The 1978 English boarding school influenza outbreak: where the classic SEIR model fails

J R Soc Interface. 2024 Nov;21(220):20240394. doi: 10.1098/rsif.2024.0394. Epub 2024 Nov 20.

Abstract

Previous work has failed to fit classic SEIR epidemic models satisfactorily to the prevalence data of the famous English boarding school 1978 influenza A/H1N1 outbreak during the children's pandemic. It is still an open question whether a biologically plausible model can fit the prevalence time series and the attack rate correctly. To construct the final model, we first used an intentionally very flexible and overfitted discrete-time epidemiologic model to learn the epidemiological features from the data. The final model was a susceptible (S) - exposed (E) - infectious (I) - confined-to-bed (B) - convalescent (C) - recovered (R) model with time delay (constant residence time) in E and I compartments and multi-stage (Erlang-distributed residence time) in B and C compartments. We simultaneously fitted the reported B and C prevalence curves as well as the attack rate (proportion of children infected during the outbreak). The non-exponential residence times were crucial for good fits. The estimates of the generation time and the basic reproductive number ([Formula: see text]) were biologically reasonable. A simplified discrete-time model was built and fitted using the Bayesian procedure. Our work not only provided an answer to the open question, but also demonstrated an approach to constructive model generation.

Keywords: Bayesian epidemic model; children’s pandemic; delay differential equations; influenza progression model; modelling; residence time.

Publication types

  • Historical Article

MeSH terms

  • Child
  • Disease Outbreaks*
  • England / epidemiology
  • Epidemiological Models
  • History, 20th Century
  • Humans
  • Influenza A Virus, H1N1 Subtype*
  • Influenza, Human* / epidemiology
  • Influenza, Human* / history
  • Schools*