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The impact of case diagnosis coverage and diagnosis delays on the effectiveness of antiviral strategies in mitigating pandemic influenza a/h1n1 2009.
| Content Provider | CiteSeerX |
|---|---|
| Author | Kelso, Joel K. Halder, Nilimesh Milne, George J. |
| Abstract | Background: Neuraminidase inhibitors were used to reduce the transmission of pandemic influenza A/H1N1 2009 at the early stages of the 2009/2010 pandemic. Policies for diagnosis of influenza for the purposes of antiviral intervention differed markedly between and within countries, leading to differences in the timing and scale of antiviral usage. Methodology/Principal Findings: The impact of the percentage of symptomatic infected individuals who were diagnosed, and of delays to diagnosis, for three antiviral intervention strategies (each with and without school closure) were determined using a simulation model of an Australian community. Epidemic characteristics were based on actual data from the A/H1N1 2009 pandemic including reproduction number, serial interval and age-specific infection rate profile. In the absence of intervention an illness attack rate (AR) of 24.5 % was determined from an estimated R0 of 1.5; this was reduced to 21%, 16.5 % or 13 % by treatment-only, treatment plus household prophylaxis, or treatment plus household plus extended prophylaxis antiviral interventions respectively, assuming that diagnosis occurred 24 hours after symptoms arose and that 50 % of symptomatic cases were diagnosed. If diagnosis occurred without delay, ARs decreased to 17%, 12.2 % or 8.8% respectively. If 90 % of symptomatic cases were diagnosed (with a 24 hour delay), ARs decreased to 17.8%, 11.1 % and 7.6%, respectively. Conclusion: The ability to rapidly diagnose symptomatic cases and to diagnose a high proportion of cases was shown to |
| File Format | |
| Access Restriction | Open |
| Subject Keyword | Pandemic Influenza H1n1 Case Diagnosis Coverage Diagnosis Delay Antiviral Strategy Symptomatic Case High Proportion Extended Prophylaxis Antiviral Intervention Methodology Principal Finding Actual Data Australian Community Neuraminidase Inhibitor Serial Interval Antiviral Intervention Strategy Household Prophylaxis Symptomatic Infected Individual Age-specific Infection Rate Profile Epidemic Characteristic Early Stage Antiviral Intervention School Closure Antiviral Usage Simulation Model Hour Delay Reproduction Number Illness Attack Rate |
| Content Type | Text |
