TY - JOUR
T1 - Household transmission of influenza A and B in a school-based study of non-pharmaceutical interventions
AU - Azman, Andrew S.
AU - Stark, James H.
AU - Althouse, Benjamin M.
AU - Vukotich, Charles J.
AU - Stebbins, Samuel
AU - Burke, Donald S.
AU - Cummings, Derek A.T.
N1 - Funding Information:
ASA's work on this project was funded by the Johns Hopkins Sommer Scholars Program. DATC's work was supported by a grant from the NIH (NIGMS, U54 GM088491-01 ) and the CDC. DATC holds a Career Award at the Scientific Interface from the Burroughs Welcome Fund. BMA holds an NSF Graduate Research Fellowship (DGE-0707427). ASA, BMA, and DATC would like to thank the JHPSH Infectious Disease Dynamics Group for useful discussions. Finally, we would like to thank Janet Yuhasz and Barbara Rudiak and the Pittsburgh Public Schools for their support and collegiality.
PY - 2013/12
Y1 - 2013/12
N2 - 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.
AB - 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.
KW - Dynamics
KW - Household
KW - Influenza
KW - Intervention
KW - Transmission
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U2 - 10.1016/j.epidem.2013.09.001
DO - 10.1016/j.epidem.2013.09.001
M3 - Article
C2 - 24267874
AN - SCOPUS:84886438204
SN - 1755-4365
VL - 5
SP - 181
EP - 186
JO - Epidemics
JF - Epidemics
IS - 4
ER -