Pittsburgh Influenza Prevention Project
Why Don't We Do It In Our Sleeves
The Pittsburgh Influenza Prevention Project (PIPP) was a three year partnership with the Pittsburgh Public Schools to understand if non- pharmaceutical interventions were effective in reducing influenza in school children, grades K-5. There were 10 schools. Five schools received a WHACK THE FLU intervention; 5 did not. Absences were monitored in all schools.
PIPP demonstrated that children: could learn about how germs were spread; how non-pharmaceutical interventions can prevent their spread; can adopt the appropriate behaviors around these interventions; and maintain these behaviors over an entire school year without backsliding. Every students in the 5 intervention schools in the Pittsburgh Public Schools used hand sanitizer 2.4 times per day, every day of the school year.
The five intervention schools that adopted non-pharmaceutical interventions showed reductions in influenza A infections and in student absences. More specifically, the project had a Fifty-three percent (53%) reduction in laboratory confirmed influenza A infections in the five intervention schools than the five control schools, and twenty-six percent (26%) fewer absences in the intervention schools as compared to the controls. During the flu season, children in intervention schools had 752 fewer absent days, or one-half (1/2) fewer absent days per student, than in the control schools. Children had 0.86 fewer absent days over the entire school year.
Center for Public Health Practice staff who were part of PIPP are spreading this message throughout the community and academic through presentations, and scholarly publication.
Azman AS, Stark JH, Althouse BM, Vukotich CJ Jr, Stebbins S, Burke DS, Cummings DA Householdtransmission of influenza A and B in a school-based study of non-pharmaceutical interventions. Epidemics. 2013 Dec;5(4):181-6. doi: 10.1016/j.epidem.2013.09.001. Epub 2013 Sep 26. PMID: 2426787
Stebbins S, Stark JH, Prasad R, Thompson WW, Mitruka K, Rinaldo C, Vukotich CJ Jr, Cummings DAT, “Sensitivity and Specificity of Rapid Influenza Testing of Children in a Community Setting”, Influenza Other Respi Viruses. 2011 Mar;5(2):104-109. doi: 10.1111/j.1750-2659.2010.00171.x. Epub 2010 Oct 1.
Vukotich CJ, Jr, Assessing the Impact of Pandemic School Closure on the Workforce. Western PA Hospital News. 2010 July 10; 4.
Stebbins S, Downs JS, and Vukotich CJ Jr. Using Nonpharmaceutical Interventions to Prevent Influenza Transmission in Elementary School Children: Parent and Teacher Perspectives. J Public Health Manag Practice. 2009 Mar-Apr; 15(2):112-7.
Uyeki TM, Prasad R, Vukotich CJ, Jr, Stebbins S, Rinaldo C, Ferng Y, Morse SS, Larson EL, Aiello AE, Davis B, Monto AS, Low Sensitivity of Rapid Diagnostic Test for Influenza. Clin Inf Dis. 2009 May 1;48(9):e89-92.
Stebbins, S, Stark, JH, & Vukotich CJ Jr., Compliance with a Multilayered Non-Pharmaceutical Intervention in an Urban Elementary School Setting. J Public Health Manag Practice. 2010 Jul-Aug;16(4):316-24.
Vukotich CJ Jr. Coulborn RM, Aragon TJ, Baker MG, Burrus BB, Cowling BJ, Duncan A, Enanoria W, Fabian MP, Ferng Y, Larson EL, Leung GM, Markel H, Milton D, Monto AS, Morse SS, Navarro JA, Park SY, Priest P, Stebbins S, . Stern AM, Uddin M, Wetterhall SF, Aiello AE, Findings, Gaps and Future Direction for Research in Non-Pharmaceutical Interventions for Pandemic Flu, . Emerg Infect Dis. 2010 Apr;16(4):e2.
Aiello AE. Coulborn RM, Aragon TJ, Baker MG, Burrus BB, Cowling BJ, Duncan A, Enanoria W, Fabian MP, Ferng Y, Larson EL, Leung GM, Markel H, Milton D, Monto AS, Morse SS, Navarro JA, Park SY, Priest P, Stebbins S, . Stern AM, Uddin M, Wetterhall SF, Vukotich, CJ Jr, Research findings from nonpharmaceutical intervention studies for pandemic influenza and current gaps in the research, Am J Infect Control. 2010 May;38(4):251-8. Epub 2010 Mar 12.
Stebbins S, Cummings DAT, Stark JH, Vukotich CJ Jr., Mitruka K, Thompson WW, Rinaldo C, Roth L, Wagner M, Wisniewski SR, Dato V, Eng H, Burke DS, "Reduction in the incidence of influenza A but not influenza B associated with use of hand sanitizer and cough hygiene in schools: a randomized controlled trial", DOI: 10.1097/INF.0b013e3182218656 Pedi Infect Dis Jn 2011, June 17
Stebbins S, Downs JS, and Vukotich CJ Jr. The Effect of Grade on Compliance using Non-Pharmaceutical Interventions to Reduce Influenza in an Urban Elementary School Setting, JPHMP. 2011 Jan-Feb; 12(1):64-70.
Lee BY, Brown ST, Cooley P, Potter MA, Wheaton WD, Voorhees RE, Stebbins S, Grefenstette JJ, Zimmer SM, Zimmerman RK, Assi TM, Bailey RR, Wagener DK, Burke DS, Simulating School Closure Strategies to Mitigate an Influenza Epidemic. J Public Health Manag Practice. 2009 Dec 23. [Epub ahead of print]
Preliminary and final results have been presented in multiple venues, including:
- February 2010, NACCHO 2010 National preparedness Summit, Atlanta, GA
- December 2009, EPIDEMICS2 Conference, Athens, Greece.
- October 2009, Pennsylvania Department of Health, Statewide
- Epidemiology Conference, Harrisburg, PA.
- Fall 2009, Letter report to the Pittsburgh Public Schools, Pittsburgh, PA
- March 2009, CDC, Atlanta, GA
- March 2009, University of Pittsburgh, Pittsburgh, PA
- February 2009, NACCHO National Preparedness Summit, San Diego, CA
- Fall 2008, Presentation to Pittsburgh School Nurses, Pittsburgh, PA
- June 2008, Report to Pittsburgh Public School Principals, Pittsburgh, PA
- March 2008, CDC, Atlanta, GA
- March 2008, University of Pittsburgh, Pittsburgh, PA
Funded through the Center for Public Health Practice by the Centers for Disease Control and Prevention cooperative agreement number U90/CCU324238-04