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Published Online August 3, 2005
Science DOI: 10.1126/science.1115717

Reports

Submitted on June 6, 2005
Accepted on July 14, 2005

Containing Pandemic Influenza at the Source

Ira M. Longini Jr 1*, Azhar Nizam 1, Shufu Xu 1, Kumnuan Ungchusak 2, Wanna Hanshaoworakul 2, Derek A. T. Cummings 3, Elizabeth M. Halloran 1

1 Department of Biostatistics, The Rollins School of Public Health, Emory University, 1518 Clifton Road, N.E., Atlanta, GA, USA.
2 Ministry of Public Health, Nonthaburi, Thailand.
3 Department of International Health, The Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD, USA.

* To whom correspondence should be addressed.
Ira M. Longini Jr , E-mail: longini{at}sph.emory.edu

Highly pathogenic avian influenza A (H5N1) is threatening a human pandemic of potentially devastating proportions. We use a stochastic influenza simulation model for rural South East Asia to investigate the effectiveness of targeted antiviral prophylaxis, quarantine, and pre-vaccination in containing an emerging influenza strain at the source. If the basic reproductive number (R0) were below 1.60, our simulations show that a prepared response with targeted antivirals would have a high probability of containment. In this case, an antiviral agent stockpile on the order of 100,000 to one million courses would be sufficient. If pre-vaccination occurs, then targeted antiviral prophylaxis could be effective for containing strains with an R0 as high as 2.1. Combinations of targeted antiviral prophylaxis, pre-vaccination and quarantine could contain strains with an R0 as high as 2.4.


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