title: Antiviral treatment for the control of pandemic influenza: some logistical constraints.
abstract: Disease control programmes for an influenza pandemic will rely initially on the deployment of antiviral drugs such as Tamiflu, until a vaccine becomes available. However, such control programmes may be severely hampered by logistical constraints such as a finite stockpile of drugs and a limit on the distribution rate. We study the effects of such constraints using a compartmental modelling approach. We find that the most aggressive possible antiviral programme minimizes the final epidemic size, even if this should lead to premature stockpile run-out. Moreover, if the basic reproductive number R(0) is not too high, such a policy can avoid run-out altogether. However, where run-out would occur, such benefits must be weighed against the possibility of a higher epidemic peak than if a more conservative policy were followed. Where there is a maximum number of treatment courses that can be dispensed per day, reflecting a manpower limit on antiviral distribution, our results suggest that such a constraint is unlikely to have a significant impact (i.e. increasing the final epidemic size by more than 10%), as long as drug courses sufficient to treat at least 6% of the population can be dispensed per day.
authors.affiliation: Institute for Emergent Infections of Humans, James Martin 21st Century School, Department of Zoology, University of Oxford, Oxford, UK. nim.pathy@zoo.ox.ac.uk
authors.forename: N
authors.initials: N
authors.lastname: Arinaminpathy
authors.forename: A R
authors.initials: AR
authors.lastname: McLean
mesh_terms: D000998:Antiviral Agents / Q000600:supply & distribution / Q000627:therapeutic use*; D003140:Communicable Disease Control / Q000379:methods; D004196:Disease Outbreaks / Q000517:prevention & control*; D006801:Humans; D053124:Influenza A Virus, H5N1 Subtype; D007251:Influenza, Human / Q000188:drug therapy* / Q000517:prevention & control*; D008954:Models, Biological
chemical_list: D000998:Antiviral Agents