[Role of antiviral drugs in containing pandemic influenza. Contribution of recent modelling exercises synthesis prepared by the InVS/Inserm "epidemiology" group - November 2005].
The growing threat of influenza pandemic has lead many countries to stockpile specific antiviral drugs, mainly oseltamivir, as it can be used both for prophylaxis and therapy. Several recently published studies, based on mathematical modelling, have assessed the impact of a large scale use of this drug to contain an emerging pandemic, slow its spread within a country or reduce its epidemiological impact. They conclude that ring antiviral prophylaxis around the first cases, combined with social distancing measures, may halt a nascent pandemic, if the human-to-human transmissibility of the virus is limited and the control measures implemented promptly and with a high coverage. In case of failure, these same strategies could delay the spread of the virus within a country. The use of influenza antiviral drugs would reduce the burden of disease and even the clinical attack rate, under the assumption of a shorter infectious period for treated patients. These studies are in favour of stockpiling influenza antiviral drugs, at least to cover the curative needs and, even better, to contribute to the global effort to contain an emergent pandemic and to allow an intervention around the first chains of indigenous transmission in a country, thus slowing the virus spread. These results are based on the hypothesis of the effectiveness of oseltamivir on the pandemic virus and confirm the critical importance of a sensitive and reactive surveillance.
Lévy-Bruhl
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Département des Maladies Infectieuses, Institut de Veille Sanitaire, 12, rue du Val-d'Osne, 94415 Saint-Maurice cedex, France. d.levybruhl@invs.sante.fr
D000998:Antiviral Agents / Q000138:chemical synthesis / Q000627:therapeutic use*; D004196:Disease Outbreaks; D006801:Humans; D007251:Influenza, Human / Q000188:drug therapy* / Q000453:epidemiology* / Q000517:prevention & control; D008962:Models, Theoretical
D000998:Antiviral Agents