School closures and influenza: systematic review of epidemiological studies
Open accessAbstract
Objective: To review the effects of school closures on pandemic and seasonal influenza outbreaks. Design: Systematic review. Data sources: MEDLINE and EMBASE, reference lists of identified articles, hand searches of key journals and additional papers from the authors' collections. Study selection: Studies were included if they reported on a seasonal or pandemic influenza outbreak coinciding with a planned or unplanned school closure. Results: Of 2579 papers identified through MEDLINE and EMBASE, 65 were eligible for inclusion in the review along with 14 identified from other sources. Influenza incidence frequently declined after school closure. The effect was sometimes reversed when schools reopened, supporting a causal role for school closure in reducing incidence. Any benefits associated with school closure appeared to be greatest among school-aged children. However, as schools often closed late in the outbreak or other interventions were used concurrently, it was sometimes unclear how much school closure contributed to the reductions in incidence. Conclusions: School closures appear to have the potential to reduce influenza transmission, but the heterogeneity in the data available means that the optimum strategy (eg, the ideal length and timing of closure) remains unclear.
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School closures have for long been known as a potentially effective intervention for reducing the spread of infectious diseases by increasing social distancing.
“school closures have for long been known as a potentially effective intervention for reducing the spread of infectious diseases by increasing social distancing (Hatchett et al. 2007; Jackson et al. 2013).”
From Precaution and proportionality in pandemic politics: democracy, state capacity, and COVID-19-related school closures around the world (2022) · cites this paper as Jackson et al. 2013
The Conclusions say school closures can potentially reduce influenza transmission, and the Results section on modelling reports reduced contact rates during closures and holidays. The review concerns influenza, however, so it does not establish effectiveness against infectious diseases generally. The supplied copy has no page numbers. (LLM, conf=0.85)
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- Authors
- Jackson, C., Vynnycky, E., Hawker, J., Olowokure, B., & Mangtani, P.
- Affiliations
- London School of Hygiene & Tropical Medicine (GB)
- Health Protection Agency, London, UK
- Health Protection Agency (GB)
- Corresponding author
- Jackson, Charlotte
- Venue
- BMJ Open
- Publisher
- BMJ
- Published
- 2013
- Volume
- 3
- Issue
- 2
- Pages
- e002149
- ISSN
- 2044-6055 (ISSN-L)
- PMC
- PMC3586057
- OpenAlex
- W2121157266
- Cited by
- 224
- References
- 85
- Citations by year
- 2026: 6 · 2025: 8 · 2024: 23 · 2023: 18 · 2022: 20 · 2021: 66 · 2020: 42 · 2019: 6 · 2018: 4 · 2017: 6 · 2016: 7 · 2015: 7 · 2014: 9 · 2013: 2
- FWCI
- 0.99
- Type
- journal article
- Language
- en
- Open access
- gold
- doi.org
- Licence
- cc-by-nc
- Locations
- BMJ Open (publishedVersion, cc-by-nc)
- Europe PMC (PubMed Central) (publishedVersion, cc-by-nc)
- PubMed Central (publishedVersion, cc-by-nc)
- PubMed (publishedVersion)
- LSHTM Research Online (London School of Hygiene and Tropical Medicine) (acceptedVersion)
- UCL Discovery (University College London) (submittedVersion)
- Funders
- London School of Hygiene and Tropical Medicine
- National Institute for Health and Care Research (RTF/01/038)
- Topics
- Health Sciences › Medicine › Epidemiology › Influenza Virus Research Studies
- Health Sciences › Medicine › Epidemiology › Respiratory viral infections research
- Social Sciences › Health › Vaccine Coverage and Hesitancy
- Keywords
- school closures, influenza, pandemic influenza, seasonal influenza, influenza transmission, influenza incidence, school-aged children, school reopening, non-pharmaceutical interventions
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Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
Statistics and arithmetic are recomputed, not judged.
Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.
What counts as a claim ›How we measure confidence ›How we check this ›
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