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Scott AM, Bakhit M, Clark J, Vermeulen M, Jones M, Looke D, Del Mar C, Glasziou P. Australian state influenza notifications and school holiday closures in 2019. F1000Res 2019; 8:1899. [PMID: 33976871 PMCID: PMC8097737 DOI: 10.12688/f1000research.21145.3] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 05/12/2021] [Indexed: 11/20/2022] Open
Abstract
Background: The impact of school holidays on influenza rates has been sparsely documented in Australia. In 2019, the early winter influenza season coincided with mid-year school breaks, enabling us the unusual opportunity to examine how influenza incidence changed during school holiday closure dates. Methods: The weekly influenza data from five Australian state and one territory health departments for the period of week 19 (mid-May) to week 39 (early October) 2019 were compared to each state's public-school holiday closure dates. We used segmented regression to model the weekly counts and a negative binomial distribution to account for overdispersion due to autocorrelation. The models' goodness-of-fit was assessed by plots of observed versus expected counts, plots of residuals versus predicted values, and Pearson's Chi-square test. The main exposure was the July two-week school holiday period, using a lag of one week. The effect is estimated as a percent change in incidence level, and in slope. Results: School holidays were associated with significant declines in influenza incidence in three states and one territory by between 41% and 65%. Two states did not show evidence of declines although one of those states had already passed its peak by the time of the school holidays. The models showed acceptable goodness-of-fit. The first decline during school holidays is seen in the school aged (5-19 years) population, with the declines in the adult and infant populations being smaller and following a week later. Conclusions: Given the significant and rapid reductions in incidence, these results have important public health implications. Closure or extension of holiday periods could be an emergency option for state governments.
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Affiliation(s)
- Anna Mae Scott
- Institute for Evidence-Based Healthcare, Bond University, Robina, Queensland, 4226, Australia
| | - Mina Bakhit
- Institute for Evidence-Based Healthcare, Bond University, Robina, Queensland, 4226, Australia
| | - Justin Clark
- Institute for Evidence-Based Healthcare, Bond University, Robina, Queensland, 4226, Australia
| | - Melanie Vermeulen
- Institute for Evidence-Based Healthcare, Bond University, Robina, Queensland, 4226, Australia
| | - Mark Jones
- Institute for Evidence-Based Healthcare, Bond University, Robina, Queensland, 4226, Australia
| | - David Looke
- Department of Medicine, University of Queensland, St Lucia, Queensland, 4072, Australia.,Infectious Disease and Clinical Microbiology, Princess Alexandra Hospital, Brisbane, Queensland, Australia
| | - Chris Del Mar
- Institute for Evidence-Based Healthcare, Bond University, Robina, Queensland, 4226, Australia
| | - Paul Glasziou
- Institute for Evidence-Based Healthcare, Bond University, Robina, Queensland, 4226, Australia
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