Health Publication Examines History of School Closures to Stop Spread of Flu

The following was released by Health Affairs, The Policy Journal of the Health Sphere on Sept. 29, 2009:

Bethesda, MD — With schools open and the flu season upon us, school administrators and health officials across the country will again be deciding the best ways to respond. Health Affairs, the leading health policy journal, today published an article that examines how the public school systems in 43 U.S. cities handled the issue of school closures during the 1918-19 influenza pandemic that killed thousands of Americans.


The researchers, from the University of Michigan and the Centers for Disease Control and Prevention, conducted a qualitative analysis of the cities and their public school systems, reviewing scientific, medical, and educational literature of the time as well as newspapers and municipal reports. They found that school closure orders were almost always issued in conjunction with communitywide measures such as quarantine, isolation, and public gathering bans.

The analysis unearthed widely differing practices across the country. While New York City kept schools open and relied on daily inspection of students, Los Angeles closed its schools for as long as 19 weeks and offered correspondence courses to many students. The amount of cooperation between government authorities and the school officials also varied.

This historical snapshot mirrors many of the issues facing school administrators today. “The recently issued CDC guidance for K-12 school dismissal provides a framework for communities to make decisions based on local factors and considerations, much like what we saw for cities in 1918,” says author Alexandra Minna Stern, associate director at the University of Michigan Center for the History of Medicine. “Then and now, there are parallels in the social, political, and organizational factors influencing the smooth implementation of school closure.”

The full article, Closing The Schools: Lessons From The 1918- 19 U.S. Influenza Pandemic by Alexandra M. Stern, Martin S. Cetron, and Howard Markel, can be found here.