Monitoring and Analyzing School Health and Absenteeism Data New York City Department of Health and Mental Hygiene ISDS Webinar – July 30, 2009

School Health Data (ASHR) EHR set up in schools by Office of School Health (2005) ~ 1000 public schools in NYC on system –Predominantly Kindergarten - 8 th Grade –~700 report on any day Visits to school nurse –Chief complaint (drop down menu) –Coded to syndromes –Fevflu = fever and/or general achiness –*ILI = fever GE AND cough OR sore throat 8000 – 9000 visits per day SQL server

Absenteeism Data Initially evaluated by NYCDOHMH in 2003 –Restarted May 2009 Data from DOE –All public schools (~1500) –Present, absent, enrollment –Data 90% complete by 4pm that afternoon SFTP transfer from DOE to NYCDOHMH

Active Surveillance May 11 – June 26, 2009 Schools asked to call if 5 or more students with ILI seen at nurse –Continue calling to report ILI for at least 5 days Schools considered for closure if: –1% ILI for 1 or more days –2% ILI for one day 63 schools met closure criteria 23 schools closed (3 to 13 days)

Current Analysis Modeling effect of school closure on daily ILI counts. Adjusting for: –Day of week –Week of H1N1 outbreak –Borough –School type (elementary, middle, high) –Days since meeting closure criteria –Absenteeism –Enrollment Estimating attributable %ILI due to school closure Preliminary estimates show effect due to school closure Currently assessing overall impact of school closure on influenza transmission