title: Prophylaxis or treatment? Optimal use of an antiviral stockpile during an influenza pandemic.
abstract: We introduce a novel mathematical model that effectively incorporates contact tracing in a realistic distribution mechanism for antiviral drugs in an influenza pandemic scenario. A strategy focused on targeted provision of post-exposure prophylaxis, rather than treatment, will provide the greatest chance of minimising the impact of an influenza pandemic. Targeted post-exposure prophylaxis delays the onset of the pandemic and for a wide range of parameter values, a delay of the order of 6-18 months may be achievable. This may provide enough time to develop and distribute a vaccine. In contrast, a treatment based strategy typically does not delay the onset of a pandemic by an appreciable amount and, in general, is not capable of significantly reducing the attack rate from baseline.
authors.affiliation: Vaccine and Immunisation Research Group, School of Population Health, The University of Melbourne, Vic. 3010, Australia. jamesm@unimelb.edu.au
authors.forename: James M
authors.initials: JM
authors.lastname: McCaw
authors.forename: Jodie
authors.initials: J
authors.lastname: McVernon
mesh_terms: D000998:Antiviral Agents / Q000008:administration & dosage / Q000627:therapeutic use; D003153:Community Health Services; D004196:Disease Outbreaks / Q000517:prevention & control*; D006801:Humans; D007251:Influenza, Human / Q000188:drug therapy / Q000453:epidemiology* / Q000517:prevention & control*; D008433:Mathematics; D008954:Models, Biological; D011314:Preventive Health Services
chemical_list: D000998:Antiviral Agents