Article: Logistical feasibility and potential benefits of a population-wide passive-immunotherapy program during an influenza pandemic
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- Publisher Website: 10.1073/pnas.0911596107
- Scopus: eid_2-s2.0-77649239972
- PMID: 20133660
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| Title | Logistical feasibility and potential benefits of a population-wide passive-immunotherapy program during an influenza pandemic | ||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|
| Authors | Wu, JT3 Lee, CK1 Cowling, BJ3 Yuen, KY2 | ||||||||||
| Keywords | Convalescent IVIG Plasma Plasmapheresis | ||||||||||
| Issue Date | 2010 | ||||||||||
| Publisher | National Academy of Sciences. The Journal's web site is located at http://www.pnas.org | ||||||||||
| Citation | Proceedings 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 | ||||||||||
| Abstract | Treatment 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. | ||||||||||
| ISSN | 0027-8424 2011 Impact Factor: 9.681 2011 SCImago Journal Rankings: 1.754 | ||||||||||
| DOI | http://dx.doi.org/10.1073/pnas.0911596107 | ||||||||||
| ISI Accession Number ID | WOS:000274599500100
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). | ||||||||||
| PubMed Central ID | PMC2840340 | ||||||||||
| References | References in Scopus | ||||||||||
| Grants | Control of Pandemic and Inter-pandemic Influenza |
| dc.contributor.author | Wu, JT | ||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|
| dc.contributor.author | Lee, CK | ||||||||||
| dc.contributor.author | Cowling, BJ | ||||||||||
| dc.contributor.author | Yuen, KY | ||||||||||
| dc.date.accessioned | 2010-12-23T08:37:38Z | ||||||||||
| dc.date.available | 2010-12-23T08:37:38Z | ||||||||||
| dc.date.issued | 2010 | ||||||||||
| dc.description.abstract | Treatment 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.grant | Control of Pandemic and Inter-pandemic Influenza | ||||||||||
| dc.description.grantcode | 97655 | ||||||||||
| dc.description.nature | link_to_OA_fulltext | ||||||||||
| dc.identifier.citation | Proceedings 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.doi | http://dx.doi.org/10.1073/pnas.0911596107 | ||||||||||
| dc.identifier.epage | 3274 | ||||||||||
| dc.identifier.hkuros | 178068 | ||||||||||
| dc.identifier.isi | WOS:000274599500100
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.issn | 0027-8424 2011 Impact Factor: 9.681 2011 SCImago Journal Rankings: 1.754 | ||||||||||
| dc.identifier.issue | 7 | ||||||||||
| dc.identifier.openurl | | ||||||||||
| dc.identifier.pmcid | PMC2840340 | ||||||||||
| dc.identifier.pmid | 20133660 | ||||||||||
| dc.identifier.scopus | eid_2-s2.0-77649239972 | ||||||||||
| dc.identifier.spage | 3269 | ||||||||||
| dc.identifier.uri | http://hdl.handle.net/10722/129461 | ||||||||||
| dc.identifier.volume | 107 | ||||||||||
| dc.language | eng | ||||||||||
| dc.publisher | National Academy of Sciences. The Journal's web site is located at http://www.pnas.org | ||||||||||
| dc.publisher.place | United States | ||||||||||
| dc.relation.ispartof | Proceedings of the National Academy of Sciences of the United States of America | ||||||||||
| dc.relation.references | References in Scopus | ||||||||||
| dc.rights | Proceedings of the National Academy of Sciences. Copyright © National Academy of Sciences. | ||||||||||
| dc.subject.mesh | Convalescent | ||||||||||
| dc.subject.mesh | Plasma | ||||||||||
| dc.subject.mesh | IVIG | ||||||||||
| dc.subject.mesh | Plasmapheresis | ||||||||||
| dc.subject | Convalescent | ||||||||||
| dc.subject | IVIG | ||||||||||
| dc.subject | Plasma | ||||||||||
| dc.subject | Plasmapheresis | ||||||||||
| dc.title | Logistical feasibility and potential benefits of a population-wide passive-immunotherapy program during an influenza pandemic | ||||||||||
| dc.type | Article |
Author Affiliations
- Hong Kong Hospital Authority
- The University of Hong Kong Li Ka Shing Faculty of Medicine
- The University of Hong Kong