Strategies for containing an emerging influenza pandemic in Southeast Asia

Neil M. Ferguson (), Derek A.T. Cummings, Simon Cauchemez, Christophe Fraser, Steven Riley, Aronrag Meeyai, Sopon Iamsirithaworn and Donald S. Burke
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Neil M. Ferguson: Imperial College London
Derek A.T. Cummings: Johns Hopkins Bloomberg School of Public Health
Simon Cauchemez: INSERM U707
Christophe Fraser: Imperial College London
Steven Riley: The University of Hong Kong
Aronrag Meeyai: Imperial College London
Sopon Iamsirithaworn: Bureau of Epidemiology, Department of Diseases Control, Ministry of Public Health
Donald S. Burke: Johns Hopkins Bloomberg School of Public Health

Nature, 2005, vol. 437, issue 7056, 209-214

Abstract: 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.

Date: 2005
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DOI: 10.1038/nature04017

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