Household transmission of influenza A and B in a school-based study of non-pharmaceutical interventions

Andrew Azman, James H. Stark, Benjamin M. Althouse, Charles J. Vukotich, Samuel Stebbins, Donald S. Burke, Derek A T Cummings

Research output: Contribution to journalArticle

Abstract

The effect of school-based non-pharmaceutical interventions (NPIs) on influenza A and B transmission in children's households has not been estimated in published literature. We use data from a large school-based cluster randomized trial of improved hand and respiratory hygiene measures to explore the secondary transmission of influenza A and B in households of laboratory confirmed influenza cases. Data were taken from the Pittsburgh Influenza Prevention Project, a cluster-randomized trial of NPIs conducted in ten Pittsburgh, PA elementary schools during the 2007-2008 influenza season. We estimated two measures of influenza transmissibility in households; the susceptible infectious transmission probability, using variants of the Reed-Frost chain binomial model, and the secondary attack rate. We identified predictors of ILI using a logistic generalized estimating equation model. We estimate the secondary attack rates in intervention households to be 0.26 (95% confidence interval (CI) 0.19-0.34) compared to 0.30 (95% CI 0.23-0.38) in control households. Race and age were significant risk factors for secondary ILI acquisition in this study. We found no significant differences between the transmission probabilities for infectious individuals in intervention (0.19, 95% CI 0.14-0.25), and control households (0.22, 95% CI 0.16-0.29). Similarly, estimates for secondary attack rates and transmission probabilities for households with confirmed influenza A (0.31 and 0.22) were not significantly different from estimates from households with confirmed influenza B (0.25 and 0.20). While influenza A and B are thought to have different transmission characteristics, we find no significant differences in their transmissibility within households. Though our results suggest a potential effect, we found no statistically significant effect of school-based non-pharmaceutical interventions on transmission in symptomatic children's homes.

Original languageEnglish (US)
Pages (from-to)181-186
Number of pages6
JournalEpidemics
Volume5
Issue number4
DOIs
StatePublished - Dec 2013

Fingerprint

Human Influenza
Confidence Intervals
Hand Hygiene
Statistical Models

Keywords

  • Dynamics
  • Household
  • Influenza
  • Intervention
  • Transmission

ASJC Scopus subject areas

  • Epidemiology
  • Infectious Diseases
  • Public Health, Environmental and Occupational Health
  • Microbiology
  • Parasitology
  • Virology

Cite this

Azman, A., Stark, J. H., Althouse, B. M., Vukotich, C. J., Stebbins, S., Burke, D. S., & Cummings, D. A. T. (2013). Household transmission of influenza A and B in a school-based study of non-pharmaceutical interventions. Epidemics, 5(4), 181-186. https://doi.org/10.1016/j.epidem.2013.09.001

Household transmission of influenza A and B in a school-based study of non-pharmaceutical interventions. / Azman, Andrew; Stark, James H.; Althouse, Benjamin M.; Vukotich, Charles J.; Stebbins, Samuel; Burke, Donald S.; Cummings, Derek A T.

In: Epidemics, Vol. 5, No. 4, 12.2013, p. 181-186.

Research output: Contribution to journalArticle

Azman, A, Stark, JH, Althouse, BM, Vukotich, CJ, Stebbins, S, Burke, DS & Cummings, DAT 2013, 'Household transmission of influenza A and B in a school-based study of non-pharmaceutical interventions', Epidemics, vol. 5, no. 4, pp. 181-186. https://doi.org/10.1016/j.epidem.2013.09.001
Azman, Andrew ; Stark, James H. ; Althouse, Benjamin M. ; Vukotich, Charles J. ; Stebbins, Samuel ; Burke, Donald S. ; Cummings, Derek A T. / Household transmission of influenza A and B in a school-based study of non-pharmaceutical interventions. In: Epidemics. 2013 ; Vol. 5, No. 4. pp. 181-186.
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