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Article: Logistical feasibility and potential benefits of a population-wide passive-immunotherapy program during an influenza pandemic
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TitleLogistical feasibility and potential benefits of a population-wide passive-immunotherapy program during an influenza pandemic
 
AuthorsWu, JT3
Lee, CK2
Cowling, BJ3
Yuen, KY1
 
KeywordsConvalescent
IVIG
Plasma
Plasmapheresis
 
Issue Date2010
 
PublisherNational Academy of Sciences. The Journal's web site is located at http://www.pnas.org
 
CitationProceedings Of The National Academy Of Sciences Of The United States Of America, 2010, v. 107 n. 7, p. 3269-3274 [How to Cite?]
DOI: http://dx.doi.org/10.1073/pnas.0911596107
 
AbstractTreatment strategies for severe cases of pandemic influenza have focused on antiviral therapies. In contrast, passive immunotherapy with convalescent blood products has received limited attention. We consider the hypothesis that a passive-immunotherapy program that collects plasma from a small percentage of recovered adults can harvest sufficient convalescent plasma to treat a substantial percentage of severe cases during a pandemic. We use a mathematical model to estimate the demand and supply of passive immunotherapy during an influenza pandemic in Hong Kong. If>5%of 20- to 55-year-old individuals recovered from symptomatic infection donate their plasma (donor percentage > 5%), >67% of severe cases can be offered convalescent plasma transfusion (treatment coverage>67%) in a moderately severe epidemic (R0 < 1.4 with 0.5% of symptomatic cases becoming severe). A donor percentage of 5% is comparable to the average blood donation rate of 38.1 donations per 1,000 people in developed countries. Increasing the donor percentage above 15% does not significantly boost the convalescent plasma supply because supply is constrained by plasmapheresis capacity during most stages of the epidemic. The demand-supply balance depends on the natural history and transmission dynamics of the disease via the epidemic growth rate only. Compared to other major cities, Hong Kong has a low plasmapheresis capacity. Therefore, the proposed passive-immunotherapy program is a logistically feasible mitigation option for many developed countries. As such, passive immunotherapy deserves more consideration by clinical researchers regarding its safety and efficacy as a treatment for severe cases of pandemic influenza.
 
ISSN0027-8424
2013 Impact Factor: 9.809
 
DOIhttp://dx.doi.org/10.1073/pnas.0911596107
 
PubMed Central IDPMC2840340
 
ISI Accession Number IDWOS:000274599500100
Funding AgencyGrant Number
Research Fund for the Control of Infectious Diseases of the Health
Welfare and Food Bureau of the Hong Kong Special Administrative Region Government
US National Institutes of Health Models of Infectious Disease Agent Study program1 U54 GM088558
Area of Excellence Scheme of the Hong Kong University Grants CommitteeAoE/M-12/06
Funding Information:

We thank Professors Gabriel Leung, J.S.M. Peiris, Marc Lipsitch, and John Clements for helpful discussions. This study was funded in part by the Research Fund for the Control of Infectious Diseases of the Health, Welfare and Food Bureau of the Hong Kong Special Administrative Region Government; the Harvard Center for Communicable Disease Dynamics from the US National Institutes of Health Models of Infectious Disease Agent Study program (Grant 1 U54 GM088558), and the Area of Excellence Scheme of the Hong Kong University Grants Committee (Grant AoE/M-12/06).

