Abstract
BackgroundDue to the lack of timely access to resources for critical care, strategic use of antiviral drugs is crucial for mitigating the impact of novel influenza viruses with pandemic potential in remote and isolated communities. We sought to evaluate the effect of antiviral treatment and prophylaxis of close contacts in a Canadian remote northern community.MethodsWe used an agent-based, discrete-time simulation model for disease spread in a remote community, which was developed as an in-silico population using population census data. Relative and cumulative age-specific attack rates, and the total number of infections in simulated model scenarios were obtained.ResultsWe found that early initiation of antiviral treatment is more critical for lowering attack rates in a remote setting with a low population-average age compared to an urban population. Our results show that a significant reduction in the relative, age-specific attack rates due to increasing treatment coverage does not necessarily translate to a significant reduction in the overall arrack rate. When treatment coverage varies from low to moderate, targeted prophylaxis has a very limited impact in reducing attack rates and should be offered at a low level (below 10%) to avoid excessive waste of drugs.ConclusionsIn contrast to previous work, for conservative treatment coverages, our results do not provide any convincing evidence for the implementation of targeted prophylaxis. The findings suggest that public health strategies in remote communities should focus on the wider availability (higher coverage) and timely distribution of antiviral drugs for treatment of clinically ill individuals.
Highlights
In the event of an emerging disease, of greatest concerns to public health are the geographic spread, severity, and time course of the outbreak
Simulation Design We developed an in-silico population of individuals in a latticelike environment consisting of homes, workplaces, school classrooms, and communal spaces that represent a remote community in northern Canada
Treatment coverage refers to the fraction of infectious individuals receiving treatment, and prophylaxis coverage refers to the fraction of close contacts that receives prophylaxis
Summary
In the event of an emerging disease, of greatest concerns to public health are the geographic spread, severity, and time course of the outbreak. Determining the most effective utilization of available social, preventive, and therapeutic resources to reduce population vulnerability and mitigate disease outcomes is the main focus of the public health response. Understanding the effectiveness of control measures in population settings with distinct demographic variables and social structures can inform public health response plans for the allocation and optimal distribution of health resources prior to and during the spread of an emerging infection [1,2]. Limited healthcare resources and a significant delay in the initiation of antiviral treatment post infection appear to have been barriers to realizing the full potential that antiviral drugs may have had in mitigating disease burden especially in northern communities [7]. Due to the lack of timely access to resources for critical care, strategic use of antiviral drugs is crucial for mitigating the impact of novel influenza viruses with pandemic potential in remote and isolated communities. We sought to evaluate the effect of antiviral treatment and prophylaxis of close contacts in a Canadian remote northern community
Sign-in/Register to view highlights & summary Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
