title: Avian flu pandemic: Can we prevent it?
abstract: Outbreaks of highly pathogenic H5N1 avian influenza in Southeast Asia, Europe and Africa have led to devastating consequences for poultry, and have resulted in numerous infections in humans. Although these infections from the animal reservoir continue to accumulate, the virus does not seem to spread extensively among humans. However, for example, a process of genetic reassortment could occur in a human who is co-infected with avian influenza A virus and a human strain of influenza A virus. The resulting new virus might then be able to easily infect humans and spread from human to human. Therefore, many experts expect the occurrence of a pandemic due to a mutant virus which can be easily transmitted among humans. Thus, currently, a major public health concern is the next influenza pandemic; yet it remains unclear how to control such a crisis. In this paper, we investigate relations between the evolution of virulence and an effectiveness of pandemic control measures after the emergence of mutant avian influenza; one is an elimination policy of infected birds with avian influenza and the other is a quarantine policy of infected humans with mutant avian influenza. We found that each of these prevention policies can be ineffective (i.e., increase human morbidity or mortality). Further, interestingly, the same intervention might, under the same conditions, increase human morbidity and decrease human mortality, or vice versa. Our practical findings are that the quarantine policy can effectively reduce both human morbidity and mortality but the elimination policy increases either human morbidity or mortality in a worst case situation.
authors.affiliation: Graduate School of Science and Technology, Shizuoka University, 3-5-1 Johoku, Naka-ku, Hamamatsu 432-8561, Japan. f5745020@ipc.shizuoka.ac.jp
authors.forename: Shingo
authors.initials: S
authors.lastname: Iwami
authors.forename: Yasuhiro
authors.initials: Y
authors.lastname: Takeuchi
authors.forename: Xianning
authors.initials: X
authors.lastname: Liu
mesh_terms: D000818:Animals; D001717:Birds; D004196:Disease Outbreaks / Q000517:prevention & control* / Q000662:veterinary; D006801:Humans; D009980:Influenza A virus / Q000235:genetics / Q000472:pathogenicity; D005585:Influenza in Birds / Q000453:epidemiology / Q000517:prevention & control* / Q000635:transmission; D007251:Influenza, Human / Q000453:epidemiology / Q000517:prevention & control / Q000635:transmission / Q000821:virology; D009154:Mutation; D011200:Poultry; D011790:Quarantine; D014774:Virulence