[In silico evaluation of an aviar influenza AH5N1 virus outbreak with human to human transmission: effects of sanitary measures in Valencia, Venezuela, 2012].
BACKGROUND
There is a risk for an avian influenza AH5N1 virus pandemia.


OBJECTIVE
To estimate the magnitude and impact of an AH5N1 pandemic in areas of Latin-America in order to design interventions and to reduce morbidity-mortality.


METHODS
The InfluSim program was used to simulate a highly pathogenic AH5N1 aviar virus epidemic outbreak with human to human transmission in Valencia, Venezuela. We estimated the day of maximal number of cases, number of moderately and severely ill patients, exposed individuals, deaths and associated costs for 5 different interventions: absence of any intervention; implementation of antiviral treatment; reduction of 20% in population general contacts; closure of 20% of educational institutions; and reduction of 50% in massive public gatherings. Simulation parameters used were: population: 829.856 persons, infection risk 6-47%, contagiousness Index Rh o 2,5; relative contagiousness 90%, overall lethality 64,1% and, costs according to the official basic budget.


RESULTS
For an outbreak lasting 200 days direct and indirect deaths by intervention strategies would be: 29,907; 29,900; 9,701; 29,295 and 14,752. Costs would follow a similar trend.


CONCLUSIONS
Reduction of 20% in general population contacts results in a significant reduction of up to 68% of cases. The outbreak would collapse the health care system. Antiviral treatment would not be efficient during the outbreak. Interpersonal contact reduction proved to be the best sanitary measure to control an AH5N1 theoretical epidemic outbreak.
Centro de Biofísica y Neurociencia, Facultad de Ciencias de la Salud, Universidad de Carabobo, El Trigal, Valencia, Venezuela.
Mariana
M
Reggeti
Centro de Biofísica y Neurociencia, Facultad de Ciencias de la Salud, Universidad de Carabobo, El Trigal, Valencia, Venezuela.
Emilse
E
Romero
Centro de Biofísica y Neurociencia, Facultad de Ciencias de la Salud, Universidad de Carabobo, El Trigal, Valencia, Venezuela, aeblen@uc.edu.ve.
Antonio
A
Eblen-Zajjur
D000367:Age Factors; D000818:Animals; D001717:Birds; D003198:Computer Simulation; D003430:Cross-Sectional Studies; D058872:Epidemics; D005544:Forecasting / Q000379:methods; D006760:Hospitalization / Q000706:statistics & numerical data; D006801:Humans; D053124:Influenza A Virus, H5N1 Subtype; D005585:Influenza in Birds / Q000453:epidemiology* / Q000635:transmission*; D007251:Influenza, Human / Q000453:epidemiology* / Q000635:transmission*; D012929:Psychological Distance; D012016:Reference Values; D018570:Risk Assessment / Q000379:methods*; D012307:Risk Factors; D014687:Venezuela / Q000453:epidemiology