Note to users. If you're seeing this message, it means that your browser cannot find this page's style/presentation instructions -- or possibly that you are using a browser that does not support current Web standards. Find out more about why this message is appearing, and what you can do to make your experience of our site the best it can be.

Site Tools

  • AAAS
  • Subscribe
  • Feedback

Site Search

Search Advanced

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
Prev | Table of Contents | Next

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

Read the Full Text


THIS ARTICLE HAS BEEN CITED BY OTHER ARTICLES:
Estimating antiviral effectiveness against pandemic influenza using household data.
K. Glass and N. G Becker (2009)
J R Soc Interface 6, 695-703
   Abstract »    Full Text »    PDF »
Environmental transmission of low pathogenicity avian influenza viruses and its implications for pathogen invasion.
P. Rohani, R. Breban, D. E. Stallknecht, and J. M. Drake (2009)
PNAS 106, 10365-10369
   Abstract »    Full Text »    PDF »
A Bayesian model for evaluating influenza antiviral efficacy in household studies with asymptomatic infections.
Y. Yang, M. E. Halloran, and I. M. Longini Jr (2009)
Biostat. 10, 390-403
   Abstract »    Full Text »    PDF »
Threshold parameters for a model of epidemic spread among households and workplaces.
L Pellis, N.M Ferguson, and C Fraser (2009)
J R Soc Interface
   Abstract »    Full Text »    PDF »
Estimating Influenza Vaccine Efficacy From Challenge and Community-based Study Data.
N. E. Basta, M. E. Halloran, L. Matrajt, and I. M. Longini Jr. (2008)
Am. J. Epidemiol. 168, 1343-1352
   Abstract »    Full Text »    PDF »
Therapeutic Activity of an Anti-Idiotypic Antibody-Derived Killer Peptide against Influenza A Virus Experimental Infection.
G. Conti, W. Magliani, S. Conti, L. Nencioni, R. Sgarbanti, A. T. Palamara, and L. Polonelli (2008)
Antimicrob. Agents Chemother. 52, 4331-4337
   Abstract »    Full Text »    PDF »
Dynamic social networks and the implications for the spread of infectious disease.
J. M Read, K. T.D Eames, and W. J. Edmunds (2008)
J R Soc Interface 5, 1001-1007
   Abstract »    Full Text »    PDF »
Protecting residential care facilities from pandemic influenza.
M. Nuno, T. A. Reichert, G. Chowell, and A. B. Gumel (2008)
PNAS 105, 10625-10630
   Abstract »    Full Text »    PDF »
Individual space-time activity-based modelling of infectious disease transmission within a city.
Y. Yang, P. Atkinson, and D. Ettema (2008)
J R Soc Interface 5, 759-772
   Abstract »    Full Text »    PDF »
Quantifying social distancing arising from pandemic influenza.
P. Caley, D. J Philp, and K. McCracken (2008)
J R Soc Interface 5, 631-639
   Abstract »    Full Text »    PDF »
Management of drug resistance in the population: influenza as a case study.
S. M Moghadas (2008)
Proc R Soc B 275, 1163-1169
   Abstract »    Full Text »    PDF »
Antiviral treatment for the control of pandemic influenza: some logistical constraints.
N Arinaminpathy and A.R McLean (2008)
J R Soc Interface 5, 545-553
   Abstract »    Full Text »    PDF »
Modeling targeted layered containment of an influenza pandemic in the United States.
M. E. Halloran, N. M. Ferguson, S. Eubank, I. M. Longini Jr., D. A. T. Cummings, B. Lewis, S. Xu, C. Fraser, A. Vullikanti, T. C. Germann, et al. (2008)
PNAS 105, 4639-4644
   Abstract »    Full Text »    PDF »
Pandemic lessons from Iceland.
S. F. Dowell and J. S. Bresee (2008)
PNAS 105, 1109-1110
   Full Text »    PDF »
