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Open Access Highly Accessed Research article

Social contact networks for the spread of pandemic influenza in children and teenagers

Laura M Glass1 and Robert J Glass23*

Author Affiliations

1 Albuquerque Public Schools, Albuquerque, New Mexico, USA

2 National Infrastructure Simulation and Analysis Center (NISAC) [NISAC is a program of the Department of Homeland Security's Infrastructure Protection/Risk Management Division and comprised of a core partnership of Sandia National Laboratories (SNL) and Los Alamos National Laboratory (LANL)] Albuquerque, New Mexico, USA

3 Sandia National Laboratories (SNL) [SNL is a multiprogram laboratory operated by Sandia Corporation, a Lockheed Martin Company for the United States Department of Energy's National Nuclear Security Administration under contract DE-AC04-94AL85000] Albuquerque, New Mexico, USA

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BMC Public Health 2008, 8:61  doi:10.1186/1471-2458-8-61

Published: 14 February 2008

Abstract

Background

Influenza is a viral infection that primarily spreads via fluid droplets from an infected person's coughs and sneezes to others nearby. Social contact networks and the way people interact within them are thus important to its spread. We developed a method to characterize the social contact network for the potential transmission of influenza and then applied the method to school aged children and teenagers.

Methods

Surveys were administered to students in an elementary, middle and high-school in the United States. The social contact network of a person was conceptualized as a set of groups to which they belong (e.g., households, classes, clubs) each composed of a sub-network of primary links representing the individuals within each group that they contact. The size of the group, number of primary links, time spent in the group, and level of contact along each primary link (near, talking, touching, or kissing) were characterized. Public activities done by groups venturing into the community where random contacts occur (e.g., friends viewing a movie) also were characterized.

Results

Students, groups and public activities were highly heterogeneous. Groups with high potential for the transmission of influenza were households, school classes, friends, and sports; households decreased and friends and sports increased in importance with grade level. Individual public activity events (such as dances) were also important but lost their importance when averaged over time. Random contacts, primarily in school passing periods, were numerous but had much lower transmission potential compared to those with primary links within groups. Students are highly assortative, interacting mainly within age class. A small number of individual students are identified as likely "super-spreaders".

Conclusion

High-school students may form the local transmission backbone of the next pandemic. Closing schools and keeping students at home during a pandemic would remove the transmission potential within these ages and could be effective at thwarting its spread within a community. Social contact networks characterized as groups and public activities with the time, level of contact and primary links within each, yields a comprehensive view, which if extended to all ages, would allow design of effective community containment for pandemic influenza.