Absences, symptoms and respiratory viruses in a Swiss school:
Longitudinal study with serial saliva sampling
Abstract
Background: Viral respiratory infections contribute to sick
days in school children. We monitored respiratory infections, absences,
and symptoms in a Swiss school. Methods: Serial saliva sampling
(three per week) and daily recording of absences and symptoms over six
weeks during the winter of 2023/24 in four Swiss school classes (age
14–15). Results: We analyzed 1,047 samples of 67/84 (80%)
participants, identifying 87 infections across eight viruses: 28 (32%)
human rhinovirus, 18 (21%) influenza A/B, 11 (13%) respiratory
syncytial virus, and 14 (16%) human coronaviruses, 6 (7%)
parainfluenza virus, and 5 (6%) influenza B: SARS-CoV-2 was not
detected. Spatiotemporal trends revealed seasonal epidemic trends and
evidence of transmission within classes. Viral loads (interquartile
range 29.5–36.9 Ct) and duration of detection (modeled range 3.2–5.3
days) were similar for all viruses. School absences were more likely for
Influenza B than for other viruses (>99% vs. 38%,
p=0.005), and absences tended to be longer (average 4.2 vs. 2.2
days). Symptoms varied depending on the pathogen detected, with human
rhinovirus and parainfluenza virus infections commonly presenting with
runny nose and sore throat, while influenza infections were often
associated with fever. Conclusions: Class-specific distribution
patterns suggest a major contribution of within-class to overall
respiratory virus transmission. Respiratory viruses showed distinct
profiles regarding school absences and symptoms. This highlights the
importance of infection control measures, including vaccination, and
virus-specific monitoring to better understand transmission dynamics in
schools.