Influenza virus is a leading cause of acute respiratory infection worldwide and an important respiratory pathogen in young children, with the greatest morbidity and hospitalization rates in young infants. The emergence of novel swine-origin influenza A H1N1 in April of 2009 was followed by the declaration of the first pandemic since 1968 by the World Health Organization. The majority of cases including severe cases, are reported in individuals younger than 65 years of age (age range 5-24 years), more severe disease occurs in the 5-55 year old age group compared to those resulting from seasonal influenza and almost half of cases occur in children below 18 years old. Patients receiving antiviral medications continue shedding the virus, thus transmitting the infection. Randomized clinical trials in infants and children starting at 6 months of age provided evidence that the pandemic influenza A (H1N1) 2009 vaccine was immunogenic and the vaccine related adverse events were mild to moderate, similar to those of seasonal vaccine and with no noticeable differences between vaccine and placebo groups. Among all settings the schools and other venues of students’ social activities account for the greater proportion of the expansion of the infection in the community. A review of the school outbreaks, the hygiene measures implemented and their effectiveness is attempted. In urban settings i.e. in Mexico, in New York, in Australia, in the United Kingdom, in Japan, school outbreaks of influenza A (H1N1) 2009 virus occurred relatively early, before wider transmission in the community with broader age distribution had ensued. The public health interventions were scheduled according to the epidemiological characteristics of the pandemic. As of yet there are no reviews reporting the vaccination coverage and the protection this conferred in school age children worldwide. Consequently, the sustained use of hygiene measures, the latter being characterized by their transient protective nature, within school premises, before and after school closure, have had a critical role in the delay of the spread of the pandemic among the school age children. Hygiene measures and relevant training were modified according to the type of school; nursery/day care, elementary, junior, senior high school. Training was offered via communication and subsided by mass media campaigns to parents, guardians, students, children and staff. School closure has been decided in all aforementioned outbreaks but in Hawaii and in local rather than national level with the exception of Mexico where there was nationwide school closure for two weeks. The selective school closure of particular schools was decided after careful estimation of the transmission rate in the premises and consultation with local public health authorities. The delineation of authority among all relevant stakeholders and the transparent communication between Public Health officials and population under circumstances of severe disease, set school closure is an easier decision. Proactive school closure in national or local level were applied in Mexico and Japan respectively and kept as alternate in the majority of countries. All the above mentioned outbreaks triggered initiation of enhanced active surveillance of ILI, uncomplicated and complicated respiratory illness in students and staff members, as well as among household contacts when circumstances allowed this. School operation was considered to have optimal impact on the pandemic evolution as it educated children and families about pandemic and hygiene measures, supported the economy and the social infrastructures, and facilitated influenza A (H1N1) 2009 surveillance, outbreak detection and recognition of the circulation of the virus in the community. Children need factual age appropriate information and reasonable mass media attendance about the potential seriousness of disease and concrete instruction about prevention of the infection. Further epidemiological studies are needed to determine the degree to which Influenza A (H1N1)v infection spreads in the community during and after school outbreaks, and analyze the impact of school dismissal on peak mortality and overall mortality rates. The latter has been speculated to be slightly reduced or not affected at al in existing simulation studies.