ArticleInfectious diseases of poverty2021
Increased urbanization reduced the effectiveness of school closures on seasonal influenza epidemics in China.
Article in Infectious diseases of poverty, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 11 papers.
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11 citing papers in PubMed.
- Absolute humidity drives seasonal influenza A transmission in Hong Kong through social contact modulation: Evidence from compartmental modeling.Infectious Disease Modelling · 2026Article
- Optimizing spatiotemporal nonpharmaceutical interventions for influenza: An adaptive reinforcement learning approach for regional heterogeneity.Infectious Disease Modelling · 2026Article
- The optimal strategy for seasonal influenza vaccination to prevent high-intensity level of influenza epidemics in Zhejiang, China: an integrated transmission-dynamic and health-economic modeling analysis.BMC public health · 2025Article
- Rapid aging of influenza epidemics in China from 2005/06 to 2016/17: A population-based study.Infectious Disease Modelling · 2025Article
- Enhancing infectious diseases early warning: A deep learning approach for influenza surveillance in China.Preventive medicine reports · 2024Article
- Intensity and drivers of subtypes interference between seasonal influenza viruses in mainland China: A modeling study.iScience · 2024Article
- Association between ozone and influenza transmissibility in China.BMC infectious diseases · 2023Article
- Effect of Rapid Urbanization in Mainland China on the Seasonal Influenza Epidemic: Spatiotemporal Analysis of Surveillance Data From 2010 to 2017.JMIR public health and surveillance · 2023Article
- Quantifying the rebound of influenza epidemics after the adjustment of zero-COVID policy in China.PNAS nexus · 2023Article
- The Impact of Urbanization and Human Mobility on Seasonal Influenza in Northern China.Viruses · 2022Article
- Combinational Recommendation of Vaccinations, Mask-Wearing, and Home-Quarantine to Control Influenza in Megacities: An Agent-Based Modeling Study With Large-Scale Trajectory Data.Frontiers in public health · 2022Article
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8 authors.
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Abstract
backgroundSchool closure is a common mitigation strategy during severe influenza epidemics and pandemics. However, the effectiveness of this strategy remains controversial. In this study, we aimed to explore the effectiveness of school closure on seasonal influenza epidemics in provincial-level administrative divisions (PLADs) with varying urbanization rates in China.
methodsThis study analyzed influenza surveillance data between 2010 and 2019 provided by the Chinese National Influenza Center. Taking into consideration the climate, this study included a region with 3 adjacent PLADs in Northern China and another region with 4 adjacent PLADs in Southern China. The effect of school closure on influenza transmission was evaluated by the reduction of the effective reproductive number of seasonal influenza during school winter breaks compared with that before school winter breaks. An age-structured Susceptible-Infected-Recovered-Susceptible (SIRS) model was built to model influenza transmission in different levels of urbanization. Parameters were determined using the surveillance data via robust Bayesian method.
resultsBetween 2010 and 2019, in the less urbanized provinces: Hebei, Zhejiang, Jiangsu and Anhui, during school winter breaks, the effective reproductive number of seasonal influenza epidemics reduced 14.6% [95% confidential interval (CI): 6.2-22.9%], 9.6% (95% CI: 2.5-16.6%), 7.3% (95% CI: 0.1-14.4%) and 8.2% (95% CI: 1.1-15.3%) respectively. However, in the highly urbanized cities: Beijing, Tianjin and Shanghai, it reduced only 5.2% (95% CI: -0.7-11.2%), 4.1% (95% CI: -0.9-9.1%) and 3.9% (95% CI: -1.6-9.4%) respectively. In China, urbanization is associated with decreased proportion of children and increased social contact. According to the SIRS model, both factors could reduce the impact of school closure on seasonal influenza epidemics, and the proportion of children in the population is thought to be the dominant influencing factor.
conclusionsEffectiveness of school closure on the epidemics varies with the age structure in the population and social contact patterns. School closure should be recommended in the low urbanized regions in China in the influenza seasons.
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