Family Medicine & Primary Care Review

Full text

2/2026 vol. 28
Original paper

Age-stratified effects of school session on respiratory infections

Marcin Piotr Walkowiak 1
,
Dariusz Walkowiak 2

  1. Department of Preventive Medicine, Poznan University of Medical Sciences, Poznan, Poland

  2. Department of Organization and Management in Health Care, Poznan University of Medical Sciences, Poznan, Poland

Family Medicine & Primary Care Review 2026; 28(2): 186–192

DOI: https://doi.org/10.5114/fmpcr.2026.161517
Data publikacji online: 2026/06/22
Article file
13 FM&PCR 2 26 - O - Walkowiak - Age-stratified.pdf
Confronting perimenopausal women’s knowledge of coronary heart disease with their health behaviours. Controversial role of hormone replacement therapy in the protection of coronary heart disease
  1. World Health Organisation. Non-pharmaceutical public health measures for mitigating the risk and impact of epidemic and pandemic influenza. Geneva: WHO; 2019.
  2. Ali ST, Cowling BJ, Lau EHY, et al. Mitigation of Influenza B Epidemic with School Closures, Hong Kong, 2018. Emerg Infect Dis 2018; 24: 2071–2073, doi: 10.3201/eid2411.180612.
  3. Kawano S, Kakehashi M. Substantial Impact of School Closure on the Transmission Dynamics during the Pandemic Flu H1N1-2009 in Oita, Japan. PLOS ONE 2015; 10: e0144839, doi: 10.1371/journal.pone.0144839.
  4. Eames KTD. The influence of school holiday timing on epidemic impact. Epidemiol Infect 2014; 142: 1963–1971, doi: 10.1017/S0950268813002884.
  5. He C, Norton D, Temte JL, et al. Effect of planned school breaks on student absenteeism due to influenza-like illness in school aged children – Oregon School District, Wisconsin September 2014–June 2019. Influenza Other Respir Viruses 2024; 18(1): e13244, doi: 10.1111/irv.13244.
  6. Bin Nafisah S, Alamery AH, Al Nafesa A, et al. School closure during novel influenza: A systematic review. J Infect Public Health 2018; 11: 657–661, doi: 10.1016/j.jiph.2018.01.003.
  7. Beest DE, te, Boven M, van, Hooiveld M, et al. Driving factors of influenza transmission in the Netherlands. Am J Epidemiol 2013; 178: 1469–1477, doi: 10.1093/aje/kwt132.
  8. Ewing A, Lee EC, Viboud C, et al. Contact, Travel, and Transmission: The Impact of Winter Holidays on Influenza Dynamics in the United States. J Infect Dis 2017; 215: 732–739, doi: 10.1093/infdis/jiw642.
  9. Chan EH, Tamblyn R, Charland KML, et al. Outpatient physician billing data for age and setting specific syndromic surveillance of influenza-like illnesses. J Biomed Inform 2011; 44: 221–228, doi: 10.1016/j.jbi.2010.10.001.
  10. Noort SP, van, Codeço CT, Koppeschaar CE, et al. Ten-year performance of Influenzanet: ILI time series, risks, vaccine effects, and care-seeking behaviour. Epidemics 2015; 13: 28–36, doi: 10.1016/j.epidem.2015.05.001.
  11. Brownstein JS, Mandl KD. Pediatric Population Size Is Associated With Geographic Patterns of Acute Respiratory Infections Among Adults. Ann Emerg Med 2008; 52: 63–68, doi: 10.1016/j.annemergmed.2008.02.009.
  12. Szymański K, Kondratiuk K, Hallmann E, et al. Hemagglutinin Antibodies in the Polish Population during the 2019/2020 Epidemic Season. Viruses 2023; 15: 760, doi: 10.3390/v15030760.
  13. Bodewes R, Mutsert G, de, Klis FRM, van der, et al. Prevalence of Antibodies against Seasonal Influenza A and B Viruses in Children in Netherlands. Clin Vaccine Immunol 2011; 18: 469–476, doi: 10.1128/CVI.00396-10.
  14. King JC, Stoddard JJ, Gaglani MJ, et al. Effectiveness of school-based influenza vaccination. N Engl J Med 2006; 355: 2523–2532, doi: 10.1056/NEJMoa055414.
  15. Loeb M, Russell ML, Moss L, et al. Effect of influenza vaccination of children on infection rates in Hutterite communities: a randomized trial. JAMA 2010; 303: 943–950, doi: 10.1001/jama.2010.250.
