Running head: Epidemiology 1

Influenza A Outbreak Community Response Plan

Name

Institutional Affiliation

Date

(Total words: 987)

Response Plan 2

Influenza A Outbreak Community Response Plan

Introduction

From a historical approach, the CDC confirms that the 1918 influenza pandemic was the

most severe outbreak in the modern ages (CDC,n.d). Based on epidemiological data, there is a

need to implement many prevention measures to reduce the possibility of a future outbreak.

Scientific researchers support the implementation of the three major nonpharmacological

interventions in the infection reservoir, which are the following: personal, community, and

environmental NPIs. Personal NPIS pertains to the individual itself and consists of voluntary

isolation at home, adequate hand hygiene, and face masks in public spaces. Community NPIs

affect the entire society and aim to reduce the risk of transmission by closing the schools,

dismissing different events, or proposing social distancing measures in different gathering

locations. Besides, environmental NPIs are related to the disinfection process and include all

surface cleaning measures to eliminate the pathogen or sterilizing the environment in which an

infected person has passed through (Lai,2020). Considering the variety of interventions that can

be approached in case of an Influenza A possible outbreak, this paper aims to inform about the

major categories of NPIs. The goal is to provide data in favor of or against the education system

closing to reduce the virus's transmission in the community.

Research Paper Analysis

According to the study published by Modchang et al. (2012), in Thailand, schools are

significant sources of outbreaks that can affect the entire community. The study focused on a

private school located in Bangkok and consisted of collecting various epidemiological data to

create a school model that would predict school closure efficiency. The results obtained from
Response Plan 3

Susceptive-Exposed-Infectious-Recovered equations assess the efficiency of these measures.

They concluded that this approach is practical only when reaching the peak number. In the

opposite situation, closing it too early will result in an increasing number of cases. In contrast

with this community intervention, researchers recommend individual student screenings as they

pointed out to reduce the number of confirmed cases by 40% effectively.

The research paper of Glass and Barnes (2007) underlines the importance of deciding if

school closure benefits outweigh the possible side effects. The paper's thesis tried to understand

school closure reasoning in contrast with the limited data to support it. The study uses stochastic

mathematical approaches that describe the transmission of pathogens based on past influenza

outbreaks. Researchers state that for achieving this method's efficiency, the school needs to be

closed before 2% of the students are confirmed infected. Approaching the intervention after

20% of all the students have the disease, the result underlines little to no benefit. The data

obtained from the calculus supports closing school during outbreaks because even though it does

not reduce adults' infection rates, it is beneficial in children's cases.

The article published by Lee et al. (2010) confirms that school closure remains a debatable

subject in mitigating influenza pandemics, especially compared to the 2009 H1N1 pandemic.

The method used to obtain the result is an agent-based computer simulation model focusing on

school activities in Allegheny's county, Pennsylvania. From a statistical analysis perspective,

closing the entire education system, even in areas that lack a high number of cases, is not

supported when compared to individual school closures. The intervention needs to be maintained

during most of the epidemic to affect the attack rate significantly. In contrast with these results,

opening the school before two weeks can increase the overall attack rate as they remain at a

value of 33%. The recorded data suggest that only after 16 weeks it reached a value of 19% and
Response Plan 4

proved to be effective. The conclusion confirms that school closure as a single intervention is not

an effective method to approach this outbreak until it remains closed during the entire epidemic

crisis.

The purpose of the Copeland et al. (2012) study was to determine the efficiency of school

closure on the number of cases in different households. This study's importance relies on the fact

that it does not calculate the risk of transmission in the education system but tries to show that

school closure can impact society, not only students and professors. The study consisted of

collecting data before, during, and after this intervention. The results depict a lower ARI value

(self-reported cases) and ED visits after approaching the intervention. In contrast with a control

community group, the intervention group presented fewer complaints o infectious

symptomatology. During school closure, the intervention group has an infection rate of 1.2%,

while the control group of 1.5%. These results further support the closure of schools during

possible outbreaks.

In 2015, Davis et al. conducted a research paper to determine if school closing will reduce

the state of Michigan's illness counts. The researchers retrieved the data from the

epidemiological databases used in the 2009 H1N1 pandemic. The sample included 548 schools,

and the results underline the increase in the number of cases of areas which had all school closed

in contrast with those. This research concludes that district schools' reactive closure is not an

efficient method and can increase the number of cases. The study's limitation relies on the fact

that closed school districts also had a higher number of students, explaining the higher rate of

infection. Another explanation is the fact that this approach was taken later in the case of this

group.

Conclusion
Response Plan 5

The subject of school closure during the potential outbreaks remains debatable. Except for

one research that concluded that this measure is inefficient, others have provided results to

confirm this approach's advantage. Most of the studies pointed out that timing is essential, and

closing schools too late might be detrimental. One of the articles confirms that it might not

reduce the risk of infection in the general population, but in the case of students and children

who attend a public or private school, it might be beneficial. In conclusion to this paper, the

community proposal is to monitor the current cases and take immediate actions as long as the

number of the reported cases increases.

Response Plan 6