title: Epidemiological consequences of household-based antiviral prophylaxis for pandemic influenza.
abstract: Antiviral treatment offers a fast acting alternative to vaccination; as such it is viewed as a first-line of defence against pandemic influenza in protecting families and households once infection has been detected. In clinical trials, antiviral treatments have been shown to be efficacious in preventing infection, limiting disease and reducing transmission, yet their impact at containing the 2009 influenza A(H1N1)pdm outbreak was limited. To understand this seeming discrepancy, we develop a general and computationally efficient model for studying household-based interventions. This allows us to account for uncertainty in quantities relevant to the 2009 pandemic in a principled way, accounting for the heterogeneity and variability in each epidemiological process modelled. We find that the population-level effects of delayed antiviral treatment and prophylaxis mean that their limited overall impact is quantitatively consistent (at current levels of precision) with their reported clinical efficacy under ideal conditions. Hence, effective control of pandemic influenza with antivirals is critically dependent on early detection and delivery ideally within 24 h.
authors: Stochastic Modelling Group, School of Mathematical Sciences, The University of Adelaide, Adelaide, South Australia 5005, Australia.
authors: Andrew J
authors: AJ
authors: Black
authors: Thomas
authors: T
authors: House
authors: M J
authors: MJ
authors: Keeling
authors: J V
authors: JV
authors: Ross
mesh_terms: D000998:Antiviral Agents / Q000627:therapeutic use*; D001499:Bayes Theorem; D005191:Family Characteristics; D006801:Humans; D053118:Influenza A Virus, H1N1 Subtype; D007251:Influenza, Human / Q000188:drug therapy* / Q000453:epidemiology*; D008954:Models, Biological; D058873:Pandemics / Q000517:prevention & control*
chemical_list: D000998:Antiviral Agents
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