title: Strategies for containing a global influenza pandemic.
abstract: Mathematical modelling provides useful insight into the geographic and temporal spread of pandemic influenza. It has been recently used to assess the ability to stop a pandemic at a very early stage. Here, we model the global diffusion of pandemic influenza and the impact of available preventive and control measures. We refined a published SEIR deterministic model of disease dynamics within 52 cities interconnected via air transport to simulate the impact of five interventions in a variety of scenarios: vaccination, case isolation, therapeutic and prophylactic antiviral treatment, and air traffic reduction. The impact of these measures was assessed on the spread of a potential pandemic strain profile, with an average attack-rate of 26%, a case-fatality rate of 2.5% and a residual immunity of 25%. Our analysis highlighted the importance of: (1) a global perspective for dealing with pandemic risks; (2) the time factor and, hence, the importance of surveillance systems; (3) the complementary role of available control measures. Results provide general guidance for the issues of concern to public-health decision-makers: when to set up interventions, where, and at which administrative levels.
authors.affiliation: Institut National de la Santé et de la Recherche Médicale (Inserm), Unit 707, WHO Collaborating Centre for Electronic Disease Surveillance, Université Pierre et Marie Curie, 27, rue Chaligny, F-75571 Paris Cedex 12, France. antoine.flahault@upmc.fr
authors.forename: Antoine
authors.initials: A
authors.lastname: Flahault
authors.forename: Elisabeta
authors.initials: E
authors.lastname: Vergu
authors.forename: Laurent
authors.initials: L
authors.lastname: Coudeville
authors.forename: Rebecca F
authors.initials: RF
authors.lastname: Grais
mesh_terms: D000998:Antiviral Agents / Q000627:therapeutic use; D003140:Communicable Disease Control / Q000379:methods*; D003198:Computer Simulation; D004196:Disease Outbreaks / Q000517:prevention & control*; D006801:Humans; D007251:Influenza, Human / Q000453:epidemiology* / Q000635:transmission; D008962:Models, Theoretical; D014195:Travel / Q000706:statistics & numerical data
chemical_list: D000998:Antiviral Agents