Abstract
In the absence of effective vaccines, antiviral drugs and personal protective measures, such as voluntary self-isolation, have been a part of preparedness plans for the next influenza pandemic. We used a household model to assess the effect of voluntary self-isolation on outbreak control when antiviral drugs are not provided sufficiently early. We found that the early initiation of voluntary self-isolation can overcome the negative effects caused by a delay in antiviral drug distribution when enough symptomatic individuals comply with home confinement at symptom onset. For example, for the baseline household reproduction number , if delays of one or two days occur between clinical symptom development and the start of antiviral prophylaxis, then compliance rates of and , respectively, are required to achieve the same level of effectiveness as starting antiviral prophylaxis at symptom onset. When the time to beginning voluntary self-isolation after symptom onset increases from zero to two days, this strategy has a limited effect on reducing the transmission of influenza; therefore, this strategy should be implemented as soon as possible. In addition, the effect of voluntary self-isolation decreases substantially with the proportion of asymptomatic infections increasing.
Highlights
Influenza viruses are associated with high morbidity and mortality in humans and continue to be a major threat to public health [1]
For the purpose of containing an outbreak, we show the effectiveness of various interventions strategies in reducing the household reproduction number, RH
As in [8], we show the change in the household reproduction number, RH, with respect to the parameters μ, which is the average number of cases that an infected individual generates outside his or her household, and θ, which is the probability that an individual escapes infection by an infectious household member during the latter’s entire infectious period, with the goal of describing the effects of interventions on transmission
Summary
Influenza viruses are associated with high morbidity and mortality in humans and continue to be a major threat to public health [1]. Because influenza is an important global public health concern, the methods by which pandemic influenza could be contained are of widespread interest, and a variety of control measures have been implemented to contain the spread of influenza strains. The measure of providing antiviral prophylaxis to the close contacts of influenza patients has been recommended by the World Health Organization as a principle of early aggressive measures to prevent pandemic influenza [10,11]. Longini et al showed that targeted antiviral prophylaxis (i.e., offering antiviral prophylaxis to the close contacts of suspected index influenza patients) was an effective control measure to contain pandemic influenza until vaccines became available [1]. The combination of targeted antiviral prophylaxis and other interventions has been successfully used to combat the spread of pandemic influenza [13,14,15,16,17,18]
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