Reactive strategies for containing developing outbreaks of pandemic influenza

BMC Public Health

Research

Azhar Nizam¹  David N Fisman²  Sigrún Andradóttir³  Wenchi Chiu³  Kwok-Leung Tsui³  David Goldsman³  Mi Lim Lee³  Beate Sander⁴ 

[1] Department of Biostatistics and Bioinformatics, Emory University, 30322, Atlanta, Georgia, USA;Department of Epidemiology, Dalla Lana School of Public Health, University of Toronto, M5T 3M7, Toronto, Ontario, Canada;H. Milton Stewart School of Industrial and Systems Engineering, Georgia Institute of Technology, 30332, Atlanta, Georgia, USA;Toronto Health Economics and Technology Assessment Collaborative, M5S 3M2, Toronto, Ontario, Canada;Department of Health Policy, Management and Evaluation, University of Toronto, M5T 3M6, Toronto, Ontario, Canada;Division of Clinical Decision-Making and Health Care Research, University Health Network, M5G 2C4, Toronto, Ontario, Canada;

关键词: Influenza;    Attack Rate;    Social Distance;    Pandemic Influenza;    Vaccination Coverage;   

DOI  :  10.1186/1471-2458-11-S1-S1

来源: Springer

【 摘 要 】

BackgroundIn 2009 and the early part of 2010, the northern hemisphere had to cope with the first waves of the new influenza A (H1N1) pandemic. Despite high-profile vaccination campaigns in many countries, delays in administration of vaccination programs were common, and high vaccination coverage levels were not achieved. This experience suggests the need to explore the epidemiological and economic effectiveness of additional, reactive strategies for combating pandemic influenza.MethodsWe use a stochastic model of pandemic influenza to investigate realistic strategies that can be used in reaction to developing outbreaks. The model is calibrated to documented illness attack rates and basic reproductive number (R0) estimates, and constructed to represent a typical mid-sized North American city.ResultsOur model predicts an average illness attack rate of 34.1% in the absence of intervention, with total costs associated with morbidity and mortality of US$81 million for such a city. Attack rates and economic costs can be reduced to 5.4% and US$37 million, respectively, when low-coverage reactive vaccination and limited antiviral use are combined with practical, minimally disruptive social distancing strategies, including short-term, as-needed closure of individual schools, even when vaccine supply-chain-related delays occur. Results improve with increasing vaccination coverage and higher vaccine efficacy.ConclusionsSuch combination strategies can be substantially more effective than vaccination alone from epidemiological and economic standpoints, and warrant strong consideration by public health authorities when reacting to future outbreaks of pandemic influenza.

【 授权许可】

Unknown   
© Andradóttir et al; licensee BioMed Central Ltd. 2011. This article is published under license to BioMed Central Ltd. This is an open access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.