Targeted antiviral prophylaxis of flu case contacts could successfully contain pandemic influenza

ATLANTA In a future outbreak of pandemic influenza, such as the three pandemics that sickened millions and killed hundreds of thousands of people during the 20th century, supplies of flu vaccine might not be available quickly enough to contain the spread of disease. However, according to research by biostatisticians in Emory University's Rollins School of Public Health, many thousands of deaths could be prevented if antiviral agents were given to the close contacts of those with suspected cases of flu until adequate supplies of vaccine could be manufactured and distributed. The results of the research by Emory professors of biostatistics Ira Longini, Jr,, PhD, and M. Elizabeth Halloran, MD, DSc, and their colleagues Azhar Nizam, MS, and Yang Yang, BSc, will appear online on March 26, and will be published as a special article in the American Journal of Epidemiology on April 1, 2004.

The Emory scientists used a dynamic stochastic simulation model of an influenza pandemic or bioterrorist attack for an agent similar to influenza A(H2N2), which caused the Asian influenza pandemic of 1957-58 and resulted in approximately 70,000 deaths in the U.S. (A stochastic model includes elements of chance or probability). They determined that if no interventions were used in a similar pandemic, 33 percent of the population would become ill, resulting in a death rate of 0.58 per 1,000 people. If antiviral prophylaxis was given to close contacts of 80% of suspected influenza cases, however, in a strategy that the authors call "targeted antiviral prophylaxis" (TAP), the epidemic could be contained. If TAP were begun within one day of identifying suspected flu cases and used for up to eight weeks, only 2 percent of the population would become ill, and the death rate would be only 0.04 per 1,000 people. The researchers found that eight weeks of TAP would be nearly as effective as vaccinating 80 percent of the population.

"The ability to rely on targeted antiviral t

Contact: Holly Korschun
Emory University Health Sciences Center

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