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<record><TEI><teiHeader><fileDesc><titleStmt><title xml:lang="en">Mitigation strategies for pandemic influenza in the United States</title><author><name sortKey="Germann, Timothy C" sort="Germann, Timothy C" uniqKey="Germann T" first="Timothy C." last="Germann">Timothy C. Germann</name><affiliation><nlm:aff id="aff1">*Los Alamos National Laboratory, Los Alamos, NM 87545; and</nlm:aff></affiliation></author><author><name sortKey="Kadau, Kai" sort="Kadau, Kai" uniqKey="Kadau K" first="Kai" last="Kadau">Kai Kadau</name><affiliation><nlm:aff id="aff1">*Los Alamos National Laboratory, Los Alamos, NM 87545; and</nlm:aff></affiliation></author><author><name sortKey="Longini, Ira M" sort="Longini, Ira M" uniqKey="Longini I" first="Ira M." last="Longini">Ira M. Longini</name><affiliation><nlm:aff id="aff2">Program of Biostatistics and Biomathematics, Fred Hutchinson Cancer Research Center and Department of Biostatistics, School of Public Health and Community Medicine, University of Washington, Seattle, WA 98109</nlm:aff></affiliation></author><author><name sortKey="Macken, Catherine A" sort="Macken, Catherine A" uniqKey="Macken C" first="Catherine A." last="Macken">Catherine A. Macken</name><affiliation><nlm:aff id="aff1">*Los Alamos National Laboratory, Los Alamos, NM 87545; and</nlm:aff></affiliation></author></titleStmt><publicationStmt><idno type="wicri:source">PMC</idno><idno type="pmid">16585506</idno><idno type="pmc">1458676</idno><idno type="url">http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1458676</idno><idno type="RBID">PMC:1458676</idno><idno type="doi">10.1073/pnas.0601266103</idno><date when="2006">2006</date><idno type="wicri:Area/Pmc/Corpus">000762</idno><idno type="wicri:explorRef" wicri:stream="Pmc" wicri:step="Corpus" wicri:corpus="PMC">000762</idno></publicationStmt><sourceDesc><biblStruct><analytic><title xml:lang="en" level="a" type="main">Mitigation strategies for pandemic influenza in the United States</title><author><name sortKey="Germann, Timothy C" sort="Germann, Timothy C" uniqKey="Germann T" first="Timothy C." last="Germann">Timothy C. Germann</name><affiliation><nlm:aff id="aff1">*Los Alamos National Laboratory, Los Alamos, NM 87545; and</nlm:aff></affiliation></author><author><name sortKey="Kadau, Kai" sort="Kadau, Kai" uniqKey="Kadau K" first="Kai" last="Kadau">Kai Kadau</name><affiliation><nlm:aff id="aff1">*Los Alamos National Laboratory, Los Alamos, NM 87545; and</nlm:aff></affiliation></author><author><name sortKey="Longini, Ira M" sort="Longini, Ira M" uniqKey="Longini I" first="Ira M." last="Longini">Ira M. Longini</name><affiliation><nlm:aff id="aff2">Program of Biostatistics and Biomathematics, Fred Hutchinson Cancer Research Center and Department of Biostatistics, School of Public Health and Community Medicine, University of Washington, Seattle, WA 98109</nlm:aff></affiliation></author><author><name sortKey="Macken, Catherine A" sort="Macken, Catherine A" uniqKey="Macken C" first="Catherine A." last="Macken">Catherine A. Macken</name><affiliation><nlm:aff id="aff1">*Los Alamos National Laboratory, Los Alamos, NM 87545; and</nlm:aff></affiliation></author></analytic><series><title level="j">Proceedings of the National Academy of Sciences of the United States of America</title><idno type="ISSN">0027-8424</idno><idno type="eISSN">1091-6490</idno><imprint><date when="2006">2006</date></imprint></series></biblStruct></sourceDesc></fileDesc><profileDesc><textClass></textClass></profileDesc></teiHeader><front><div type="abstract" xml:lang="en"><p>Recent human deaths due to infection by highly pathogenic (H5N1) avian influenza A virus have raised the specter of a devastating pandemic like that of 1917–1918, should this avian virus evolve to become readily transmissible among humans. We introduce and use a large-scale stochastic simulation model to investigate the spread of a pandemic strain of influenza virus through the U.S. population of 281 million individuals for <bold><italic>R</italic></bold><sub>0</sub> (the basic reproductive number) from 1.6 to 2.4. We model the impact that a variety of levels and combinations of influenza antiviral agents, vaccines, and modified social mobility (including school closure and travel restrictions) have on the timing and magnitude of this spread. Our simulations demonstrate that, in a highly mobile population, restricting travel after an outbreak is detected is likely to delay slightly the time course of the outbreak without impacting the eventual number ill. For <bold><italic>R</italic></bold><sub>0</sub> < 1.9, our model suggests that the rapid production and distribution of vaccines, even if poorly matched to circulating strains, could significantly slow disease spread and limit the number ill to <10% of the population, particularly if children are preferentially vaccinated. Alternatively, the aggressive deployment of several million courses of influenza antiviral agents in a targeted prophylaxis strategy may contain a nascent outbreak with low <bold><italic>R</italic></bold><sub>0</sub>, provided adequate contact tracing and distribution capacities exist. For higher <bold><italic>R</italic></bold><sub>0</sub>, we predict that multiple strategies in combination (involving both social and medical interventions) will be required to achieve similar limits on illness rates.</p></div></front></TEI><pmc article-type="research-article"><pmc-comment>The publisher of this article does not allow downloading of the full text in XML form.</pmc-comment>
