PONE-D-21-11837Cause-specific student absenteeism monitoring in K-12 schools for detection of increased influenza activity in the surrounding community - Dane County, Wisconsin, 2014-2020PLOS ONE

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PLOS ONE

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Reviewers' comments:

Reviewer's Responses to Questions

Comments to the Author

1. Is the manuscript technically sound, and do the data support the conclusions?

The manuscript must describe a technically sound piece of scientific research with data that supports the conclusions. Experiments must have been conducted rigorously, with appropriate controls, replication, and sample sizes. The conclusions must be drawn appropriately based on the data presented.

Reviewer #1: No

Reviewer #2: Yes

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2. Has the statistical analysis been performed appropriately and rigorously?

Reviewer #1: No

Reviewer #2: I Don't Know

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3. Have the authors made all data underlying the findings in their manuscript fully available?

The PLOS Data policy requires authors to make all data underlying the findings described in their manuscript fully available without restriction, with rare exception (please refer to the Data Availability Statement in the manuscript PDF file). The data should be provided as part of the manuscript or its supporting information, or deposited to a public repository. For example, in addition to summary statistics, the data points behind means, medians and variance measures should be available. If there are restrictions on publicly sharing data—e.g. participant privacy or use of data from a third party—those must be specified.

Reviewer #1: No

Reviewer #2: Yes

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4. Is the manuscript presented in an intelligible fashion and written in standard English?

PLOS ONE does not copyedit accepted manuscripts, so the language in submitted articles must be clear, correct, and unambiguous. Any typographical or grammatical errors should be corrected at revision, so please note any specific errors here.

Reviewer #1: Yes

Reviewer #2: Yes

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5. Review Comments to the Author

Please use the space provided to explain your answers to the questions above. You may also include additional comments for the author, including concerns about dual publication, research ethics, or publication ethics. (Please upload your review as an attachment if it exceeds 20,000 characters)

Reviewer #1: It is a pleasure to read this excellent manuscript, and I will be happy if my comments are helpful to improve the manuscript. Please find my specific comments below.

1. My main concern is regarding the methods of the paper. It says this is a prospective study. I am not sure how is it a prospective study. Would you please clarify it in the methods section?

2. Assuming it is a prospective study, is the same individual were repeatedly participating in the survey?

3. Assuming it is a prospective study, please provide descriptive statistics of the baseline, final wave and pooled in all waves.

4. Would you please report the regression results in tabular form?

5. Would you please run Zero-inflated negative binomial regression and compare with the existing regression results?

6. Would you please provide a figure for the flow of the sample and missing data analyses?

I hope my comments will be helpful.

Reviewer #2: This work deals with the assessment of the relation between students' absenteeism and influenza activity (epidemics) in the surrounding communities. The data rely on a 6 -year observation of student attendance in the Oregon school district employing Infinite Campus system. The main conclusion is that there is a correlation between absenteeism due to illness (a-I) and particularly influenza-like illness (a-ILI) and influenza spikes. This observation can be used to mitigate influenza outbreaks. The work is sound and well written and potentially publishable. However, I find the a-ILI lead time rather short to be useful, while the a-I correlation seems relatively weak. Of course it is an improvement over a-TOT, but I somehow miss a strong practical message of immediate applicability, which makes me wonder if a more specialized epidemics journal would not be a better place for this work. Perhaps the authors can strengthen this point,

-  In the abstract the authors suggest that monitoring a-ILI and a-I can provide early warning, but isn't a 1 day lead time too short for early warning? I suggest making this point clear.

- For the general audience of PLOS One, it will be useful if the authors briefly mention what kind of mitigation measures could be undertaken after a-I and a-ILI warning signals.

- What is the reason for decreasing a-ILI and increasing a-TOT with grades? Are they related to medical/social issues?

-  Perhaps I missed it, but were (some) students also ARI patients?

- Figs 4 and 5 shows that the a-ILI and MAI spikes nearly coincide, which agrees with the 1-day lead time, questioning whether this can be used as an early warning signal to mitigate influenza. I suggest to discuss this issue when discussing these figures and also in the Conclusions.

- Why did the authors expect that  dividing the data into K4 and K5-12 would have improved correlations?

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Reviewer #1: No

Reviewer #2: No

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PONE-D-21-11837R1Cause-specific student absenteeism monitoring in K-12 schools for detection of increased influenza activity in the surrounding community - Dane County, Wisconsin, 2014-2020PLOS ONE

Dear Dr. Bell,

Thank you for submitting your manuscript to PLOS ONE. After careful consideration, we feel that it has merit but does not fully meet PLOS ONE’s publication criteria as it currently stands. Therefore, we invite you to submit a revised version of the manuscript that addresses the points raised during the review process.

Please submit your revised manuscript by Apr 30 2022 11:59PM. If you will need more time than this to complete your revisions, please reply to this message or contact the journal office at plosone@plos.org. When you're ready to submit your revision, log on to https://www.editorialmanager.com/pone/ and select the 'Submissions Needing Revision' folder to locate your manuscript file.

Please include the following items when submitting your revised manuscript:

• A rebuttal letter that responds to each point raised by the academic editor and reviewer(s). You should upload this letter as a separate file labeled 'Response to Reviewers'.
• A marked-up copy of your manuscript that highlights changes made to the original version. You should upload this as a separate file labeled 'Revised Manuscript with Track Changes'.
• An unmarked version of your revised paper without tracked changes. You should upload this as a separate file labeled 'Manuscript'.

If you would like to make changes to your financial disclosure, please include your updated statement in your cover letter. Guidelines for resubmitting your figure files are available below the reviewer comments at the end of this letter.

