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Table 2 Countries with early child clusters of cases (or school outbreaks) during the influenza pandemic (H1N1-2009)

From: The feasibility of age-specific travel restrictions during influenza pandemics


Report month


Australia [51]

February 2010

The return of children to school in the North American autumn 2009 was associated with a substantial increase in the number of cases of pandemic H1N1 2009 influenza

Australia [52]

May 2009

55% of H1N1-2009 cases in Australia and 63% of cases in Victoria to date have been school aged children (5 - 17 years)

Argentina [53]

May 2009

First imported case seeded an elementary school outbreak in Buenos Aires, and, within days, several schools reported increasing numbers of cases

Cyprus [54]

June 2009

The disease spread quickly, initially among younger people who visited tourist resorts and entertainment clubs or school-aged children who stayed at camping places or summer schools

France [55]

July 2009

The first time in France, a confirmed outbreak without history of travel occurred in a secondary school in Toulouse district

Germany [56]

June 2009

About two thirds of indigenous cases were associated with two large school-associated outbreaks

Italy [42]

December 2009

First cluster of in-country transmission involved a 33-month-old and a 11-year-old child

Japan [57]

May 2009

Most of new cases were seen in high school students in western Japan

Macau [58]

July 2009

Three locally-infected cases were all local primary school students

Malaysia [59]

July 2009

The first case was a student returning from the US followed by multiple clusters in schools, which all involved cases returning from abroad with the infection.

Thailand [48]

October 2009

The number of reported cases was most prevalent in primary school students aged 6-12 years, followed by secondary school students aged 13-18 years

United Kingdom [49]

August 2009

First confirmed case, a pupil at a school in England, was imported. During the following two weeks, 16 further cases were confirmed with epidemiological links to the first imported case.

United States of America [60]

October 2009

In May 2009, one of the earliest outbreaks of 2009 pandemic influenza A virus (pH1N1) infection resulted in the closure of a semi-rural Pennsylvania elementary school