Longini Ira M, Nizam Azhar, Xu Shufu, Ungchusak Kumnuan, Hanshaoworakul Wanna, Cummings Derek A T, Halloran M Elizabeth
Department of Biostatistics, The Rollins School of Public Health, Emory University, 1518 Clifton Road, N.E., Atlanta, GA 30322, USA.
Science. 2005 Aug 12;309(5737):1083-7. doi: 10.1126/science.1115717. Epub 2005 Aug 3.
Highly pathogenic avian influenza A (subtype H5N1) is threatening to cause a human pandemic of potentially devastating proportions. We used a stochastic influenza simulation model for rural Southeast Asia to investigate the effectiveness of targeted antiviral prophylaxis, quarantine, and pre-vaccination in containing an emerging influenza strain at the source. If the basic reproductive number (R0) was below 1.60, our simulations showed that a prepared response with targeted antivirals would have a high probability of containing the disease. In that case, an antiviral agent stockpile on the order of 100,000 to 1 million courses for treatment and prophylaxis would be sufficient. If pre-vaccination occurred, then targeted antiviral prophylaxis could be effective for containing strains with an R0 as high as 2.1. Combinations of targeted antiviral prophylaxis, pre-vaccination, and quarantine could contain strains with an R(0) as high as 2.4.
高致病性甲型禽流感（H5N1亚型）有可能引发一场规模可能极具破坏性的全球大流行。我们使用了一个针对东南亚农村地区的随机流感模拟模型，来研究有针对性的抗病毒预防、隔离和疫苗接种前预防措施在源头遏制新出现的流感毒株方面的有效性。如果基本再生数（R0）低于1.60，我们的模拟结果表明，采用有针对性的抗病毒药物进行准备充分的应对措施，有很高的概率控制住疫情。在这种情况下，储备10万至100万疗程用于治疗和预防的抗病毒药物就足够了。如果进行了疫苗接种前预防，那么有针对性的抗病毒预防措施对于控制R0高达2.1的毒株可能会有效。有针对性的抗病毒预防、疫苗接种前预防和隔离措施相结合，可以控制R0高达2.4的毒株。
