title: Rescinding community mitigation strategies in an influenza pandemic.
abstract: Using a networked, agent-based computational model of a stylized community, we evaluated thresholds for rescinding 2 community mitigation strategies after an influenza pandemic. We ended child sequestering or all-community sequestering when illness incidence waned to thresholds of 0, 1, 2, or 3 cases in 7 days in 2 levels of pandemic severity. An unmitigated epidemic or strategy continuation for the epidemic duration served as control scenarios. The 0-case per 7-day rescinding threshold was comparable to the continuation strategy on infection and illness rates but reduced the number of days strategies would be needed by 6% to 32% in mild or severe pandemics. If cases recurred, strategies were resumed at a predefined 10-case trigger, and epidemic recurrence was thwarted. Strategies were most effective when used with high compliance and when combined with stringent rescinding thresholds. The need for strategies implemented for control of an influenza pandemic was reduced, without increasing illness rates.
authors.affiliation: Office of Public Health and Environmental Hazards, Department of Veterans Affairs, Veterans Health Administration, 810 Vermont Ave NW, Mailcode 13, Washington, DC 20420, USA. victoria.davey@va.gov
authors.forename: Victoria J
authors.initials: VJ
authors.lastname: Davey
authors.forename: Robert J
authors.initials: RJ
authors.lastname: Glass
mesh_terms: D000293:Adolescent; D000328:Adult; D002648:Child; D003140:Communicable Disease Control / Q000379:methods*; D003198:Computer Simulation; D004196:Disease Outbreaks; D006801:Humans; D007251:Influenza, Human / Q000453:epidemiology / Q000517:prevention & control*; D008962:Models, Theoretical; D010349:Patient Compliance; D011790:Quarantine