Breaking the waves: modelling the potential impact of public health measures to defer the epidemic peak of novel influenza A/H1N1.

<h4>Background</h4>On June 11, 2009, the World Health Organization declared phase 6 of the novel influenza A/H1N1 pandemic. Although by the end of September 2009, the novel virus had been reported from all continents, the impact in most countries of the northern hemisphere has been limit...

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Autores principales:	Matthias An der Heiden, Udo Buchholz, Gérard Krause, Göran Kirchner, Hermann Claus, Walter H Haas
Formato:	article
Lenguaje:	EN
Publicado:	Public Library of Science (PLoS) 2009
Materias:	Medicine R Science Q
Acceso en línea:	https://doaj.org/article/80ff164cbd9d45548a8ddc5ab244a28e
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spelling	oai:doaj.org-article:80ff164cbd9d45548a8ddc5ab244a28e2021-11-25T06:27:15ZBreaking the waves: modelling the potential impact of public health measures to defer the epidemic peak of novel influenza A/H1N1.1932-620310.1371/journal.pone.0008356https://doaj.org/article/80ff164cbd9d45548a8ddc5ab244a28e2009-12-01T00:00:00Zhttps://www.ncbi.nlm.nih.gov/pmc/articles/pmid/20027293/pdf/?tool=EBIhttps://doaj.org/toc/1932-6203<h4>Background</h4>On June 11, 2009, the World Health Organization declared phase 6 of the novel influenza A/H1N1 pandemic. Although by the end of September 2009, the novel virus had been reported from all continents, the impact in most countries of the northern hemisphere has been limited. The return of the virus in a second wave would encounter populations that are still nonimmune and not vaccinated yet. We modelled the effect of control strategies to reduce the spread with the goal to defer the epidemic wave in a country where it is detected in a very early stage.<h4>Methodology/principal findings</h4>We constructed a deterministic SEIR model using the age distribution and size of the population of Germany based on the observed number of imported cases and the early findings for the epidemiologic characteristics described by Fraser (Science, 2009). We propose a two-step control strategy with an initial effort to trace, quarantine, and selectively give prophylactic treatment to contacts of the first 100 to 500 cases. In the second step, the same measures are focused on the households of the next 5,000 to 10,000 cases. As a result, the peak of the epidemic could be delayed up to 7.6 weeks if up to 30% of cases are detected. However, the cumulative attack rates would not change. Necessary doses of antivirals would be less than the number of treatment courses for 0.1% of the population. In a sensitivity analysis, both case detection rate and the variation of R0 have major effects on the resulting delay.<h4>Conclusions/significance</h4>Control strategies that reduce the spread of the disease during the early phase of a pandemic wave may lead to a substantial delay of the epidemic. Since prophylactic treatment is only offered to the contacts of the first 10,000 cases, the amount of antivirals needed is still very limited.Matthias An der HeidenUdo BuchholzGérard KrauseGöran KirchnerHermann ClausWalter H HaasPublic Library of Science (PLoS)articleMedicineRScienceQENPLoS ONE, Vol 4, Iss 12, p e8356 (2009)
institution	DOAJ
collection	DOAJ
language	EN
topic	Medicine R Science Q
spellingShingle	Medicine R Science Q Matthias An der Heiden Udo Buchholz Gérard Krause Göran Kirchner Hermann Claus Walter H Haas Breaking the waves: modelling the potential impact of public health measures to defer the epidemic peak of novel influenza A/H1N1.
description	<h4>Background</h4>On June 11, 2009, the World Health Organization declared phase 6 of the novel influenza A/H1N1 pandemic. Although by the end of September 2009, the novel virus had been reported from all continents, the impact in most countries of the northern hemisphere has been limited. The return of the virus in a second wave would encounter populations that are still nonimmune and not vaccinated yet. We modelled the effect of control strategies to reduce the spread with the goal to defer the epidemic wave in a country where it is detected in a very early stage.<h4>Methodology/principal findings</h4>We constructed a deterministic SEIR model using the age distribution and size of the population of Germany based on the observed number of imported cases and the early findings for the epidemiologic characteristics described by Fraser (Science, 2009). We propose a two-step control strategy with an initial effort to trace, quarantine, and selectively give prophylactic treatment to contacts of the first 100 to 500 cases. In the second step, the same measures are focused on the households of the next 5,000 to 10,000 cases. As a result, the peak of the epidemic could be delayed up to 7.6 weeks if up to 30% of cases are detected. However, the cumulative attack rates would not change. Necessary doses of antivirals would be less than the number of treatment courses for 0.1% of the population. In a sensitivity analysis, both case detection rate and the variation of R0 have major effects on the resulting delay.<h4>Conclusions/significance</h4>Control strategies that reduce the spread of the disease during the early phase of a pandemic wave may lead to a substantial delay of the epidemic. Since prophylactic treatment is only offered to the contacts of the first 10,000 cases, the amount of antivirals needed is still very limited.
format	article
author	Matthias An der Heiden Udo Buchholz Gérard Krause Göran Kirchner Hermann Claus Walter H Haas
author_facet	Matthias An der Heiden Udo Buchholz Gérard Krause Göran Kirchner Hermann Claus Walter H Haas
author_sort	Matthias An der Heiden
title	Breaking the waves: modelling the potential impact of public health measures to defer the epidemic peak of novel influenza A/H1N1.
title_short	Breaking the waves: modelling the potential impact of public health measures to defer the epidemic peak of novel influenza A/H1N1.
title_full	Breaking the waves: modelling the potential impact of public health measures to defer the epidemic peak of novel influenza A/H1N1.
title_fullStr	Breaking the waves: modelling the potential impact of public health measures to defer the epidemic peak of novel influenza A/H1N1.
title_full_unstemmed	Breaking the waves: modelling the potential impact of public health measures to defer the epidemic peak of novel influenza A/H1N1.
title_sort	breaking the waves: modelling the potential impact of public health measures to defer the epidemic peak of novel influenza a/h1n1.
publisher	Public Library of Science (PLoS)
publishDate	2009
url	https://doaj.org/article/80ff164cbd9d45548a8ddc5ab244a28e
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Breaking the waves: modelling the potential impact of public health measures to defer the epidemic peak of novel influenza A/H1N1.

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