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

nclude the indirect effects to people not directly receiving the intervention. The model population consisted of people whose characteristics simulated the age distribution and approximate household sizes from the U.S. 2000 Census. The spread of influenza was simulated through measuring typical numbers of close and casual contacts during the course of a day.

Although the researchers acknowledged that vaccination, if available, would be the most effective strategy to prevent an epidemic, they found that using TAP for up to four weeks would be almost as effective as vaccinating 50 percent of the entire population. TAP when used for up to eight weeks would be nearly as effective as vaccinating 80 percent of the entire population. If only limited quantities of vaccine were available, they found that vaccinating 80 percent of children younger than 19 would be nearly as effective as vaccinating 80 percent of the entire population.

"Although we know that vaccination is the best intervention for influenza, vaccine supplies may be limited," Dr. Halloran emphasized. "Using 80 percent TAP for six to eight weeks is almost as effective as vaccinating 80 percent of the entire population, but even given more limited supplies of antiviral agents, TAP for just one week could prevent millions of cases of influenza and save thousands of lives."

The researchers also addressed possible concerns about the emergence of drug-resistant influenza due to the widespread use of antivirals. Two classes of antiviral drugs adamantanes and neuraminidase inhibitors currently are used for influenza, either therapeutically or prophylactically. Drug resistance developing from prophylactic use of these agents has been shown to be much lower than for therapeutic use. The Emory scientists emphasize that the properties of neuraminidase inhibitors would lead to minimal spread of resistant strains with the TAP strategy, suggesting that this class of antiviral drug would be
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Contact: Holly Korschun
hkorsch@emory.edu
404-727-3990
Emory University Health Sciences Center
1-Mar-2004


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