title: Comparing effectiveness of top-down and bottom-up strategies in containing influenza.
abstract: This research compares the performance of bottom-up, self-motivated behavioral interventions with top-down interventions targeted at controlling an "Influenza-like-illness". Both types of interventions use a variant of the ring strategy. In the first case, when the fraction of a person's direct contacts who are diagnosed exceeds a threshold, that person decides to seek prophylaxis, e.g. vaccine or antivirals; in the second case, we consider two intervention protocols, denoted Block and School: when a fraction of people who are diagnosed in a Census Block (resp., School) exceeds the threshold, prophylax the entire Block (resp., School). Results show that the bottom-up strategy outperforms the top-down strategies under our parameter settings. Even in situations where the Block strategy reduces the overall attack rate well, it incurs a much higher cost. These findings lend credence to the notion that if people used antivirals effectively, making them available quickly on demand to private citizens could be a very effective way to control an outbreak.
authors.affiliation: Network Dynamics and Simulation Science Lab, Virginia Bioinformatics Institute at Virginia Tech, Blacksburg, Virginia, United States of America. amarathe@vbi.vt.edu
authors.forename: Achla
authors.initials: A
authors.lastname: Marathe
authors.forename: Bryan
authors.initials: B
authors.lastname: Lewis
authors.forename: Christopher
authors.initials: C
authors.lastname: Barrett
authors.forename: Jiangzhuo
authors.initials: J
authors.lastname: Chen
authors.forename: Madhav
authors.initials: M
authors.lastname: Marathe
authors.forename: Stephen
authors.initials: S
authors.lastname: Eubank
authors.forename: Yifei
authors.initials: Y
authors.lastname: Ma
mesh_terms: D000998:Antiviral Agents / Q000627:therapeutic use; D004196:Disease Outbreaks / Q000517:prevention & control; D006801:Humans; D007252:Influenza Vaccines / Q000627:therapeutic use; D007251:Influenza, Human / Q000517:prevention & control*
chemical_list: D000998:Antiviral Agents; D007252:Influenza Vaccines