PMID- 16585506
OWN - NLM
STAT- MEDLINE
DA  - 20060412
DCOM- 20060609
LR  - 20081120
IS  - 0027-8424 (Print)
VI  - 103
IP  - 15
DP  - 2006 Apr 11
TI  - Mitigation strategies for pandemic influenza in the United States.
PG  - 5935-40
AB  - 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.
AD  - Los Alamos National Laboratory, Los Alamos, NM 87545, USA. tcg@lanl.gov
FAU - Germann, Timothy C
AU  - Germann TC
FAU - Kadau, Kai
AU  - Kadau K
FAU - Longini, Ira M Jr
AU  - Longini IM Jr
FAU - Macken, Catherine A
AU  - Macken CA
LA  - eng
GR  - U01-GM070749/GM/NIGMS NIH HHS/United States
PT  - Journal Article
PT  - Research Support, N.I.H., Extramural
PT  - Research Support, U.S. Gov't, Non-P.H.S.
DEP - 20060403
PL  - United States
TA  - Proc Natl Acad Sci U S A
JT  - Proceedings of the National Academy of Sciences of the United States of America
JID - 7505876
RN  - 0 (Influenza Vaccines)
SB  - IM
MH  - Computer Simulation
MH  - *Disease Outbreaks
MH  - Humans
MH  - *Influenza A Virus, H5N1 Subtype
MH  - Influenza Vaccines
MH  - Influenza, Human/*epidemiology/immunology/prevention & control/transmission
MH  - United States/epidemiology
PMC - PMC1458676
OID - NLM: PMC1458676
EDAT- 2006/04/06 09:00
MHDA- 2006/06/10 09:00
CRDT- 2006/04/06 09:00
PHST- 2006/04/03 [aheadofprint]
AID - 0601266103 [pii]
AID - 10.1073/pnas.0601266103 [doi]
PST - ppublish
SO  - Proc Natl Acad Sci U S A. 2006 Apr 11;103(15):5935-40. Epub 2006 Apr 3.