Pandemic Influenza, Reopening Schools, and Returning to Work

Meltzer, Martin I.

doi:10.3201/eid1403.080026

Cited by 6 publications

(3 citation statements)

References 8 publications

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“…Models can be built to try to emulate the real world and as a result, are extraordinarily complex. Reviewers call for better quantification of model uncertainty [25] , [34] . Simulation studies such as ours can avoid much uncertainty by focusing on finding the best strategies for policy consideration and then testing sensitivity of the best strategy choice to perturbations in model parameters and underlying assumptions.…”

Section: Discussionmentioning

confidence: 99%

Effective, Robust Design of Community Mitigation for Pandemic Influenza: A Systematic Examination of Proposed US Guidance

et al. 2008

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BackgroundThe US government proposes pandemic influenza mitigation guidance that includes isolation and antiviral treatment of ill persons, voluntary household member quarantine and antiviral prophylaxis, social distancing of individuals, school closure, reduction of contacts at work, and prioritized vaccination. Is this the best strategy combination? Is choice of this strategy robust to pandemic uncertainties? What are critical enablers of community resilience?Methods and FindingsWe systematically simulate a broad range of pandemic scenarios and mitigation strategies using a networked, agent-based model of a community of explicit, multiply-overlapping social contact networks. We evaluate illness and societal burden for alterations in social networks, illness parameters, or intervention implementation. For a 1918-like pandemic, the best strategy minimizes illness to <1% of the population and combines network-based (e.g. school closure, social distancing of all with adults' contacts at work reduced), and case-based measures (e.g. antiviral treatment of the ill and prophylaxis of household members). We find choice of this best strategy robust to removal of enhanced transmission by the young, additional complexity in contact networks, and altered influenza natural history including extended viral shedding. Administration of age-group or randomly targeted 50% effective pre-pandemic vaccine with 7% population coverage (current US H5N1 vaccine stockpile) had minimal effect on outcomes. In order, mitigation success depends on rapid strategy implementation, high compliance, regional mitigation, and rigorous rescinding criteria; these are the critical enablers for community resilience.ConclusionsSystematic evaluation of feasible, recommended pandemic influenza interventions generally confirms the US community mitigation guidance yields best strategy choices for pandemic planning that are robust to a wide range of uncertainty. The best strategy combines network- and case-based interventions; network-based interventions are paramount. Because strategies must be applied rapidly, regionally, and stringently for greatest benefit, preparation and public education is required for long-lasting, high community compliance during a pandemic.

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Section: Discussionmentioning

confidence: 99%

Effective, Robust Design of Community Mitigation for Pandemic Influenza: A Systematic Examination of Proposed US Guidance

et al. 2008

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“…Recent publications demonstrate that it is still very uncertain and unclear which areas should be prioritized for funding, whether it is non-pharmaceutical interventions such as social-distancing [Bartlett and Borio, 2008;Davey and Glass, 2008;Meltzer, 2008], vaccination [Ehrlich et al, 2008;Monto and Whitley, 2008;Wright, 2008], or antiviral drugs [Beigel and Bray, 2008], though with the latter, there is an alarming rate of seasonal influenza antiviral resistance, which is still being reported even until very recently [Lackenby et al, 2008;Saito et al, 2008;Tang et al, 2008]. In addition, resource planning is quite different for developed and developing countries [Bartlett and Borio, 2008;Oshitani et al, 2008;Paranthaman et al, 2008], and knowing what benefits can be expected from any cross-immunity from the previous influenza infection and seasonal influenza vaccine may help to set a baseline upon which pandemic preparedness can be more accurately based.…”

Section: Discussionmentioning

confidence: 99%

Lack of cross‐immune reactivity against influenza H5N1 from seasonal influenza vaccine in humans

Tang

Ngai

Chan

2008

Journal of Medical Virology

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In a small pilot study, sera from 10 healthy human volunteers were taken pre‐vaccine, then 1, 3, and 6 months post‐seasonal influenza immunization (using the 2005/2006 Northern hemisphere vaccine: A/New Caledonia/20/99(H1N1)‐like, A/California/7/2004(H3N2)‐like, and B/Shanghai/361/2002‐like strains). Eight out of 10 subjects demonstrated satisfactory HAI titers (≥40) after seasonal influenza vaccination between 1 and 6 months post‐vaccine. These sera were then tested for inhibitory activity against A/HK/483/97 and A/Thailand/1(KAN‐1)/04 H5N1 influenza viruses using standard hemagglutination inhibition and microneutralization assays. In contrast to several other studies in both humans and animals on the cross‐immunity between different influenza A viruses, antibodies produced to the influenza A(H1N1) component of the seasonal influenza vaccine showed no cross‐reactivity to these avian influenza A(H5N1) viruses. Possible reasons for this contrasting result are discussed. J. Med. Virol. 80:1992–1996, 2008. © 2008 Wiley‐Liss, Inc.

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“…These individuals may avoid contact with public officials because of fear of detention and deportation; this leads to higher risk of adverse consequences of pandemic influenza than is faced by citizens and by other immigrants and refugees. 2,[8][9][10][11] We describe the implications of available guidance on community mitigation and related strategies [12][13][14][15][16][17][18][19][20][21][22][23][24][25][26][27][28][29] for these vulnerable populations and their stakeholders and provide advice from an expert panel of public health scientists and service program managers convened by the Centers for Disease Control and Prevention (CDC) on May 1 and 2, 2008, in Atlanta, Georgia. Their advice is tailored to the interests of public health practitioners and service agencies addressing the special needs and circumstances of immigrants and refugees living in the United States.…”

Section: Pandemic Influenza Preparedness and Response Among Immigrantmentioning

confidence: 99%

Pandemic Influenza Preparedness and Response Among Immigrants and Refugees

Truman

Tinker²,

Vaughan³

et al. 2009

Am J Public Health

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Some immigrants and refugees might be more vulnerable than other groups to pandemic influenza because of preexisting health and social disparities, migration history, and living conditions in the United States. Vulnerable populations and their service providers need information to overcome limited resources, inaccessible health services, limited English proficiency and foreign language barriers, cross-cultural misunderstanding, and inexperience applying recommended guidelines. To increase the utility of guidelines, we searched the literature, synthesized relevant findings, and examined their implications for vulnerable populations and stakeholders. Here we summarize advice from an expert panel of public health scientists and service program managers who attended a meeting convened by the Centers for Disease Control and Prevention, May 1 and 2, 2008, in Atlanta, Georgia.

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Pandemic Influenza, Reopening Schools, and Returning to Work

Abstract: Pandemic Influenza, Reopening Schools, and Returning to Work

Cited by 6 publications

References 8 publications

Effective, Robust Design of Community Mitigation for Pandemic Influenza: A Systematic Examination of Proposed US Guidance

Effective, Robust Design of Community Mitigation for Pandemic Influenza: A Systematic Examination of Proposed US Guidance

Lack of cross‐immune reactivity against influenza H5N1 from seasonal influenza vaccine in humans

Pandemic Influenza Preparedness and Response Among Immigrants and Refugees

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