Identification

Author

Germann TC, Kadau K, Longini Jr. IM, Mackenn CA

Title

Mitigation strategies for Pandemic Influenza in the United States

Year

2006

Publication type

Article

Journal

Proceedings of the National Academy of Sciences of the United States of America

Created

2013-12-17 23:01:01+00:00

Modified

2016-07-27 17:01:32.696004+00:00

Details

Volume

103

Number

15

Access

Language

English

URL http://www.pnas.org/content/103/15/5935.abstract
DOI

10.1073/pnas.0601266103

Accessed

2016-06-27

Extended information

Abstract

Recent human deaths due to infection by highly pathogenic (H5N1) avian influenza A virus have raised the specter of a devastating pandemic like that of 1917–1918, should this avian virus evolve to become readily transmissible among humans. We introduce and use a large-scale stochastic simulation model to investigate the spread of a pandemic strain of influenza virus through the U.S. population of 281 million individuals for R 0 (the basic reproductive number) from 1.6 to 2.4. We model the impact that a variety of levels and combinations of influenza antiviral agents, vaccines, and modified social mobility (including school closure and travel restrictions) have on the timing and magnitude of this spread. Our simulations demonstrate that, in a highly mobile population, restricting travel after an outbreak is detected is likely to delay slightly the time course of the outbreak without impacting the eventual number ill. For R 0 < 1.9, our model suggests that the rapid production and distribution of vaccines, even if poorly matched to circulating strains, could significantly slow disease spread and limit the number ill to <10% of the population, particularly if children are preferentially vaccinated. Alternatively, the aggressive deployment of several million courses of influenza antiviral agents in a targeted prophylaxis strategy may contain a nascent outbreak with low R 0, provided adequate contact tracing and distribution capacities exist. For higher R 0, we predict that multiple strategies in combination (involving both social and medical interventions) will be required to achieve similar limits on illness rates.