Author/Editor		Sočan, Maja
Title		Odsotnost od pouka in iz vrtca kot kazalec za spremljanje gripe
Translated title		School and preschool absenteeism as an indicator for influenza surveillance
Type		članek
Source		Zdrav Vars
Vol. and No.		Letnik 46, št. 2
Publication year		2007
Volume		str. 55-62
Language		slo
Abstract		Surveillance of influenza is based on routine reporting of illness by sentinel care providers, laboratories and hospitals. During epidemics of respiratory illness, nasopharyngeal swabs are taken to confirm influenza activity. Several other indirect indicators, such as school and pre-school absenteeism, can be used for influenza epidemic surveillance. During an epidemic, the illness first occurs among school-aged children, and children were shown to have he highest attack rate compared to other age groups. Excess school absenteeism can therefore serve as a good indicator of the presence and extent of influenza epidemic. Japan is the only country with a long-term school-based surveillance system measuring school absenteeism. The majority of studies validating the use of school-based surveillance systems were published in the USA. In the European countries, including Slovenia, the start of an influenza epidemic is signaled by sentinel surveillance. In Slovenia, the data on pre-school and school absenteeism are not analysed promptly. At the end of the school year, the percentage of students who missed school is recorded in a class school dairy. During the interpandemic period, phase 3, data on the extent of influenza epidemic are obtainable through the sentinel surveillance system. During phases 4 and 5, more intensive surveillance will be required to provide timely information needed for an effective response. During the prepandemic period, and especially at the beginning of an epidemic, a school-based surveillance system should be set up in Slovenia, serving as a public health tool to indicate the presence and extent of influenza in the community.
Summary		Spremljanje gripe temelji na rutinskem poročanju mreže osnovnega zdravstva, laboratorijev in bolnišnic. V obdobju povečanega števila okužb dihal se zbirajo kužnine, da bi potrdili virusa influence. Pojav gripe lahko spremljamo ne samo preko opozorilne mreže pač pa preko drugih posrednih kazalcev kot npr. izostankov od pouka in vrtca. Običajno se ob epidemiji gripe najprej poveča obolevnost pri šolarjih. Pri šolarjih je v primerjavi z drugimi starostnimi skupinami največji delež obolelih. Podatki iz opravljenih raziskav podpirajo mnenje, da je povečano število izostankov od pouka ustrezen kazalec za oceno prisotnosti gripe in obsega epidemije. Dolgoletne izkušnje s šolskim sistemom spremljanja imajo na Japonskem in v zadnjih letih tudi v ZDA, od koder je objavljenih največ študij, ki so ocenjevale izostanek od pouka kot kazalec pojava gripe. V Evropi kot tudi v Sloveniji se pojav gripe zazna predvsem preko virološkega spremljanja in povečanega števila gripi podobne bolezni. V Sloveniji podatkov o deležu odsotnih otrok od pouka ali iz vrtca ne zbiramo sproti. Ob koncu šolskega leta se izračuna delež izostankov od pouka in zapiše v dnevnik šolskega dela razreda. Ocenjujemo, da je v trenutnem interpandemičnem obdobju (faza 3) smiselnost vzpostavitve šolskega sistema spremljanja pri nas vprašljiva, saj lahko dobimo ustrezno informacijo iz obstoječega sistema. V fazi 4 in fazi 5 pandemije bo potrebno intenzivnejše spremljanje, da si zagotovimo pravočasno informacijo in s tem možnost naglega ukrepanja. V prepandemičnem obdobju in na začetku pandemije v Sloveniji bo potrebno razviti šolski sistem spremljanja kot javno- zdravstveno orodje za ugotavljanje prisotnosti in obsega širjenja novega podtipa virusa pri nas.
Descriptors		INFLUENZA DISEASE OUTBREAKS SCHOOLS CHILD DAY CARE CENTERS ABSENTEEISM CHILD