<front><journal-meta><journal-id journal-id-type="nlm-ta">Proc Natl Acad Sci U S A</journal-id><journal-id journal-id-type="pmc">pnas</journal-id><journal-id journal-id-type="pubmed">PNAS</journal-id><journal-id journal-id-type="publisher-id">PNAS</journal-id><journal-title>Proceedings of the National Academy of Sciences of the United States of America</journal-title><issn pub-type="ppub">0027-8424</issn><issn pub-type="epub">1091-6490</issn><publisher><publisher-name>National Academy of Sciences</publisher-name></publisher></journal-meta><article-meta><article-id pub-id-type="pmid">16585506</article-id><article-id pub-id-type="pmc">1458676</article-id><article-id pub-id-type="publisher-id">1780</article-id><article-id pub-id-type="doi">10.1073/pnas.0601266103</article-id><article-categories><subj-group subj-group-type="heading"><subject>Biological Sciences</subject><subj-group><subject>Medical Sciences</subject></subj-group></subj-group><series-title>From the Cover</series-title></article-categories><title-group><article-title>Mitigation strategies for pandemic influenza in the United States</article-title></title-group><contrib-group><contrib contrib-type="author"><name><surname>Germann</surname><given-names>Timothy C.</given-names></name><xref ref-type="aff" rid="aff1">*</xref><xref ref-type="corresp" rid="cor1"></xref></contrib><contrib contrib-type="author"><name><surname>Kadau</surname><given-names>Kai</given-names></name><xref ref-type="aff" rid="aff1">*</xref></contrib><contrib contrib-type="author"><name><surname>Longini</surname><given-names>Ira M.</given-names><suffix>Jr.</suffix></name><xref ref-type="aff" rid="aff2"><sup>‡</sup></xref></contrib><contrib contrib-type="author"><name><surname>Macken</surname><given-names>Catherine A.</given-names></name><xref ref-type="aff" rid="aff1">*</xref></contrib><aff id="aff1">*Los Alamos National Laboratory, Los Alamos, NM 87545; and</aff><aff id="aff2"><sup>‡</sup>Program of Biostatistics and Biomathematics, Fred Hutchinson Cancer Research Center and Department of Biostatistics, School of Public Health and Community Medicine, University of Washington, Seattle, WA 98109</aff></contrib-group><author-notes><corresp id="cor1"><sup>†</sup>To whom correspondence should be addressed. E-mail:
<email>tcg@lanl.gov</email></corresp><fn fn-type="com"><p>Communicated by G. Balakrish Nair, International Centre for Diarrhoeal Disease Research Bangladesh, Dhaka, Bangladesh, February 16, 2006</p></fn><fn fn-type="con"><p>Author contributions: T.C.G., K.K., I.M.L., and C.A.M. designed research, performed research, contributed new reagents/analytic tools, analyzed data, and wrote the paper.</p></fn><fn fn-type="conflict"><p>Conflict of interest statement: No conflicts declared.</p></fn></author-notes><pub-date pub-type="ppub"><day>11</day><month>4</month><year>2006</year></pub-date><pub-date pub-type="epub"><day>3</day><month>4</month><year>2006</year></pub-date><volume>103</volume><issue>15</issue><fpage>5935</fpage><lpage>5940</lpage><history><date date-type="received"><day>10</day><month>1</month><year>2006</year></date></history><copyright-statement>© 2006 by The National Academy of Sciences of the USA</copyright-statement><copyright-year>2006</copyright-year><self-uri xlink:title="pdf" xlink:href="zpq01506005935.pdf"></self-uri><abstract><p>Recent human deaths due to infection by highly pathogenic (H5N1) avian influenza A virus have raised the specter of a devastating pandemic like that of 1917–1918, should this avian virus evolve to become readily transmissible among humans. We introduce and use a large-scale stochastic simulation model to investigate the spread of a pandemic strain of influenza virus through the U.S. population of 281 million individuals for <bold><italic>R</italic></bold><sub>0</sub> (the basic reproductive number) from 1.6 to 2.4. We model the impact that a variety of levels and combinations of influenza antiviral agents, vaccines, and modified social mobility (including school closure and travel restrictions) have on the timing and magnitude of this spread. Our simulations demonstrate that, in a highly mobile population, restricting travel after an outbreak is detected is likely to delay slightly the time course of the outbreak without impacting the eventual number ill. For <bold><italic>R</italic></bold><sub>0</sub> < 1.9, our model suggests that the rapid production and distribution of vaccines, even if poorly matched to circulating strains, could significantly slow disease spread and limit the number ill to <10% of the population, particularly if children are preferentially vaccinated. Alternatively, the aggressive deployment of several million courses of influenza antiviral agents in a targeted prophylaxis strategy may contain a nascent outbreak with low <bold><italic>R</italic></bold><sub>0</sub>, provided adequate contact tracing and distribution capacities exist. For higher <bold><italic>R</italic></bold><sub>0</sub>, we predict that multiple strategies in combination (involving both social and medical interventions) will be required to achieve similar limits on illness rates.</p></abstract><kwd-group><kwd>antiviral agents</kwd><kwd>infectious diseases</kwd><kwd>simulation modeling</kwd><kwd>social network dynamics</kwd><kwd>vaccines</kwd></kwd-group><custom-meta-wrap><custom-meta><meta-name>PDF</meta-name><meta-value><uri xlink:type="simple" xlink:href="zpq01506005935.pdf"></uri></meta-value></custom-meta></custom-meta-wrap></article-meta></front></pmc></record>Pour manipuler ce document sous Unix (Dilib)
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