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

Azman, AS and Stark, JH and Althouse, BM and Vukotich, CJ and Stebbins, S and Burke, DS and Cummings, DAT (2013) Household transmission of influenza A and B in a school-based study of non-pharmaceutical interventions. Epidemics, 5 (4). 181 - 186. ISSN 1755-4365

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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. © 2013 Elsevier B.V.


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Item Type: Article
Status: Published
CreatorsEmailPitt UsernameORCID
Azman, AS
Stark, JH
Althouse, BM
Vukotich, CJ
Stebbins, S
Burke, DSdonburke@pitt.eduDONBURKE
Cummings, DAT
Centers: Other Centers, Institutes, Offices, or Units > Center for Public Health Practice
Other Centers, Institutes, Offices, or Units > Center for Vaccine Research
Date: 1 December 2013
Date Type: Publication
Journal or Publication Title: Epidemics
Volume: 5
Number: 4
Page Range: 181 - 186
DOI or Unique Handle: 10.1016/j.epidem.2013.09.001
Schools and Programs: Graduate School of Public Health > Epidemiology
Refereed: Yes
ISSN: 1755-4365
Date Deposited: 07 May 2015 18:59
Last Modified: 02 Feb 2019 16:57


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