Active surveillance to track school closures

The fall resurgence of 2009 novel H1N1 influenza contributed to a large number of schools being dismissed across Michigan. In early October, there was a dramatic increase in reports of influenza like illness (ILI) and confirmed influenza cases in Michigan.By mid-October, the ILI activity had peaked and had contributed to a dramatic increase in absenteeism-related school closures. Over the next six weeks there were over 550 school closures in the state. Initially, closures had been reported to the Michigan Department of Community Health (MDCH) via the Centers for Disease Control and Prevention-based electronic self-reporting system, as well as through anecdotal reports from MDCH Regional Epidemiologists and local health jurisdictions. The increase in closures prompted a shift from passive to active event surveillance.

Active surveillance was initiated with a regular outreach for school closure data from news media websites (often local television stations) across the state. These reports were then corroborated by MDCH regional epidemiologists and local health departments. A spreadsheet template was developed for use by all reporting parties and daily synchronization of that data contributed to a single master spreadsheet. The master spreadsheet had been pre-populated with information from the Michigan Department of Education with information that included most recent enrollment numbers, address and coordinate information, public/private/charter status, and school district. This dataset was then used in the development of a mid-day school closures report. As part of this effort, information collected included school closure dates, the number of students and faculty Ill, primary symptoms, lab confirmation availability/status, and federal reporting status of the school closure.

From this data, the state was able to produce a daily report that included the number of closures in each county and maps that showed real-time school closure and re-opening status as well as community impact assessments.

News media websites proved to be an excellent source of school closure data because of their accepted role in disseminating closure information for other types of school closings, such as weather-related dismissals. Individual schools and school districts in Michigan have been reporting closure information to news outlets for decades. For that reason, it made sense to attempt to leverage news media outlets as sources of school closure information. At least one outlet per metropolitan market region in the state was routinely evaluated. Having the daily reports demonstrated trends in school closures across the state and their correlation to ILI activity that is reported via state supported syndromic surveillance systems.

At the end of the six-week period, school closures quickly declined and MDCH state was able to analyze the data it had collected against the data simultaneously collected by the CDC. The state was able to contribute to a CDC sponsored Epi-Aid investigation. While the results of this multi-level investigation are not yet available (as of Feb 24, 2010), they should lead to greater understanding of the factors that contribute to school closures and the impact of these closures on the community.

Products developed include maps of school closures, which were included in the daily school closings report. The map showed locations of current school closings, marked in red, and schools that had closed, but since reopened, in blue. The map was updated on daily and disseminated openly on Michigan's H1N1 Influenza site as part of the School Closures Report.

Also included in the report was a table of school closures by county. The table showed, for each county in Michigan, the number of schools that were closed at the time of the report as well as the number of schools that had closed and then reopened at the time of the report. This table was updated on a daily basis and disseminated openly on Michigan's H1N1 Influenza site as part of the School Closures Report.

Finally, a list of Michigan schools was modified and enhanced. Originally a product of the Michigan Department of Education, the list contained all school buildings registered with the state as well as their addresses, school districts, other information. The list was pared down to include all public, private, and charter K-12 schools. The most recent enrollment data and map coordinate data were added. It was then easily modified to incorporate closure status, closure dates, announced reopen date, previous closure dates, reporting status, absentee rates prior to closing, and any other information deemed relevant to the investigation. This list was only shared internally.

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