Detecting Robust Patterns in the Spread of Epidemics: A Case Study of Influenza in the United States and France.
P. Crepey and M. Barthelemy (2007)
Am. J. Epidemiol. 166, 1244-1251
   Abstract »    Full Text »    PDF »
Analyzing Pathogen Transmission in the Dialysis Unit: Time for a (Schedule) Change?.
J. R. Hotchkiss, P. Holley, and P. S. Crooke (2007)
Clin. J. Am. Soc. Nephrol. 2, 1176-1185
   Abstract »    Full Text »    PDF »
The effect of population structure on the emergence of drug resistance during influenza pandemics.
F. Debarre, S. Bonhoeffer, and R. R Regoes (2007)
J R Soc Interface 4, 893-906
   Abstract »    Full Text »    PDF »
The impact of prophylaxis of healthcare workers on influenza pandemic burden.
M. Gardam, D. Liang, S. M Moghadas, J. Wu, Q. Zeng, and H. Zhu (2007)
J R Soc Interface 4, 727-734
   Abstract »    Full Text »    PDF »
Transmissibility of swine flu at Fort Dix, 1976.
J. Lessler, D. A.T Cummings, S. Fishman, A. Vora, and D. S Burke (2007)
J R Soc Interface 4, 755-762
   Abstract »    Full Text »    PDF »
Nonpharmaceutical Interventions Implemented by US Cities During the 1918-1919 Influenza Pandemic.
H. Markel, H. B. Lipman, J. A. Navarro, A. Sloan, J. R. Michalsen, A. M. Stern, and M. S. Cetron (2007)
JAMA 298, 644-654
   Abstract »    Full Text »    PDF »
Emergence of drug resistance: implications for antiviral control of pandemic influenza.
M. E Alexander, C. S Bowman, Z. Feng, M. Gardam, S. M Moghadas, G. Rost, J. Wu, and P. Yan (2007)
Proc R Soc B 274, 1675-1684
   Abstract »    Full Text »    PDF »
Conserved Surface Features Form the Double-stranded RNA Binding Site of Non-structural Protein 1 (NS1) from Influenza A and B Viruses.
C. Yin, J. A. Khan, G. V. T. Swapna, A. Ertekin, R. M. Krug, L. Tong, and G. T. Montelione (2007)
J. Biol. Chem. 282, 20584-20592
   Abstract »    Full Text »    PDF »
Media, Metaphors and Modelling: How the UK Newspapers Reported the Epidemiological Modelling Controversy during the 2001 Foot and Mouth Outbreak.
B. Nerlich (2007)
Science Technology Human Values 32, 432-457
   Abstract »    PDF »
Global Infectious Disease Surveillance And Health Intelligence.
S. S. Morse (2007)
Health Aff. 26, 1069-1077
   Abstract »    Full Text »    PDF »
Assessing the role of basic control measures, antivirals and vaccine in curtailing pandemic influenza: scenarios for the US, UK and the Netherlands.
M Nuno, G Chowell, and A.B Gumel (2007)
J R Soc Interface 4, 505-521
   Abstract »    Full Text »    PDF »
Large-Scale Spatial-Transmission Models of Infectious Disease.
S. Riley (2007)
Science 316, 1298-1301
   Abstract »    Full Text »    PDF »
Simple Models of Influenza Progression Within a Heterogeneous Population.
R. C. Larson (2007)
Operations Research 55, 399-412
   Abstract »    PDF »
A model for the spread and control of pandemic influenza in an isolated geographical region.
M.G Roberts, M Baker, L.C Jennings, G Sertsou, and N Wilson (2007)
J R Soc Interface 4, 325-330
   Abstract »    Full Text »    PDF »
Avian Influenza Virus (H5N1): a Threat to Human Health.
J. S. M. Peiris, M. D. de Jong, and Y. Guan (2007)
Clin. Microbiol. Rev. 20, 243-267
   Abstract »    Full Text »    PDF »
Long-standing influenza vaccination policy is in accord with individual self-interest but not with the utilitarian optimum.
A. P. Galvani, T. C. Reluga, and G. B. Chapman (2007)
PNAS 104, 5692-5697
   Abstract »    Full Text »    PDF »
What is the best control strategy for multiple infectious disease outbreaks?.