 
ReferencesReferences in Scopus
 
GrantsControl of Pandemic and Inter-pandemic Influenza
 
DC FieldValue
dc.contributor.authorWu, JT
 
dc.contributor.authorLee, CK
 
dc.contributor.authorCowling, BJ
 
dc.contributor.authorYuen, KY
 
dc.date.accessioned2010-12-23T08:37:38Z
 
dc.date.available2010-12-23T08:37:38Z
 
dc.date.issued2010
 
dc.description.abstractTreatment strategies for severe cases of pandemic influenza have focused on antiviral therapies. In contrast, passive immunotherapy with convalescent blood products has received limited attention. We consider the hypothesis that a passive-immunotherapy program that collects plasma from a small percentage of recovered adults can harvest sufficient convalescent plasma to treat a substantial percentage of severe cases during a pandemic. We use a mathematical model to estimate the demand and supply of passive immunotherapy during an influenza pandemic in Hong Kong. If>5%of 20- to 55-year-old individuals recovered from symptomatic infection donate their plasma (donor percentage > 5%), >67% of severe cases can be offered convalescent plasma transfusion (treatment coverage>67%) in a moderately severe epidemic (R0 < 1.4 with 0.5% of symptomatic cases becoming severe). A donor percentage of 5% is comparable to the average blood donation rate of 38.1 donations per 1,000 people in developed countries. Increasing the donor percentage above 15% does not significantly boost the convalescent plasma supply because supply is constrained by plasmapheresis capacity during most stages of the epidemic. The demand-supply balance depends on the natural history and transmission dynamics of the disease via the epidemic growth rate only. Compared to other major cities, Hong Kong has a low plasmapheresis capacity. Therefore, the proposed passive-immunotherapy program is a logistically feasible mitigation option for many developed countries. As such, passive immunotherapy deserves more consideration by clinical researchers regarding its safety and efficacy as a treatment for severe cases of pandemic influenza.
 
dc.description.naturelink_to_OA_fulltext
 
dc.identifier.citationProceedings Of The National Academy Of Sciences Of The United States Of America, 2010, v. 107 n. 7, p. 3269-3274 [How to Cite?]
DOI: http://dx.doi.org/10.1073/pnas.0911596107
 
dc.identifier.doihttp://dx.doi.org/10.1073/pnas.0911596107
 
dc.identifier.eissn1091-6490
 
dc.identifier.epage3274
 
dc.identifier.hkuros178068
 
dc.identifier.isiWOS:000274599500100
Funding AgencyGrant Number
Research Fund for the Control of Infectious Diseases of the Health
Welfare and Food Bureau of the Hong Kong Special Administrative Region Government
US National Institutes of Health Models of Infectious Disease Agent Study program1 U54 GM088558
Area of Excellence Scheme of the Hong Kong University Grants CommitteeAoE/M-12/06
Funding Information:

We thank Professors Gabriel Leung, J.S.M. Peiris, Marc Lipsitch, and John Clements for helpful discussions. This study was funded in part by the Research Fund for the Control of Infectious Diseases of the Health, Welfare and Food Bureau of the Hong Kong Special Administrative Region Government; the Harvard Center for Communicable Disease Dynamics from the US National Institutes of Health Models of Infectious Disease Agent Study program (Grant 1 U54 GM088558), and the Area of Excellence Scheme of the Hong Kong University Grants Committee (Grant AoE/M-12/06).

 
dc.identifier.issn0027-8424
2013 Impact Factor: 9.809
 
dc.identifier.issue7
 
dc.identifier.openurl
 
dc.identifier.pmcidPMC2840340
 
dc.identifier.pmid20133660
 
dc.identifier.scopuseid_2-s2.0-77649239972
 
dc.identifier.spage3269
 
dc.identifier.urihttp://hdl.handle.net/10722/129461
 
dc.identifier.volume107
 
dc.languageeng
 
dc.publisherNational Academy of Sciences. The Journal's web site is located at http://www.pnas.org
 
dc.publisher.placeUnited States
 
dc.relation.ispartofProceedings of the National Academy of Sciences of the United States of America
 
dc.relation.projectControl of Pandemic and Inter-pandemic Influenza
 
dc.relation.referencesReferences in Scopus
 
dc.rightsProceedings of the National Academy of Sciences. Copyright © National Academy of Sciences.
 
dc.subject.meshConvalescent
 
dc.subject.meshPlasma
 
dc.subject.meshIVIG
 
dc.subject.meshPlasmapheresis
 
dc.subjectConvalescent
 
dc.subjectIVIG
 
dc.subjectPlasma
 
dc.subjectPlasmapheresis
 
dc.titleLogistical feasibility and potential benefits of a population-wide passive-immunotherapy program during an influenza pandemic
 
dc.typeArticle
 
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Author Affiliations
  1. The University of Hong Kong Li Ka Shing Faculty of Medicine
  2. Hong Kong Hospital Authority
  3. The University of Hong Kong