Children are important transmitters of infection. Within schools they encounter large numbers of contacts and infections can spread easily causing outbreaks. However, not all schools are affected equally. We conducted a retrospective analysis of school outbreaks to identify factors associated with the risk of gastroenteritis, influenza, rash or other outbreaks. Data on reported school outbreaks in England were obtained from Public Health England and linked with data from the Department for Education and the Office for Standards in Education, Children’s Services and Skills (Ofsted). Primary and all-through schools were found to be at increased risk of outbreaks, compared with secondary schools (OR 5.82, 95% CI 4.50-7.58 and OR 4.66, 95% CI 3.27-6.61 respectively). School size was also significantly associated with the risk of outbreaks, with higher odds associated with larger schools. Attack rates were higher in gastroenteritis and influenza outbreaks, with lower attack rates associated with rashes (RR 0.17, 95% CI 0.15-0.20). Deprivation and Ofsted rating were not associated with either outbreak occurrence or the subsequent attack rate. This study identifies primary and all-through schools as key settings for health protection interventions. Public health teams need to work closely with these schools to encourage early identification and reporting of outbreaks.
Bibliographical noteFunding information:This research was funded by the National Institute for Health Research Health Protection Research Unit (NIHR HPRU) in Gastrointestinal Infections at University of Liverpool in partnership with Public Health England (PHE), in collaboration with University of East Anglia, University of Oxford and the Quadram Institute (Grant number NIHR HPRU 2012-10038).
Disclaimer: The research was funded by the National Institute for Health
Research Health Protection Research Unit (NIHR HPRU) in Gastrointestinal
Infections at the University of Liverpool in partnership with Public Health
England (PHE), University of East Anglia, University of Oxford and the
Institute of Food Research. The views expressed are those of the authors and
not necessarily those of the NHS, the NIHR, the Department of Health or PHE.
Open Access: This is an Open Access article, distributed under the terms of the Creative Commons Attribution licence (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted re-use, distribution, and reproduction in any medium, provided the original work is properly cited.
Publisher Copyright: © The Author(s), 2020. Published by Cambridge University Press.
Citation: Donaldson AL, Harris JP, Vivancos R, O’Brien SJ (2020). Risk factors
associated with outbreaks of seasonal infectious disease in school settings, England, UK. Epidemiology and Infection 148, e287, 1–8.