Disease Mitigation Measures in the Control of Pandemic Influenza

University of Pittsburgh, Pittsburgh, Pennsylvania, United States
Biosecurity and Bioterrorism (Impact Factor: 1.94). 02/2006; 4(4):366-75. DOI: 10.1089/bsp.2006.4.366
Source: PubMed


The threat of an influenza pandemic has alarmed countries around the globe and given rise to an intense interest in disease mitigation measures. This article reviews what is known about the effectiveness and practical feasibility of a range of actions that might be taken in attempts to lessen the number of cases and deaths resulting from an influenza pandemic. The article also discusses potential adverse second- and third-order effects of mitigation actions that decision makers must take into account. Finally, the article summarizes the authors' judgments of the likely effectiveness and likely adverse consequences of the range of disease mitigation measures and suggests priorities and practical actions to be taken.

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    • "The development of strategies for controlling epidemics such as influenza is one of the high priorities of global public health policies [11] [13] [18] [19]. SIR models, which incorporate mobility between regions, represent powerful tools for designing and testing different strategies to control epidemics. "
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    ABSTRACT: Epidemics of infectious diseases are among the largest threats to the quality of life and the economic and social well-being of developing countries. The arsenal of measures against such epidemics is well-established, but costly and insufficient to mitigate their impact. In this paper, we argue that mobile technology adds a powerful weapon to this arsenal, because (a) mobile devices endow us with the unprecedented ability to measure and model the detailed behavioral patterns of the affected population, and (b) they enable the delivery of personalized behavioral recommendations to individuals in real time. We combine these two ideas and propose several strategies to generate such recommendations from mobility patterns. The goal of each strategy is a large reduction in infections, with a small impact on the normal course of daily life. We evaluate these strategies over the Orange D4D dataset and show the benefit of mobile micro-measures, even if only a fraction of the population participates. These preliminary results demonstrate the potential of mobile technology to complement other measures like vaccination and quarantines against disease epidemics.
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    • "Treatment of symptomatic influenza with NAIs is a very effective intervention but only one of many needed to mitigate the severity of an influenza pandemic. Other key strategies, including vaccination, case isolation, school or workplace closure, and travel restrictions, will additionally be needed to have maximal reduction in influenza cases and mortality [5], [6], [7]. Furthermore, the NAI supply in a Member State is likely to be correlated with overall influenza pandemic preparedness. "
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    ABSTRACT: The influenza A (H1N1) pandemic swept across the globe from April 2009 to August 2010 affecting millions. Many WHO Member States relied on antiviral drugs, specifically neuraminidase inhibitors (NAIs) oseltamivir and zanamivir, to treat influenza patients in critical condition. Such drugs have been found to be effective in reducing severity and duration of influenza illness, and likely reduced morbidity during the pandemic. However, it is less clear whether NAIs used during the pandemic reduced H1N1 mortality. Country-level data on supply of oseltamivir and zanamivir were used to predict H1N1 mortality (per 100,000 people) from July 2009 to August 2010 in forty-two WHO Member States. Poisson regression was used to model the association between NAI supply and H1N1 mortality, with adjustment for economic, demographic, and health-related confounders. After adjustment for potential confounders, each 10% increase in kilograms of oseltamivir, per 100,000 people, was associated with a 1.6% reduction in H1N1 mortality over the pandemic period (relative rate (RR) = 0.84 per log increase in oseltamivir supply). While the supply of zanamivir was considerably less than that of oseltamivir in each Member State, each 10% increase in kilogram of active zanamivir, per 100,000, was associated with a 0.3% reduction in H1N1 mortality (RR = 0.97 per log increase). While there are limitations to the ecologic nature of these data, this analysis offers evidence of a protective relationship between antiviral drug supply and influenza mortality and supports a role for influenza antiviral use in future pandemics.
    PLoS ONE 09/2012; 7(9):e43491. DOI:10.1371/journal.pone.0043491 · 3.23 Impact Factor
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    • "Of the best practices, vaccination is by far the most important. Other practices which cause minimal social impact include respiratory etiquette (covering the mouth with the shirt sleeve instead of the hands), proper hand washing, keeping hands away from the eyes, nose and mouth, self quarantine (staying home when sick), and keeping a distance of 3-6 feet from infected individuals (Inglesby et al, 2006; CDC, 2009). "

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