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Logo of bmcphBioMed Centralsearchsubmit a manuscriptregisterthis articleBMC Public Health
BMC Public Health. 2011; 11(Suppl 1): S1.
Published online Feb 25, 2011. doi:  10.1186/1471-2458-11-S1-S1
PMCID: PMC3317583
Reactive strategies for containing developing outbreaks of pandemic influenza
Sigrún Andradóttir,1 Wenchi Chiu,1 David Goldsman,corresponding author1 Mi Lim Lee,1 Kwok-Leung Tsui,1 Beate Sander,2,3,4 David N Fisman,5 and Azhar Nizam6
1H. Milton Stewart School of Industrial and Systems Engineering, Georgia Institute of Technology, Atlanta, Georgia, 30332, USA
2Toronto Health Economics and Technology Assessment Collaborative, Toronto, Ontario, M5S 3M2, Canada
3Department of Health Policy, Management and Evaluation, University of Toronto, Toronto, Ontario, M5T 3M6, Canada
4Division of Clinical Decision-Making and Health Care Research, University Health Network, Toronto, Ontario, M5G 2C4, Canada
5Department of Epidemiology, Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, M5T 3M7, Canada
6Department of Biostatistics and Bioinformatics, Emory University, Atlanta, Georgia, 30322, USA
corresponding authorCorresponding author.
Sigrún Andradóttir: sa/at/; Wenchi Chiu: wenchichiu/at/; David Goldsman: sman/at/; Mi Lim Lee: mlee79/at/; Kwok-Leung Tsui: ktsui/at/; Beate Sander: bsander/at/; David N Fisman: david.fisman/at/; Azhar Nizam: anizam/at/
Mathematical Modelling of Influenza
Jean M Tchuenche and Robert Smith?
In 2009 and the early part of 2010, the northern hemisphere had to cope with the first waves of the new influenza A (H1N1) pandemic. Despite high-profile vaccination campaigns in many countries, delays in administration of vaccination programs were common, and high vaccination coverage levels were not achieved. This experience suggests the need to explore the epidemiological and economic effectiveness of additional, reactive strategies for combating pandemic influenza.
We use a stochastic model of pandemic influenza to investigate realistic strategies that can be used in reaction to developing outbreaks. The model is calibrated to documented illness attack rates and basic reproductive number (R0) estimates, and constructed to represent a typical mid-sized North American city.
Our model predicts an average illness attack rate of 34.1% in the absence of intervention, with total costs associated with morbidity and mortality of US$81 million for such a city. Attack rates and economic costs can be reduced to 5.4% and US$37 million, respectively, when low-coverage reactive vaccination and limited antiviral use are combined with practical, minimally disruptive social distancing strategies, including short-term, as-needed closure of individual schools, even when vaccine supply-chain-related delays occur. Results improve with increasing vaccination coverage and higher vaccine efficacy.
Such combination strategies can be substantially more effective than vaccination alone from epidemiological and economic standpoints, and warrant strong consideration by public health authorities when reacting to future outbreaks of pandemic influenza.
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