Alexander Murray E, Moghadas Seyed M, Röst Gergely, Wu Jianhong
Institute for Biodiagnostics, National Research Council Canada, Winnipeg, MB, Canada, R3B 1Y6.
Bull Math Biol. 2008 Feb;70(2):382-97. doi: 10.1007/s11538-007-9257-2. Epub 2007 Aug 16.
The use of antiviral drugs has been recognized as the primary public health strategy for mitigating the severity of a new influenza pandemic strain. However, the success of this strategy requires the prompt onset of therapy within 48 hours of the appearance of clinical symptoms. This requirement may be captured by a compartmental model that monitors the density of infected individuals in terms of the time elapsed since the onset of symptoms. We show that such a model can be expressed by a system of delay differential equations with both discrete and distributed delays. The model is analyzed to derive the criterion for disease control based on two critical factors: (i) the profile of treatment rate; and (ii) the level of treatment as a function of time lag in commencing therapy. Numerical results are also obtained to illustrate the feasible region of disease control. Our findings show that due to uncertainty in the attack rate of a pandemic strain, initiating therapy immediately upon diagnosis can significantly increase the likelihood of disease control and substantially reduce the required community-level of treatment. This suggests that reliable diagnostic methods for influenza cases should be rapidly implemented within an antiviral treatment strategy.
使用抗病毒药物已被公认为减轻新型流感大流行毒株严重程度的主要公共卫生策略。然而,这一策略的成功需要在临床症状出现后的48小时内迅速开始治疗。这一要求可以通过一个分区模型来体现,该模型根据症状出现后的时间来监测受感染个体的密度。我们表明,这样的模型可以用一个具有离散和分布延迟的延迟微分方程组来表示。对该模型进行分析,以基于两个关键因素得出疾病控制的标准:(i)治疗率曲线;(ii)作为开始治疗时间滞后函数的治疗水平。还获得了数值结果以说明疾病控制的可行区域。我们的研究结果表明,由于大流行毒株攻击率的不确定性,在诊断后立即开始治疗可以显著增加疾病控制的可能性,并大幅降低所需的社区治疗水平。这表明应在抗病毒治疗策略中迅速实施可靠的流感病例诊断方法。