A small community model for the transmission of infectious diseases: comparison of school closure as an intervention in individual-based models of an influenza pandemic.
BACKGROUND
In the absence of other evidence, modelling has been used extensively to help policy makers plan for a potential future influenza pandemic.


METHODS
We have constructed an individual based model of a small community in the developed world with detail down to exact household structure obtained from census collection datasets and precise simulation of household demographics, movement within the community and individual contact patterns. We modelled the spread of pandemic influenza in this community and the effect on daily and final attack rates of four social distancing measures: school closure, increased case isolation, workplace non-attendance and community contact reduction. We compared the modelled results of final attack rates in the absence of any interventions and the effect of school closure as a single intervention with other published individual based models of pandemic influenza in the developed world.


RESULTS
We showed that published individual based models estimate similar final attack rates over a range of values for R(0) in a pandemic where no interventions have been implemented; that multiple social distancing measures applied early and continuously can be very effective in interrupting transmission of the pandemic virus for R(0) values up to 2.5; and that different conclusions reached on the simulated benefit of school closure in published models appear to result from differences in assumptions about the timing and duration of school closure and flow-on effects on other social contacts resulting from school closure.


CONCLUSIONS
Models of the spread and control of pandemic influenza have the potential to assist policy makers with decisions about which control strategies to adopt. However, attention needs to be given by policy makers to the assumptions underpinning both the models and the control strategies examined.
Milne
George J
GJ
School of Computer Science and Software Engineering, The University of Western Australia, Crawley, Western Australia, Australia. joel@csse.uwa.edu.au
Kelso
Joel K
JK
Kelly
Heath A
HA
Huband
Simon T
ST
McVernon
Jodie
J
D003140:Communicable Disease Control / Q000379:methods*; D017714:Community-Acquired Infections / Q000517:prevention & control* / Q000635:transmission*; D003198:Computer Simulation; D004196:Disease Outbreaks / Q000517:prevention & control; D018562:Disease Transmission, Infectious / Q000517:prevention & control; D017598:Efficiency, Organizational; D006801:Humans; D007251:Influenza, Human / Q000453:epidemiology* / Q000517:prevention & control* / Q000635:transmission; D015233:Models, Statistical; D012111:Residence Characteristics; D012572:School Health Services / Q000458:organization & administration; D012574:Schools / Q000458:organization & administration; D012934:Social Isolation