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Article: Reducing the impact of the next influenza pandemic using household-based public health interventions

TitleReducing the impact of the next influenza pandemic using household-based public health interventions
Authors
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
Citation
Plos Medicine, 2006, v. 3 n. 9, p. 1532-1540 How to Cite?
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.
Persistent Identifierhttp://hdl.handle.net/10722/86977
ISSN
PubMed Central ID
ISI Accession Number ID
References

 

DC FieldValueLanguage
dc.contributor.authorWu, JTen_HK
dc.contributor.authorRiley, Sen_HK
dc.contributor.authorFraser, Cen_HK
dc.contributor.authorLeung, GMen_HK
dc.date.accessioned2010-09-06T09:23:39Z-
dc.date.available2010-09-06T09:23:39Z-
dc.date.issued2006en_HK
dc.identifier.citationPlos Medicine, 2006, v. 3 n. 9, p. 1532-1540en_HK
dc.identifier.issn1549-1277en_HK
dc.identifier.urihttp://hdl.handle.net/10722/86977-
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.en_HK
dc.languageengen_HK
dc.publisherPublic Library of Science. The Journal's web site is located at http://medicine.plosjournals.org/perlserv/?request=index-html&issn=1549-1676en_HK
dc.relation.ispartofPLoS Medicineen_HK
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 interventionsen_HK
dc.typeArticleen_HK
dc.identifier.openurlhttp://library.hku.hk:4550/resserv?sid=HKU:IR&issn=1549-1277&volume=3&issue=9&spage=e361&epage=&date=2006&atitle=Reducing+the+impact+of+the+next+influenza+pandemic+using+household-based+public+health+interventionsen_HK
dc.identifier.emailWu, JT:joewu@hkucc.hku.hken_HK
dc.identifier.emailRiley, S:sriley@hkucc.hku.hk, steven.riley@hku.hken_HK
dc.identifier.emailLeung, GM:gmleung@hku.hken_HK
dc.identifier.authorityWu, JT=rp00517en_HK
dc.identifier.authorityRiley, S=rp00511en_HK
dc.identifier.authorityLeung, GM=rp00460en_HK
dc.description.naturepublished_or_final_version-
dc.identifier.doi10.1371/journal.pmed.0030361en_HK
dc.identifier.pmid16881729-
dc.identifier.pmcidPMC1526768-
dc.identifier.scopuseid_2-s2.0-33749039988en_HK
dc.identifier.hkuros118840en_HK
dc.relation.referenceshttp://www.scopus.com/mlt/select.url?eid=2-s2.0-33749039988&selection=ref&src=s&origin=recordpageen_HK
dc.identifier.volume3en_HK
dc.identifier.issue9en_HK
dc.identifier.spage1532en_HK
dc.identifier.epage1540en_HK
dc.identifier.isiWOS:000241923800021-
dc.publisher.placeUnited Statesen_HK
dc.identifier.scopusauthoridWu, JT=7409256423en_HK
dc.identifier.scopusauthoridRiley, S=7102619416en_HK
dc.identifier.scopusauthoridFraser, C=35460815100en_HK
dc.identifier.scopusauthoridLeung, GM=7007159841en_HK
dc.identifier.citeulike4010249-

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