribune-Review.

Students wear a small electronic sensory proximitor, or "motes", on lanyards, between Nov. 5 and Nov. 7, which send out a signal about every 20 seconds, recording when students come in contact with each other for conversations, activities, and also records how far apart they are from one another.

Funded by the Centers for Disease Control and Prevention, the test will look at student interactions in and out of school during the three days, and how they affect the spread of influenza.

Data collected from the two-year project, called "Social Mixing and Respiratory Transmission in Schools" or SMART Schools study, will allow researchers to look at what strategies are the best for controlling the spread of flu, according to a university press release.

Researchers know that influenza outbreaks can be driven by children, "but we don't know how or why," Shanta Zimmer, associate professor at the University of Pittsburgh School of Medicine said in the press release.

"Knowing their interactions and contact patterns will give us much-needed real-world data," she said.

Researchers who studied the effects of school closures in mitigating influenza epidemic in Alberta, Canada, found that closing, then restarting school had a major effect on reducing waves of influenza pandemic cases.

The study, published in February in the Annals of Internal Medicine, suggests school closures can reduce the transmission of the virus among school-age children by more than half.

Preliminary findings from last year's SMART Schools test, involving eight schools from the Canon-McMillan school district, near Pittsburgh, and Propel Charter schools, within the city limits, revealed that each child interacted, on average, with 109 other students throughout the day.

Some students from that test took the motes home, and sensory readings showed that students continued to gather outside of school hours.

"This provides us some evidence that simply closing schools for a few days will not stop children from interacting with each other," Charles Vukotich Jr., M.S., senior project manager at the university's Graduate School of Public Health said in the press release, bringing into question the Alberta findings related to the effectiveness of school closures in minimizing an influenza epidemic.

In addition to wearing the mote, students were also asked to keep a diary, listing the people they came into contact with, and how (e.g. conversation, handshake, etc.).

The study was inspired by "the need to understand how schoolage children contribute to the epidemic of influenza," Zimmer said in an email.

The test being conducted this week is similar to the one from last year, except this one also includes students who were already sick from the flu.

"Schools can amplify the spread of disease in the general community," Jeanette Rainey, Ph.D., senior epidemiologist at the CDC said.

The data collected from the SMART study allow researchers to better understand how influenza spreads in schools, and help communities "develop effective strategies to prevent disease among school-aged children and also in the general community," Rainey said.

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