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Article: Logistical feasibility and potential benefits of a population-wide passive-immunotherapy program during an influenza pandemic

TitleLogistical feasibility and potential benefits of a population-wide passive-immunotherapy program during an influenza pandemic
Authors
KeywordsConvalescent
IVIG
Plasma
Plasmapheresis
Issue Date2010
PublisherNational 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?
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.
Persistent Identifierhttp://hdl.handle.net/10722/129461
ISSN
2015 Impact Factor: 9.423
2015 SCImago Journal Rankings: 6.883
PubMed Central ID
ISI Accession Number ID
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).

References
Grants

 

DC FieldValueLanguage
dc.contributor.authorWu, JTen_HK
dc.contributor.authorLee, CKen_HK
dc.contributor.authorCowling, BJen_HK
dc.contributor.authorYuen, KYen_HK
dc.date.accessioned2010-12-23T08:37:38Z-
dc.date.available2010-12-23T08:37:38Z-
dc.date.issued2010en_HK
dc.identifier.citationProceedings Of The National Academy Of Sciences Of The United States Of America, 2010, v. 107 n. 7, p. 3269-3274en_HK
dc.identifier.issn0027-8424en_HK
dc.identifier.urihttp://hdl.handle.net/10722/129461-
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.en_HK
dc.languageengen_US
dc.publisherNational Academy of Sciences. The Journal's web site is located at http://www.pnas.orgen_HK
dc.relation.ispartofProceedings of the National Academy of Sciences of the United States of Americaen_HK
dc.rightsProceedings of the National Academy of Sciences. Copyright © National Academy of Sciences.-
dc.subjectConvalescenten_HK
dc.subjectIVIGen_HK
dc.subjectPlasmaen_HK
dc.subjectPlasmapheresisen_HK
dc.subject.meshConvalescent-
dc.subject.meshPlasma-
dc.subject.meshIVIG-
dc.subject.meshPlasmapheresis-
dc.titleLogistical feasibility and potential benefits of a population-wide passive-immunotherapy program during an influenza pandemicen_HK
dc.typeArticleen_HK
dc.identifier.openurlhttp://library.hku.hk:4550/resserv?sid=HKU:IR&issn=0027-8424&volume=107&issue=7&spage=3269&epage=3274&date=2010&atitle=Logistical+feasibility+and+potential+benefits+of+a+population-wide+passive-immunotherapy+program+during+an+influenza+pandemic-
dc.identifier.emailWu, JT:joewu@hkucc.hku.hken_HK
dc.identifier.emailCowling, BJ:bcowling@hku.hken_HK
dc.identifier.emailYuen, KY:kyyuen@hkucc.hku.hken_HK
dc.identifier.authorityWu, JT=rp00517en_HK
dc.identifier.authorityCowling, BJ=rp01326en_HK
dc.identifier.authorityYuen, KY=rp00366en_HK
dc.description.naturelink_to_OA_fulltexten_US
dc.identifier.doi10.1073/pnas.0911596107en_HK
dc.identifier.pmid20133660-
dc.identifier.pmcidPMC2840340-
dc.identifier.scopuseid_2-s2.0-77649239972en_HK
dc.identifier.hkuros178068en_US
dc.relation.referenceshttp://www.scopus.com/mlt/select.url?eid=2-s2.0-77649239972&selection=ref&src=s&origin=recordpageen_HK
dc.identifier.volume107en_HK
dc.identifier.issue7en_HK
dc.identifier.spage3269en_HK
dc.identifier.epage3274en_HK
dc.identifier.eissn1091-6490-
dc.identifier.isiWOS:000274599500100-
dc.publisher.placeUnited Statesen_HK
dc.relation.projectControl of Pandemic and Inter-pandemic Influenza-
dc.identifier.scopusauthoridWu, JT=7409256423en_HK
dc.identifier.scopusauthoridLee, CK=36087620900en_HK
dc.identifier.scopusauthoridCowling, BJ=8644765500en_HK
dc.identifier.scopusauthoridYuen, KY=36078079100en_HK

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