  16. Redondo-Bravo L, Delgado-Sanz C, Oliva J, et al. Transmissibility of influenza during the 21st-century epidemics, Spain, influenza seasons 2001/02 to 2017/18. Eurosurveillance 2020; 25: 1900364, doi: 10.2807/1560-7917.ES.2020.25.21.1900364.
  17. Cauchemez S, Valleron A-J, Boëlle P-Y, et al. Estimating the impact of school closure on influenza transmission from Sentinel data. Nature 2008; 452: 750–754, doi: 10.1038/nature06732.
  18. Daniel P, Rodrigo C, Bewick T, et al. Increased incidence of adult pneumococcal pneumonia during school holiday periods. ERJ Open Res 2017; 3(1): 00100–2016, doi: 10.1183/23120541.00100-2016.
  19. Walkowiak MP, Walkowiak J, Walkowiak D. Respiratory Diagnoses Year-Round: Unraveling the Multifaceted Pediatric Infection Cycles. Influenza Other Respir Viruses 2024; 18(11): e70037, doi: 10.1111/irv.70037.
  20. Johnston NW, Johnston SL, Norman GR, et al. The September epidemic of asthma hospitalization: School children as disease vectors. J Allergy Clin Immunol 2006; 117(3): 557–562, doi: 10.1016/j.jaci.2005.11.034.
  21. Larsen K, Zhu J, Feldman LY, et al. The Annual September Peak in Asthma Exacerbation Rates. Still a Reality? Annals ATS 2016; 13: 231–239, doi: 10.1513/AnnalsATS.201508-545OC.
  22. Temte JL, Meiman JG, Gangnon RE. School sessions are correlated with seasonal outbreaks of medically attended respiratory infections: electronic health record time series analysis, Wisconsin 2004–2011. Epidemiol Infect 2019; 147: e127, doi: 10.1017/S0950268818003424.
  23. Bénet T, Amour S, Valette M, et al. Incidence of Asymptomatic and Symptomatic Influenza Among Healthcare Workers: A Multicenter Prospective Cohort Study. Clin Infect Dis 2021; 72: e311–e318, doi: 10.1093/cid/ciaa1109.
  24. Pierangeli A, Scagnolari C, Gentile M, et al. Virological diagnosis of respiratory virus infection in patients attending an emergency department during the influenza season. Clin Microbiol Infect 2010; 16(4): 391–393, doi: 10.1111/j.1469-0691.2009.03119.x.
  25. Jackson C, Mangtani P, Hawker J, et al. The Effects of School Closures on Influenza Outbreaks and Pandemics: Systematic Review of Simulation Studies. PLOS ONE 2014; 9: e97297, doi: 10.1371/journal.pone.0097297.
  26. Vlachos J, Hertegård E, Svaleryd HB. The effects of school closures on SARS-CoV-2 among parents and teachers. PNAS 2021; 118(9): e2020834118, doi: 10.1073/pnas.2020834118.
  27. Chu Y, Wu Z, Ji J, et al. Effects of school breaks on influenza-like illness incidence in a temperate Chinese region: an ecological study from 2008 to 2015. BMJ Open 2017; 7: e013159.
  28. Garza RC, Basurto-Dávila R, Ortega-Sanchez IR, et al. Effect of Winter School Breaks on Influenza-like Illness, Argentina, 2005–2008. Emerg Infect Dis 2013; 19: 938–944, doi: 10.3201/eid1906.120916.
  29. Chowell G, Towers S, Viboud C, et al. Rates of Influenza-like Illness and Winter School Breaks, Chile, 2004–2010. Emerg Infect Dis 2014; 20: 1195–1199, doi: 10.3201/eid2007.130967.
  30. Beest DE, te, Birrell PJ, Wallinga J, et al. Joint modelling of serological and hospitalization data reveals that high levels of pre-existing immunity and school holidays shaped the influenza A pandemic of 2009 in The Netherlands. J R Soc Interface 2015; 12(103): 20141244, doi: 10.1098/rsif.2014.1244.
  31. Zaremba K. School closures and respiratory infections transmission and mortality: evidence from school holidays in Poland. Am J Epidemiol 2025; 194: 2853–2860, doi: 10.1093/aje/kwae453.
  32. Lei H, Jiang H, Zhang N, et al. Increased urbanization reduced the effectiveness of school closures on seasonal influenza epidemics in China. Infect Dis Poverty 2021; 10: 1, doi: 10.1186/s40249-021-00911-7.
  33. Leung K, Jit M, Lau EHY, et al. Social contact patterns relevant to the spread of respiratory infectious diseases in Hong Kong. Sci Rep 2017; 7: 7974, doi: 10.1038/s41598-017-08241-1.