If applicable, we recommend that you deposit your laboratory protocols in protocols.io to enhance the reproducibility of your results. Protocols.io assigns your protocol its own identifier (DOI) so that it can be cited independently in the future. For instructions see: https://journals.plos.org/plosone/s/submission-guidelines#loc-laboratory-protocols. Additionally, PLOS ONE offers an option for publishing peer-reviewed Lab Protocol articles, which describe protocols hosted on protocols.io. Read more information on sharing protocols at https://plos.org/protocols?utm_medium=editorial-email&utm_source=authorletters&utm_campaign=protocols.

We look forward to receiving your revised manuscript.

Kind regards,

Ka Chun Chong

Academic Editor

PLOS ONE

Journal Requirements:

Please review your reference list to ensure that it is complete and correct. If you have cited papers that have been retracted, please include the rationale for doing so in the manuscript text, or remove these references and replace them with relevant current references. Any changes to the reference list should be mentioned in the rebuttal letter that accompanies your revised manuscript. If you need to cite a retracted article, indicate the article’s retracted status in the References list and also include a citation and full reference for the retraction notice.

Additional Editor Comments:

Please address well for the remaining comments.

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Reviewers' comments:

Reviewer's Responses to Questions

Comments to the Author

1. If the authors have adequately addressed your comments raised in a previous round of review and you feel that this manuscript is now acceptable for publication, you may indicate that here to bypass the “Comments to the Author” section, enter your conflict of interest statement in the “Confidential to Editor” section, and submit your "Accept" recommendation.

Reviewer #2: All comments have been addressed

Reviewer #3: (No Response)

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2. Is the manuscript technically sound, and do the data support the conclusions?

The manuscript must describe a technically sound piece of scientific research with data that supports the conclusions. Experiments must have been conducted rigorously, with appropriate controls, replication, and sample sizes. The conclusions must be drawn appropriately based on the data presented.

Reviewer #2: Yes

Reviewer #3: Yes

**********

3. Has the statistical analysis been performed appropriately and rigorously?

Reviewer #2: I Don't Know

Reviewer #3: Yes

**********

4. Have the authors made all data underlying the findings in their manuscript fully available?

The PLOS Data policy requires authors to make all data underlying the findings described in their manuscript fully available without restriction, with rare exception (please refer to the Data Availability Statement in the manuscript PDF file). The data should be provided as part of the manuscript or its supporting information, or deposited to a public repository. For example, in addition to summary statistics, the data points behind means, medians and variance measures should be available. If there are restrictions on publicly sharing data—e.g. participant privacy or use of data from a third party—those must be specified.

Reviewer #2: Yes

Reviewer #3: Yes

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5. Is the manuscript presented in an intelligible fashion and written in standard English?

PLOS ONE does not copyedit accepted manuscripts, so the language in submitted articles must be clear, correct, and unambiguous. Any typographical or grammatical errors should be corrected at revision, so please note any specific errors here.

Reviewer #2: Yes

Reviewer #3: Yes

**********

6. Review Comments to the Author

Please use the space provided to explain your answers to the questions above. You may also include additional comments for the author, including concerns about dual publication, research ethics, or publication ethics. (Please upload your review as an attachment if it exceeds 20,000 characters)

Reviewer #2: The authors have adequately responded to my concerns and, therefore, I can recommend the publication of this work.

Reviewer #3: Based on a high-quality database, this study examined the feasibility of using school absenteeism as an early alert signal to influenza in local communities. The data collection, preprocessing, and analysis are rigorous and clearly noted. The results showed the detailed cross-correlations between a-TOT, a-ILI, a-I absenteeism, and influenza cases in communities in consecutive influenza seasons from 2014 - 2020. The authors also discussed limitations and feasible mitigation measures according to the study results.

My suggestions for this study focus on the school absenteeism data.

1. It's reasonable that school-aged students are more vulnerable to influenza. Still, there is a limitation that the schools' Summer and Winter vacations last for months, which may lead to the missing data in these two specific periods and undermine the accessibility of alert.

2. Maybe it's better to list out the thresholds of a-I, a-ILI absenteeism numbers that represent the start of the influenza endemic in each year? It's just complementary. In real-world applications, it can help more compared to the correlation values.

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7. PLOS authors have the option to publish the peer review history of their article (what does this mean?). If published, this will include your full peer review and any attached files.

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Do you want your identity to be public for this peer review? For information about this choice, including consent withdrawal, please see our Privacy Policy.

Reviewer #2: No

Reviewer #3: No

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Cause-specific student absenteeism monitoring in K-12 schools for detection of increased influenza activity in the surrounding community - Dane County, Wisconsin, 2014-2020

PONE-D-21-11837R2

Dear Dr. Bell,

We’re pleased to inform you that your manuscript has been judged scientifically suitable for publication and will be formally accepted for publication once it meets all outstanding technical requirements.

Within one week, you’ll receive an e-mail detailing the required amendments. When these have been addressed, you’ll receive a formal acceptance letter and your manuscript will be scheduled for publication.

An invoice for payment will follow shortly after the formal acceptance. To ensure an efficient process, please log into Editorial Manager at http://www.editorialmanager.com/pone/, click the 'Update My Information' link at the top of the page, and double check that your user information is up-to-date. If you have any billing related questions, please contact our Author Billing department directly at authorbilling@plos.org.

If your institution or institutions have a press office, please notify them about your upcoming paper to help maximize its impact. If they’ll be preparing press materials, please inform our press team as soon as possible -- no later than 48 hours after receiving the formal acceptance. Your manuscript will remain under strict press embargo until 2 pm Eastern Time on the date of publication. For more information, please contact onepress@plos.org.

Kind regards,

Ka Chun Chong

Academic Editor

PLOS ONE

Additional Editor Comments (optional):

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