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Originally published in Science Express on 3 August 2005
Science 12 August 2005:
Vol. 309. no. 5737, pp. 1083 - 1087
DOI: 10.1126/science.1115717
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Reports

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 M. Elizabeth Halloran1

Highly pathogenic avian influenza A (subtype H5N1) is threatening to cause a human pandemic of potentially devastating proportions. We used a stochastic influenza simulation model for rural Southeast 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) was below 1.60, our simulations showed that a prepared response with targeted antivirals would have a high probability of containing the disease. In that case, an antiviral agent stockpile on the order of 100,000 to 1 million courses for treatment and prophylaxis would be sufficient. If pre-vaccination occurred, 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.

1 Department of Biostatistics, The Rollins School of Public Health, Emory University, 1518 Clifton Road, N.E., Atlanta, GA 30322, 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. E-mail: longini{at}sph.emory.edu

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