Mira Kojouharova, Benjamin J. Cowling, Claude Wachtel, Martin S. Cetron, Brett N. Archer, Predrag Kon, Kumnuan Ungchusak, Simon Cauchemez, Angus Nicoll, Guillaume Saour, Darren Hunt, Hongjie Yu, Caterina Rizzo, Amra Uzicanin, Peter Grove, Maria D. Van Kerkhove, Hitoshi Oshitani, Isaac Weisfuse, Andrea Pugliese, Tomimase Sunagawa, Department of Infectious Disease Epidemiology [London] (DIDE), Imperial College London, Modélisation mathématique des maladies infectieuses, Institut Pasteur [Paris]-Centre National de la Recherche Scientifique (CNRS), National Health Laboratory Service, National Institute for Communicable Diseases [Johannesburg] (NICD), Global Migration and Quarantine, Centers for Disease Control and Prevention, School of Public Health, The University of Hong Kong (HKU), Department of Health, Office of the Director of Public Health, New Zealand Ministry of Health, National Centre of Infectious and Parasitic Diseases, Center for Disease Control and Prevention, City Institute of Public Health Belgrade, Department of Disease Control, Ministry of Public Health, Department of Virology, Tohoku University Graduate School of Medicine, Department of mathematics/Dipartimento di Matematica [Univ. Trento], Università degli Studi di Trento (UNITN), National Center for Epidemiology Surveillance and Health Promotion, Istituto Superiore di Sanita [Rome], Ministère de l'intérieur, Infectious Disease Surveillance Center, National Institute of Infectious Diseases, Secretariat général de la défense et de la sécurite nationale - Prime minister Office, Prime minister Office, Paris, France, Department of Health and Mental Hygiene, NYC Department of Health and Mental Hygiene (NYC Health), Division for Infectious Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Influenza coordination, European Centre for Disease Prevention and Control (ECDC), Institut Pasteur [Paris] (IP)-Centre National de la Recherche Scientifique (CNRS), Istituto Superiore di Sanità (ISS), and European Centre for Disease Prevention and Control [Stockholm, Sweden] (ECDC)
International audience; BACKGROUND: School closure is a non-pharmaceutical intervention that was considered in many national pandemic plans developed prior to the start of the influenza A(H1N1)pdm09 pandemic, and received considerable attention during the event. Here, we retrospectively review and compare national and local experiences with school closures in several countries during the A(H1N1)pdm09 pandemic. Our intention is not to make a systematic review of country experiences; rather, it is to present the diversity of school closure experiences and provide examples from national and local perspectives. METHODS: Data were gathered during and following a meeting, organized by the European Centres for Disease Control, on school closures held in October 2010 in Stockholm, Sweden. A standard data collection form was developed and sent to all participants. The twelve participating countries and administrative regions (Bulgaria, China, France, Hong Kong Special Administrative Region (SAR), Italy, Japan, New Zealand, Serbia, South Africa, Thailand, United Kingdom, and United States) provided data. RESULTS: Our review highlights the very diverse national and local experiences on school closures during the A(H1N1)pdm09 pandemic. The processes including who was in charge of making recommendations and who was in charge of making the decision to close, the school-based control strategies, the extent of school closures, the public health tradition of responses and expectations on school closure varied greatly between countries. Our review also discusses the many challenges associated with the implementation of this intervention and makes recommendations for further practical work in this area. CONCLUSIONS: The single most important factor to explain differences observed between countries may have been the different public health practises and public expectations concerning school closures and influenza in the selected countries.