  34. Ajelli M, Litvinova M. Estimating contact patterns relevant to the spread of infectious diseases in Russia. J Theor Biol 2017; 419: 1–7, doi: 10.1016/j.jtbi.2017.01.041.
  35. Dorélien AM, Venkateswaran N, Deng J, et al. Quantifying social contact patterns in Minnesota during stay-at-home social distancing order. BMC Infect Dis 2023; 23: 324, doi: 10.1186/s12879-022-07968-1.
  36. Miyaki K, Sakurazawa H, Mikurube H, et al. An Effective Quarantine Measure Reduced the Total Incidence of Influenza A H1N1 in the Workplace: Another Way to Control the H1N1 Flu Pandemic. J Occup Health 2011; 53: 287–292, doi: 10.1539/joh.10-0024-FS.
  37. Łyszczarz B. Indirect costs and incidence of caregivers’ short-term absenteeism in Poland, 2006–2016. BMC Public Health 2019; 19: 598, doi: 10.1186/s12889-019-6952-5.
  38. Miller JC, Danon L, O’Hagan JJ, et al. Student Behavior during a School Closure Caused by Pandemic Influenza A/H1N1. PLOS ONE 2010; 5: e10425, doi: 10.1371/journal.pone.0010425.
  39. Walkowiak MP, Domaradzki J, Walkowiak D. Unmasking the COVID-19 pandemic prevention gains: excess mortality reversal in 2022. Public Health 2023; 223: 193–201, doi: 10.1016/j.puhe.2023.08.004.
  40. Kuitunen I, Artama M, Haapanen M, et al. Respiratory virus circulation in children after relaxation of COVID-19 restrictions in fall 2021 – A nationwide register study in Finland. J Med Virol 2022; 94: 4528–4532, doi: 10.1002/jmv.27857.
  41. Han P, Shen K. Covid lockdown and repaying the immunity debt in children. Glob Pediatr 2024; 9: 100195, doi: 10.1016/j.gpeds.2024.100195.
  42. Lee W-M, Lemanske RF, Evans MD, et al. Human Rhinovirus Species and Season of Infection Determine Illness Severity. Am J Respir Crit Care Med 2012; 186: 886–891, doi: 10.1164/rccm.201202-0330OC.
  43. Nenna R, Matera L, Pierangeli A, et al. First COVID-19 lockdown resulted in most respiratory viruses disappearing among hospitalised children, with the exception of rhinoviruses. Acta Paediatr 2022; 111: 1399–1403, doi: 10.1111/apa.16326.
  44. Chharia A, Jeevan G, Jha RA, et al. Accuracy of US CDC COVID-19 forecasting models. Front Public Health 2024; 12: 1359368, doi: 10.3389/fpubh.2024.1359368.
  45. Monto AS, Malosh RE, Petrie JG, et al. Frequency of Acute Respiratory Illnesses and Circulation of Respiratory Viruses in Households With Children Over 3 Surveillance Seasons. J Infect Dis 2014; 210: 1792–1799, doi: 10.1093/infdis/jiu327.
  46. Walkowiak MP, Walkowiak D. Am I Paid Well Enough to Be Diagnosed with COVID-19? Determinants of Gender Differences in Infection Detection Rate among Polish Working Age Population. J Pers Med 2022; 12(5): 793, doi: 10.3390/jpm12050793.
  47. Carcione D, Giele CM, Goggin LS, et al. Secondary attack rate of pandemic influenza A(H1N1) 2009 in Western Australian households, 29 May–7 August 2009. Euro Surveill 2011; 16: 19765.
  48. Madewell ZJ, Yang Y, Longini IM Jr, et al. Household Transmission of SARS-CoV-2: A Systematic Review and Meta-analysis. JAMA Netw Open 2020; 3: e2031756, doi: 10.1001/jamanetworkopen.2020.31756.
  49. Kuwelker K, Zhou F, Blomberg B, et al. Attack rates amongst household members of outpatients with confirmed COVID-19 in Bergen, Norway: A case-ascertained study. Lancet Reg Health Eur 2021; 3: 100014, doi: 10.1016/j.lanepe.2020.100014.
Copyright: © 2026 Family Medicine & Primary Care Review. This is an Open Access article distributed under the terms of the Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International (CC BY-NC-SA 4.0) License (http://creativecommons.org/licenses/by-nc-sa/4.0/), allowing third parties to copy and redistribute the material in any medium or format and to remix, transform, and build upon the material, provided the original work is properly cited and states its license.
SUBMIT YOUR PAPER
Share
without publication fees
Coverage in
Integrated with