Burden of School Absenteeism among School Aged Children from Influenza and Other Respiratory Viruses

Siri Peterson
University of Michigan
Ann Harbor

Siri H. Peterson1, Jennifer P. King1, Jennifer K. Meece2, Edward A. Belongia1, Huong Q. McLean1
1Center for Clinical Epidemiology & Population Health, 2Integrated Research and Development Laboratory

Research area:  Epidemiology

Background: The impact of influenza and other respiratory viruses on workplace productivity and the resulting economic burden on households has been studied extensively. However, few studies have focused on the effect of influenza on school children. We evaluated the burden of specific respiratory viruses on school absenteeism for children aged 5-17 years. 

Methods: A cross-sectional analysis was conducted using follow-up surveys from people with medically attended acute respiratory illness (MAARI) enrolled in the US Influenza Vaccine Effectiveness (Flu VE) Network Study at the Marshfield Clinic during two seasons (2012-13 and 2013-14). Data from children attending school outside of the home were analyzed. Archived negative influenza nose and throat swabs were tested using multiplex rRT-PCR to detect 16 respiratory virus targets. We used linear and logistic regression to examine the association between school absence and type of respiratory viruses; endpoints included mean days absent from school and prolonged (>2 days) absence. We also evaluated the association between influenza vaccination and school absence among children with influenza.

Results: Follow-up surveys were conducted for 623 of the 831 (75%) children aged 5-17 years. Of these, 271 (43%) had influenza, 45 (7%) had RSV, and 142 (23%) had other respiratory viruses. The mean number of days absent from school was 3.1 (95% CI: 2.7 – 3.4) for influenza, 2.9 (95% CI: 2.4 – 3.5) for RSV, and 2.0 (95% CI: 1.6 – 2.4) for other viruses. There were no significant differences in mean days absent for influenza subtypes. Influenza B, Influenza A/H3N2, and RSV infection significantly predicted prolonged absence. Among influenza positive participants, vaccination status was not associated with mean days absent from school or odds of prolonged absence.

Conclusions: Among children with MAARI, days absent from school depended on the viral infection; influenza and RSV infections resulted in longer mean days absent compared to other viruses.