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postgraduate thesis: The role of antivirals and vaccines in the control of influenza epidemics and pandemics

TitleThe role of antivirals and vaccines in the control of influenza epidemics and pandemics
Authors
Advisors
Issue Date2012
PublisherThe University of Hong Kong (Pokfulam, Hong Kong)
Citation
Ng, S. [吳鈺陪]. (2012). The role of antivirals and vaccines in the control of influenza epidemics and pandemics. (Thesis). University of Hong Kong, Pokfulam, Hong Kong SAR. Retrieved from http://dx.doi.org/10.5353/th_b4961784
AbstractInfluenza vaccination is the best preventive measure against influenza virus infection, and antivirals including oseltamivir are effective treatments. From a public health point of view, it is important to evaluate whether vaccination and antiviral treatment reduces transmission of the virus. I analyzed data from a community-based study of influenza virus transmission in households, and identified effectiveness of antiviral treatment in reducing duration of illness and some evidence that treatment reduced transmission to household contacts. I also analyzed data from a community-based placebo-controlled trial of influenza vaccination and confirmed efficacy of vaccination against seasonal influenza but differential efficacy against pandemic influenza possibly because of timing and mediation of seasonal influenza epidemics. In further analyses I found that antibody titers of 1:40 correlated with 50% protection against infection, and repeated vaccination with the same strains tended to be associated with reduced responses to those strains although there was no evidence of reduced efficacy. In the study, one child in each household was randomly allocated to receive vaccine or placebo and I did not identify any evidence of indirect benefits to the household members of vaccinated children. I reviewed vaccine target groups in different countries, and noted that some countries now include school-age children in their target groups based mainly on the principle of herd immunity. My findings did not support the inclusion of school-age children as a target group for vaccination in Hong Kong. Further studies should examine the indirect as well as direct benefits of vaccination in different settings in order to guide optimal influenza vaccination policies.
DegreeDoctor of Philosophy
SubjectAntiviral agents.
Influenza vaccines.
Influenza - Prevention.
Dept/ProgramCommunity Medicine
Persistent Identifierhttp://hdl.handle.net/10722/180964

 

DC FieldValueLanguage
dc.contributor.advisorCowling, BJ-
dc.contributor.advisorNishiura, H-
dc.contributor.advisorLam, TH-
dc.contributor.authorNg, Sophia.-
dc.contributor.author吳鈺陪.-
dc.date.accessioned2013-02-07T06:21:37Z-
dc.date.available2013-02-07T06:21:37Z-
dc.date.issued2012-
dc.identifier.citationNg, S. [吳鈺陪]. (2012). The role of antivirals and vaccines in the control of influenza epidemics and pandemics. (Thesis). University of Hong Kong, Pokfulam, Hong Kong SAR. Retrieved from http://dx.doi.org/10.5353/th_b4961784-
dc.identifier.urihttp://hdl.handle.net/10722/180964-
dc.description.abstractInfluenza vaccination is the best preventive measure against influenza virus infection, and antivirals including oseltamivir are effective treatments. From a public health point of view, it is important to evaluate whether vaccination and antiviral treatment reduces transmission of the virus. I analyzed data from a community-based study of influenza virus transmission in households, and identified effectiveness of antiviral treatment in reducing duration of illness and some evidence that treatment reduced transmission to household contacts. I also analyzed data from a community-based placebo-controlled trial of influenza vaccination and confirmed efficacy of vaccination against seasonal influenza but differential efficacy against pandemic influenza possibly because of timing and mediation of seasonal influenza epidemics. In further analyses I found that antibody titers of 1:40 correlated with 50% protection against infection, and repeated vaccination with the same strains tended to be associated with reduced responses to those strains although there was no evidence of reduced efficacy. In the study, one child in each household was randomly allocated to receive vaccine or placebo and I did not identify any evidence of indirect benefits to the household members of vaccinated children. I reviewed vaccine target groups in different countries, and noted that some countries now include school-age children in their target groups based mainly on the principle of herd immunity. My findings did not support the inclusion of school-age children as a target group for vaccination in Hong Kong. Further studies should examine the indirect as well as direct benefits of vaccination in different settings in order to guide optimal influenza vaccination policies.-
dc.languageeng-
dc.publisherThe University of Hong Kong (Pokfulam, Hong Kong)-
dc.relation.ispartofHKU Theses Online (HKUTO)-
dc.rightsThe author retains all proprietary rights, (such as patent rights) and the right to use in future works.-
dc.rightsCreative Commons: Attribution 3.0 Hong Kong License-
dc.source.urihttp://hub.hku.hk/bib/B49617849-
dc.subject.lcshAntiviral agents.-
dc.subject.lcshInfluenza vaccines.-
dc.subject.lcshInfluenza - Prevention.-
dc.titleThe role of antivirals and vaccines in the control of influenza epidemics and pandemics-
dc.typePG_Thesis-
dc.identifier.hkulb4961784-
dc.description.thesisnameDoctor of Philosophy-
dc.description.thesislevelDoctoral-
dc.description.thesisdisciplineCommunity Medicine-
dc.description.naturepublished_or_final_version-
dc.identifier.doi10.5353/th_b4961784-
dc.date.hkucongregation2013-

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