Reducing the Impact of the Next Influenza Pandemic Using Household-Based Public Health Interventions
Identifieur interne : 005306 ( Main/Merge ); précédent : 005305; suivant : 005307Reducing the Impact of the Next Influenza Pandemic Using Household-Based Public Health Interventions
Auteurs : Joseph T. Wu [République populaire de Chine, États-Unis] ; Steven Riley [République populaire de Chine] ; Christophe Fraser [Royaume-Uni] ; Gabriel M. Leung [République populaire de Chine]Source :
- PLoS Medicine [ 1549-1277 ] ; 2006.
Descripteurs français
- KwdFr :
- Administration de la santé publique, Antiviraux (usage thérapeutique), Caractéristiques familiales, Contrôle des maladies contagieuses (), Flambées de maladies (), Grippe humaine (), Grippe humaine (traitement médicamenteux), Grippe humaine (transmission), Hong Kong, Humains, Isolement du patient, Quarantaine (organisation et administration), Simulation numérique, Sous-type H5N1 du virus de la grippe A (pathogénicité), Traçage des contacts.
- MESH :
- organisation et administration : Quarantaine.
- pathogénicité : Sous-type H5N1 du virus de la grippe A.
- traitement médicamenteux : Grippe humaine.
- usage thérapeutique : Antiviraux, Grippe humaine.
- Administration de la santé publique, Caractéristiques familiales, Contrôle des maladies contagieuses, Flambées de maladies, Grippe humaine, Hong Kong, Humains, Isolement du patient, Simulation numérique, Traçage des contacts.
- Wicri :
- geographic : Hong Kong.
English descriptors
- KwdEn :
- Antiviral Agents (therapeutic use), Communicable Disease Control (methods), Computer Simulation, Contact Tracing, Disease Outbreaks (prevention & control), Family Characteristics, Hong Kong, Humans, Influenza A Virus, H5N1 Subtype (pathogenicity), Influenza, Human (drug therapy), Influenza, Human (prevention & control), Influenza, Human (transmission), Patient Isolation, Public Health Administration, Quarantine (organization & administration).
- MESH :
- chemical , therapeutic use : Antiviral Agents.
- geographic : Hong Kong.
- drug therapy : Influenza, Human.
- methods : Communicable Disease Control.
- organization & administration : Quarantine.
- pathogenicity : Influenza A Virus, H5N1 Subtype.
- prevention & control : Disease Outbreaks, Influenza, Human.
- transmission : Influenza, Human.
- Computer Simulation, Contact Tracing, Family Characteristics, Humans, Patient Isolation, Public Health Administration.
Abstract
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 [
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 [
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.
Url:
DOI: 10.1371/journal.pmed.0030361
PubMed: 16881729
PubMed Central: 1526768
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PMC:1526768Le document en format XML
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<front><div type="abstract" xml:lang="en"><sec id="st1"><title>Background</title>
<p>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 [<xref rid="pmed-0030361-b001" ref-type="bibr">1</xref>
]. If such a strain emerges, and is not controlled at source [<xref rid="pmed-0030361-b002" ref-type="bibr">2</xref>
,<xref rid="pmed-0030361-b003" ref-type="bibr">3</xref>
], a pandemic is likely to result. Health policy in most countries will then be focused on reducing morbidity and mortality.</p>
</sec>
<sec id="st2"><title>Methods and Findings</title>
<p>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 [<xref rid="pmed-0030361-b002" ref-type="bibr">2</xref>
,<xref rid="pmed-0030361-b004" ref-type="bibr">4</xref>
], 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.</p>
</sec>
<sec id="st3"><title>Conclusions</title>
<p>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.</p>
</sec>
</div>
</front>
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