School-aged children are an important group in the transmission of influenza with well documented outbreaks of influenza and influenza like illness in schools.(1) Studies examining the community burden of seasonal and pandemic influenza have demonstrated that children have significantly higher rates of PCR-confirmed disease and serological infection with influenza A than adults.(2)
Many people with influenza do not see a doctor as it is often a mild self-limiting illness, however, the majority of surveillance systems use data collected from patients interactions with the health service.(2) Current surveillance systems therefore may be less sensitive to milder forms of the infection and underestimate the amount of influenza transmission within the population, particularly in the early stages of an epidemic and in children.
Boarding schools taking part in the Medical Officers of Schools Association scheme send reports of various illnesses, including ILI to Public Health England for surveillance purposes during school term. Most of the schools taking part in this programme are located in the South of England and the majority collect data on boys aged 13 to 18 years. Most pupils attending these schools are resident and therefore interactions between them and the community. For these reasons, such surveillance data is unlikely to be representative of most children in England.
Pilot studies using school absence data for influenza surveillance have been conducted previously in England and demonstrated the potential usefulness of such an approach. The majority of data from these studies was collected in primary schools, with three secondary schools providing data for one influenza season.(3,4) These studies relied on historic electronic records from schools or daily upload of absence data, which can be administratively burdensome with minimal benefit to schools providing this information. We sought to address these issues by receiving data from schools across England on a weekly basis and involving students in the collection, submission and analysis of data for educational purposes.
This study aimed to establish an electronic system for the collection of routine school absence data as part of a Public Engagement with Science project and to determine if school absence prevalence was correlated with established healthcare surveillance measures for circulating influenza.
References:
1. Zhao H, Joseph C, Phin N. Outbreaks of influenza and influenza-like illness in schools in England and Wales, 2005/06. Euro Surveill Bull Eur Sur Mal Transm Eur Commun Dis Bull. 2007 May;12(5):E3–4.
2. Hayward AC, Fragaszy EB, Bermingham A, Wang L, Copas A, Edmunds WJ, et al. Comparative community burden and severity of seasonal and pandemic influenza: results of the Flu Watch cohort study. Lancet Respir Med [Internet]. 2014 Mar [cited 2014 Apr 7]; Available from: http://www.thelancet.com/journals/lanres/article/PIIS2213-2600(14)70034-7/abstract
3. Mook P, Joseph C, Gates P, Phin N. Pilot scheme for monitoring sickness absence in schools during the 2006/07 winter in England: can these data be used as a proxy for influenza activity? Euro Surveill Bull Eur Sur Mal Transm Eur Commun Dis Bull. 2007 Dec;12(12):E11–12.
4. Schmidt WP, Pebody R, Mangtani P. School absence data for influenza surveillance: a pilot study in the United Kingdom. Euro Surveill. 2010;15(3).
