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Proc Natl Acad Sci USA. Optimizing infectious disease interventions during an emerging epidemic.
Optimizing infectious disease interventions during an emerging epidemic. (Proc Natl Acad Sci USA, abstract, edited)
19. Proc Natl Acad Sci U S A. 2010 Jan 12;107(2):923-8. Epub 2009 Dec 28.
Optimizing infectious disease interventions during an emerging epidemic.
Wallinga J, van Boven M, Lipsitch M. - Centre for Infectious Disease Control, National Institute for Public Health and the Environment, 3720 BA Bilthoven, Netherlands. jacco.wallinga@rivm.nl
The emergence and global impact of the novel influenza A(H1N1)v highlights the continuous threat to public health posed by a steady stream of new and unexpected infectious disease outbreaks in animals and humans. Once an emerging epidemic is detected, public health authorities will attempt to mitigate the epidemic by, among other measures, reducing further spread as much as possible. Scarce and/or costly control measures such as vaccines, anti-infective drugs, and social distancing must be allocated while epidemiological characteristics of the disease remain uncertain. Here we present first principles for allocating scarce resources with limited data. We show that under a broad class of assumptions, the simple rule of targeting intervention measures at the group with the highest risk of infection per individual will achieve the largest reduction in the transmission potential of a novel infection. For vaccination of susceptible persons, the appropriate risk measure is force of infection; for social distancing, the appropriate risk measure is incidence of infection. Unlike existing methods that rely on detailed knowledge of group-specific transmission rates, the method described here can be implemented using only data that are readily available during an epidemic, and allows ready adaptation as the epidemic progresses. The need to observe risk of infection helps to focus the ongoing planning and design of new infectious disease surveillance programs; from the presented first principles for allocating scarce resources, we can adjust the prioritization of groups for intervention when new observations on an emerging epidemic become available.
PMID: 20080777 [PubMed - indexed for MEDLINE]
PMCID: PMC2818907 [Available on 2010/7/12]
Publication Types:
* Research Support, N.I.H., Extramural
MeSH Terms:
* Antiviral Agents/therapeutic use
* Communicable Disease Control/methods*
* Disease Outbreaks/prevention & control*
* Humans
* Incidence
* Influenza A Virus, H1N1 Subtype/pathogenicity*
* Influenza Vaccines
* Influenza, Human/epidemiology*
* Influenza, Human/immunology
* Influenza, Human/prevention & control
* Influenza, Human/transmission
* Resource Allocation/methods
* Resource Allocation/organization & administration
* Risk Factors
* Vaccination/statistics & numerical data
* Viral Vaccines/therapeutic use*
* World Health
Substances:
* Antiviral Agents
* Influenza Vaccines
* Viral Vaccines
Grant Support:
* 1U54GM088558/GM/NIGMS NIH HHS/United States
* 5U01GM076497/GM/NIGMS NIH HHS/United States
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19. Proc Natl Acad Sci U S A. 2010 Jan 12;107(2):923-8. Epub 2009 Dec 28.
Optimizing infectious disease interventions during an emerging epidemic.
Wallinga J, van Boven M, Lipsitch M. - Centre for Infectious Disease Control, National Institute for Public Health and the Environment, 3720 BA Bilthoven, Netherlands. jacco.wallinga@rivm.nl
The emergence and global impact of the novel influenza A(H1N1)v highlights the continuous threat to public health posed by a steady stream of new and unexpected infectious disease outbreaks in animals and humans. Once an emerging epidemic is detected, public health authorities will attempt to mitigate the epidemic by, among other measures, reducing further spread as much as possible. Scarce and/or costly control measures such as vaccines, anti-infective drugs, and social distancing must be allocated while epidemiological characteristics of the disease remain uncertain. Here we present first principles for allocating scarce resources with limited data. We show that under a broad class of assumptions, the simple rule of targeting intervention measures at the group with the highest risk of infection per individual will achieve the largest reduction in the transmission potential of a novel infection. For vaccination of susceptible persons, the appropriate risk measure is force of infection; for social distancing, the appropriate risk measure is incidence of infection. Unlike existing methods that rely on detailed knowledge of group-specific transmission rates, the method described here can be implemented using only data that are readily available during an epidemic, and allows ready adaptation as the epidemic progresses. The need to observe risk of infection helps to focus the ongoing planning and design of new infectious disease surveillance programs; from the presented first principles for allocating scarce resources, we can adjust the prioritization of groups for intervention when new observations on an emerging epidemic become available.
PMID: 20080777 [PubMed - indexed for MEDLINE]
PMCID: PMC2818907 [Available on 2010/7/12]
Publication Types:
* Research Support, N.I.H., Extramural
MeSH Terms:
* Antiviral Agents/therapeutic use
* Communicable Disease Control/methods*
* Disease Outbreaks/prevention & control*
* Humans
* Incidence
* Influenza A Virus, H1N1 Subtype/pathogenicity*
* Influenza Vaccines
* Influenza, Human/epidemiology*
* Influenza, Human/immunology
* Influenza, Human/prevention & control
* Influenza, Human/transmission
* Resource Allocation/methods
* Resource Allocation/organization & administration
* Risk Factors
* Vaccination/statistics & numerical data
* Viral Vaccines/therapeutic use*
* World Health
Substances:
* Antiviral Agents
* Influenza Vaccines
* Viral Vaccines
Grant Support:
* 1U54GM088558/GM/NIGMS NIH HHS/United States
* 5U01GM076497/GM/NIGMS NIH HHS/United States
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