A. Handel, I. M Longini Jr, and R. Antia (2007)
Proc R Soc B 274, 833-837
   Abstract »    Full Text »    PDF »
Comparative estimation of the reproduction number for pandemic influenza from daily case notification data.
G. Chowell, H. Nishiura, and L. M.A Bettencourt (2007)
J R Soc Interface 4, 155-166
   Abstract »    Full Text »    PDF »
Avian influenza: A review.
J. K. Thomas and J. Noppenberger (2007)
Am. J. Health Syst. Pharm. 64, 149-165
   Abstract »    Full Text »    PDF »
Antiviral Effects on Influenza Viral Transmission and Pathogenicity: Observations from Household-based Trials.
M. E. Halloran, F. G. Hayden, Y. Yang, I. M. Longini Jr, and A. S. Monto (2007)
Am. J. Epidemiol. 165, 212-221
   Abstract »    Full Text »    PDF »
The evolutionary emergence of pandemic influenza.
T. Day, J.-B. Andre, and A. Park (2006)
Proc R Soc B 273, 2945-2953
   Abstract »    Full Text »    PDF »
Invited Commentary: Challenges of using Contact Data to Understand Acute Respiratory Disease Transmission.
M. E. Halloran (2006)
Am. J. Epidemiol. 164, 945-946
   Full Text »    PDF »
Using Data on Social Contacts to Estimate Age-specific Transmission Parameters for Respiratory-spread Infectious Agents.
J. Wallinga, P. Teunis, and M. Kretzschmar (2006)
Am. J. Epidemiol. 164, 936-944
   Abstract »    Full Text »    PDF »
Guillain-Barre Syndrome After Influenza Vaccination in Adults: A Population-Based Study..
D. N. Juurlink, T. A. Stukel, J. Kwong, A. Kopp, A. McGeer, R. E. Upshur, D. G. Manuel, R. Moineddin, and K. Wilson (2006)
Arch Intern Med 166, 2217-2221
   Abstract »    Full Text »    PDF »
Use of neuraminidase inhibitors to combat pandemic influenza.
J. Democratis, M. Pareek, and I. Stephenson (2006)
J. Antimicrob. Chemother. 58, 911-915
   Abstract »    Full Text »    PDF »
Key strategies for reducing spread of avian influenza among commercial poultry holdings: lessons for transmission to humans.
A. Le Menach, E. Vergu, R. F Grais, D. L Smith, and A. Flahault (2006)
Proc R Soc B 273, 2467-2475
   Abstract »    Full Text »    PDF »
Simple models for containment of a pandemic.
J. Arino, F. Brauer, P van den Driessche, J. Watmough, and J. Wu (2006)
J R Soc Interface 3, 453-457
   Abstract »    Full Text »    PDF »
Emergence of drug-resistant influenza virus: population dynamical considerations..
R. R. Regoes and S. Bonhoeffer (2006)
Science 312, 389-391
   Abstract »    Full Text »    PDF »
Predictability and preparedness in influenza control..
D. J. Smith (2006)
Science 312, 392-394
   Abstract »    Full Text »    PDF »
From the Cover: Mitigation strategies for pandemic influenza in the United States.
T. C. Germann, K. Kadau, I. M. Longini Jr., and C. A. Macken (2006)
PNAS 103, 5935-5940
   Abstract »    Full Text »    PDF »
Suppression of prion protein in livestock by RNA interference.
M. C. Golding, C. R. Long, M. A. Carmell, G. J. Hannon, and M. E. Westhusin (2006)
PNAS 103, 5285-5290
   Abstract »    Full Text »    PDF »
The CPSF30 Binding Site on the NS1A Protein of Influenza A Virus Is a Potential Antiviral Target..
K. Y. Twu, D. L. Noah, P. Rao, R.-L. Kuo, and R. M. Krug (2006)
J. Virol. 80, 3957-3965
   Abstract »    Full Text »    PDF »
Avian H5N1 Influenza--Are We Inching Closer to a Global Pandemic?.
P. Sampathkumar and D. G. Maki (2005)
Mayo Clin. Proc. 80, 1552-1555
   PDF »
Avian flu pandemic could be brought under control in three weeks.
J. Parry (2005)
BMJ 331, 367
   Full Text »    PDF »


To Advertise     Find Products

Science. ISSN 0036-8075 (print), 1095-9203 (online)