Article
Initial human transmission dynamics of the pandemic (H1N1) 2009 virus in North America.
Division of Mathematical Modeling, British Columbia Centre for Disease Control, Vancouver, British Columbia, Canada.
Influenza and Other Respiratory Viruses (impact factor:
4.16).
10/2009;
3(5):215-22.
DOI:10.1111/j.1750-2659.2009.00100.x
Source: PubMed
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Article: Severe acute respiratory syndrome (SARS): a year in review.
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ABSTRACT: Severe acute respiratory syndrome (SARS) emerged from China as an untreatable and rapidly spreading respiratory illness of unknown etiology. Following point source exposure in February 2003, more than a dozen guests infected at a Hong Kong hotel seeded multi-country outbreaks that persisted through the spring of 2003. The World Health Organization responded by invoking traditional public health measures and advanced technologies to control the illness and contain the cause. A novel coronavirus was implicated and its entire genome was sequenced by mid-April 2003. The urgency of responding to this threat focused scientific endeavor and stimulated global collaboration. Through real-time application of accumulating knowledge, the world proved capable of arresting the first pandemic threat of the twenty-first century, despite early respiratory-borne spread and global susceptibility. This review synthesizes lessons learned from this remarkable achievement. These lessons can be applied to re-emergence of SARS or to the next pandemic threat to arise.Annual Review of Medicine 02/2005; 56:357-81. · 9.94 Impact Factor -
Article: Strategies for containing an emerging influenza pandemic in Southeast Asia.
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ABSTRACT: Highly pathogenic H5N1 influenza A viruses are now endemic in avian populations in Southeast Asia, and human cases continue to accumulate. Although currently incapable of sustained human-to-human transmission, H5N1 represents a serious pandemic threat owing to the risk of a mutation or reassortment generating a virus with increased transmissibility. Identifying public health interventions that might be able to halt a pandemic in its earliest stages is therefore a priority. Here we use a simulation model of influenza transmission in Southeast Asia to evaluate the potential effectiveness of targeted mass prophylactic use of antiviral drugs as a containment strategy. Other interventions aimed at reducing population contact rates are also examined as reinforcements to an antiviral-based containment policy. We show that elimination of a nascent pandemic may be feasible using a combination of geographically targeted prophylaxis and social distancing measures, if the basic reproduction number of the new virus is below 1.8. We predict that a stockpile of 3 million courses of antiviral drugs should be sufficient for elimination. Policy effectiveness depends critically on how quickly clinical cases are diagnosed and the speed with which antiviral drugs can be distributed.Nature 10/2005; 437(7056):209-14. · 36.28 Impact Factor -
Article: Pandemic potential of a strain of influenza A (H1N1): early findings.
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ABSTRACT: A novel influenza A (H1N1) virus has spread rapidly across the globe. Judging its pandemic potential is difficult with limited data, but nevertheless essential to inform appropriate health responses. By analyzing the outbreak in Mexico, early data on international spread, and viral genetic diversity, we make an early assessment of transmissibility and severity. Our estimates suggest that 23,000 (range 6000 to 32,000) individuals had been infected in Mexico by late April, giving an estimated case fatality ratio (CFR) of 0.4% (range: 0.3 to 1.8%) based on confirmed and suspected deaths reported to that time. In a community outbreak in the small community of La Gloria, Veracruz, no deaths were attributed to infection, giving an upper 95% bound on CFR of 0.6%. Thus, although substantial uncertainty remains, clinical severity appears less than that seen in the 1918 influenza pandemic but comparable with that seen in the 1957 pandemic. Clinical attack rates in children in La Gloria were twice that in adults (<15 years of age: 61%; >/=15 years: 29%). Three different epidemiological analyses gave basic reproduction number (R0) estimates in the range of 1.4 to 1.6, whereas a genetic analysis gave a central estimate of 1.2. This range of values is consistent with 14 to 73 generations of human-to-human transmission having occurred in Mexico to late April. Transmissibility is therefore substantially higher than that of seasonal flu, and comparable with lower estimates of R0 obtained from previous influenza pandemics.Science 05/2009; 324(5934):1557-61. · 31.20 Impact Factor
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Keywords
95% confidence interval range
ascertainment bias
complete case series
contact rates
effective vaccine
estimated transmission characteristics
extended case series
extrinsic sociological factors
first global pandemic
laboratory-confirmed pandemic
Mexico City
Mexico City Distrito Federal
non-pharmaceutical mitigation measures
novel contact network methodology incorporating dates
novel virus
severe outbreak
spread prior
symptom onset
time series
uncertainties
