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Preventing a pandemic: Study suggests strategies for containing a flu outbreak

illance and aggressive use of public health measures," said Katrina Kelner, Deputy Editor, Life Sciences, at Science.

A rural Southeast Asian population is a likely place for the new strain to emerge, so Longini and his colleagues based their model on the Thai 2000 census and a previous study of the social networks in the Nang Rong District in rural Thailand.

With this information, they simulated a population of 500,000 in which individuals mixed in a variety of settings, including households, household clusters, preschool groups, schools, workplaces, and a hospital. Social settings for casual contacts, such as might take place in markets, shops, and temples, were also included.

Using the model, the researchers analyzed how the disease, starting with a single case, would spread through the population in a variety of different scenarios.

They found that targeted use of antiviral drugs could be effective for containment as long as the intervention occurred within 21 days and the virus' reproductive number (which represents the average number of people within a population someone with the disease is able to infect) had a relatively moderate value of roughly 1.6.

A process of administering antiviral drugs to the people in the same mixing groups as the infected person, called TAP for "targeted antiviral prophylaxis," could contain the outbreak as long as it reached 80 percent of the people targeted. A related strategy, GTAP, for "geographically targeted antiviral prophylaxis," which targets people within a certain geographic range of the initial case, produced similar results as long as it achieved coverage of 90 percent.

Vaccination before the outbreak, even with a vaccine that is poorly matched to the actual virus strain, increased the effectiveness of TAP and GTAP.

For even higher viral reproductive numbers, household quarantines would also be necessary to contain the virus. A combination of TAP, prevaccination a
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Source:American Association for the Advancement of Science


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