Quantification of droplet and contact transmission risks among elementary school students based on network analyses...

In elementary schools, immunologically immature students come into close contact with each other and are susceptible to the spread of infectious diseases. To analyze pathogen transmission among students, it is essential to obtain behavioral data. Questionnaires and wearable sensor devices were used for communication behavior and swab sampling was employed for contact behavior. However, these methods have been insufficient in capturing information about the processes and actions of each student that contribute to pathogen transmission. Therefore, in this study, actual behavioral data were collected using video recordings to evaluate droplet and contact transmission in elementary schools. The analysis of communication behavior revealed the diverse nature of interactions among students. By calculating the droplet transmission probabilities based on conversation duration, the risk of droplet transmission was quantified. In the contact behavior, we introduced a novel approach for constructing contact networks based on contact history. According to this method, well-known items, such as students' desks, doors, and faucets, were predicted to be potential fomite. In addition, students' shirts and shared items with high contact frequency and high centrality metrics in the network, which were not evaluated in swab sampling surveys, were identified as potential fomites. The reliability of the predictions was demonstrated through micro-simulations. The micro-simulations replicated virus transmission scenarios in which virus-carrying students were present in the actual contact history. The results showed that a significant amount of virus adhered to the items predicted to be fomites. Interestingly, the micro-simulations indicated that most viral copies were transmitted through single items. The analysis of contact history, contact networks, and micro-simulations relies on video-recorded behavioral data, highlighting the importance of this method. This study contributes significantly to the prevention of infectious diseases in elementary schools by providing evidence-based information about transmission pathways and behavior-related risks.