P-633. Burden of school absenteeism and medical visits in pre-kindergarden-12th grade students and staff with acute respiratory illnesses

TL;DR

This study shows that acute respiratory illnesses cause significant school and work absenteeism, with viral infections like flu and RSV being most linked to missed days.

Contribution

The study provides new insights into the relationship between specific respiratory viruses and absenteeism in a K-12 school setting.

Findings

25% of participants with ARI symptoms missed at least one day of school or work.

Those with a detected virus were more likely to miss school/work than those without a virus.

Flu A, SARS-CoV-2, and RSV were most strongly associated with absenteeism.

Abstract

Acute respiratory illnesses (ARI) are common and their contribution to school absenteeism is poorly understood. Using school-based respiratory virus surveillance data, we examined viral detections, missed school/work, and the association between absenteeism and viral detections in students and staff with ARI.Table.Survey-reported (n=1485) ARI-associated absenteeism and medical visits of School KIDS participants during the 2024-25 school yearFigure.Proportion of respondents with ARI and a positive viral detection who missed school/work during the 2024-25 school year

Survey-reported (n=1485) ARI-associated absenteeism and medical visits of School KIDS participants during the 2024-25 school year

Proportion of respondents with ARI and a positive viral detection who missed school/work during the 2024-25 school year

School KIDS is a prospective respiratory virus surveillance program in a Kansas City, MO preK–12th grade public school district. Enrolled students and staff provide monthly anterior nasal swabs at school and can demand testing when experiencing ARI symptoms. Participants complete surveys within 24 hours before (‘pre-test’) and 7 days after (‘post-test') specimen collection. Surveys capture ARI symptoms (cough, fever, nasal congestion, shortness of breath, runny nose, wheezing, sore throat); school and work absenteeism for students, staff, and caretakers; and medical care. Analysis included participants with ARI symptoms on the pre-test survey and a completed post-test survey. Specimens were tested by PCR for respiratory syncytial virus (RSV), influenza (Flu), seasonal coronaviruses (sCoV), parainfluenza virus, adenovirus, rhinovirus/enterovirus (RV/EV), human metapneumovirus, and SARS-CoV-2.

From September 2024-March 2025, 656 participants (preK/elementary=229, middle=83, high=75, staff=269) submitted 1,485 pre-test surveys noting ARI symptoms and completed corresponding post-test surveys. Overall, 25% (364/1485) reported missing ≥1 day of school or work, and 11% reported seeking medical care (Table). Fourteen percent of caregivers missed work to care for a student. Nearly 40% (589/1485) of specimens had ≥1 detected virus; the most common were RV/EV (n=335), sCoV (n=100), SARS-CoV-2 (n=58), Flu A (n=43), and RSV (n=41). Participants with symptoms and a virus were more likely to report absence (29%) compared to those with symptoms but no virus (22%; P < 0.001, Pearson’s chi-square). Absenteeism was most common in those with Flu A (24/43), SARS-CoV-2 (21/58), and RSV (13/41) (Figure).

School absenteeism was frequent due to ARI. Additional strategies are needed to keep students and staff healthy to minimize ARI associated absenteeism and help optimize educational outcomes.

Brian R. Lee, PhD, MPH, Merck: Grant/Research Support Rangaraj Selvarangan, PhD, Altona: Grant/Research Support|Biomerieux: Advisor/Consultant|Biomerieux: Grant/Research Support|Biomerieux: Honoraria|Cepheid: Grant/Research Support|Hologic: Grant/Research Support|Hologic: Honoraria|Meridian: Grant/Research Support|Qiagen: Grant/Research Support

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