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Article: Reducing the impact of the next influenza pandemic using household-based public health interventions
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TitleReducing the impact of the next influenza pandemic using household-based public health interventions
 
AuthorsWu, JT2 1
Riley, S2
Fraser, C3
Leung, GM2
 
Issue Date2006
 
PublisherPublic Library of Science. The Journal's web site is located at http://medicine.plosjournals.org/perlserv/?request=index-html&issn=1549-1676
 
CitationPlos Medicine, 2006, v. 3 n. 9, p. 1532-1540 [How to Cite?]
DOI: http://dx.doi.org/10.1371/journal.pmed.0030361
 
AbstractBackground: The outbreak of highly pathogenic H5N1 influenza in domestic poultry and wild birds has caused global concern over the possible evolution of a novel human strain [1]. If such a strain emerges, and is not controlled at source [2,3], a pandemic is likely to result. Health policy in most countries will then be focused on reducing morbidity and mortality. Methods and Findings: We estimate the expected reduction in primary attack rates for different household-based interventions using a mathematical model of influenza transmission within and between households. We show that, for lower transmissibility strains [2,4], the combination of household-based quarantine, isolation of cases outside the household, and targeted prophylactic use of anti-virals will be highly effective and likely feasible across a range of plausible transmission scenarios. For example, for a basic reproductive number (the average number of people infected by a typically infectious individual in an otherwise susceptible population) of 1.8, assuming only 50% compliance, this combination could reduce the infection (symptomatic) attack rate from 74% (49%) to 40% (27%), requiring peak quarantine and isolation levels of 6.2% and 0.8% of the population, respectively, and an overall anti-viral stockpile of 3.9 doses per member of the population. Although contact tracing may be additionally effective, the resources required make it impractical in most scenarios. Conclusions: National influenza pandemic preparedness plans currently focus on reducing the impact associated with a constant attack rate, rather than on reducing transmission. Our findings suggest that the additional benefits and resource requirements of household-based interventions in reducing average levels of transmission should also be considered, even when expected levels of compliance are only moderate. © 2006 Wu et al.
 
ISSN1549-1277
 
DOIhttp://dx.doi.org/10.1371/journal.pmed.0030361
 
PubMed Central IDPMC1526768
 
ISI Accession Number IDWOS:000241923800021
 
ReferencesReferences in Scopus
 
DC FieldValue
dc.contributor.authorWu, JT
 
dc.contributor.authorRiley, S
 
dc.contributor.authorFraser, C
 
dc.contributor.authorLeung, GM
 
dc.date.accessioned2010-09-06T09:23:39Z
 
dc.date.available2010-09-06T09:23:39Z
 
dc.date.issued2006
 
dc.description.abstractBackground: The outbreak of highly pathogenic H5N1 influenza in domestic poultry and wild birds has caused global concern over the possible evolution of a novel human strain [1]. If such a strain emerges, and is not controlled at source [2,3], a pandemic is likely to result. Health policy in most countries will then be focused on reducing morbidity and mortality. Methods and Findings: We estimate the expected reduction in primary attack rates for different household-based interventions using a mathematical model of influenza transmission within and between households. We show that, for lower transmissibility strains [2,4], the combination of household-based quarantine, isolation of cases outside the household, and targeted prophylactic use of anti-virals will be highly effective and likely feasible across a range of plausible transmission scenarios. For example, for a basic reproductive number (the average number of people infected by a typically infectious individual in an otherwise susceptible population) of 1.8, assuming only 50% compliance, this combination could reduce the infection (symptomatic) attack rate from 74% (49%) to 40% (27%), requiring peak quarantine and isolation levels of 6.2% and 0.8% of the population, respectively, and an overall anti-viral stockpile of 3.9 doses per member of the population. Although contact tracing may be additionally effective, the resources required make it impractical in most scenarios. Conclusions: National influenza pandemic preparedness plans currently focus on reducing the impact associated with a constant attack rate, rather than on reducing transmission. Our findings suggest that the additional benefits and resource requirements of household-based interventions in reducing average levels of transmission should also be considered, even when expected levels of compliance are only moderate. © 2006 Wu et al.
 
dc.description.naturepublished_or_final_version
 
dc.identifier.citationPlos Medicine, 2006, v. 3 n. 9, p. 1532-1540 [How to Cite?]
DOI: http://dx.doi.org/10.1371/journal.pmed.0030361
 
dc.identifier.citeulike4010249
 
dc.identifier.doihttp://dx.doi.org/10.1371/journal.pmed.0030361
 
dc.identifier.epage1540
 
dc.identifier.hkuros118840
 
dc.identifier.isiWOS:000241923800021
 
dc.identifier.issn1549-1277
 
dc.identifier.issue9
 
dc.identifier.openurl
 
dc.identifier.pmcidPMC1526768
 
dc.identifier.pmid16881729
 
dc.identifier.scopuseid_2-s2.0-33749039988
 
dc.identifier.spage1532
 
dc.identifier.urihttp://hdl.handle.net/10722/86977
 
dc.identifier.volume3
 
dc.languageeng
 
dc.publisherPublic Library of Science. The Journal's web site is located at http://medicine.plosjournals.org/perlserv/?request=index-html&issn=1549-1676
 
dc.publisher.placeUnited States
 
dc.relation.ispartofPLoS Medicine
 
dc.relation.referencesReferences in Scopus
 
dc.rightsCreative Commons: Attribution 3.0 Hong Kong License
 
dc.subject.meshCommunicable Disease Control - methods
 
dc.subject.meshDisease Outbreaks - prevention and control
 
dc.subject.meshFamily Characteristics
 
dc.subject.meshInfluenza, Human - drug therapy - prevention and control - transmission
 
dc.subject.meshPublic Health Administration
 
dc.titleReducing the impact of the next influenza pandemic using household-based public health interventions
 
dc.typeArticle
 
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Author Affiliations
  1. Georgia Institute of Technology
  2. The University of Hong Kong
  3. Imperial College London