North Yorkshire and Humber Health Protection Unit, FERA, Sand Hutton, York YO41 1LZ, UK.
J Public Health (Oxf). 2012 Jun;34(2):203-8. doi: 10.1093/pubmed/fdr117. Epub 2012 Jan 20.
During the 'containment' phase of the influenza A (H1N1) pandemic 2009, antivirals were used for treatment and prophylaxis. This audit aimed to review the speed of the process involved in delivering antivirals and to assess whether this was likely to have occurred fast enough to be in keeping with the aims of reducing transmission.
Flu Response Centres in each region were tasked with co-ordinating local delivery and all case data were entered into Fluzone (an electronic case management system). All data between 1 June and 2 July in the Yorkshire and Humber region were reviewed. Forty-eight hours from the onset of illness to treatment and prophylaxis were used as reference standards.
The median estimate for the earliest point cases could have received treatment was 2 days (95% CI 2-3 days) and the earliest point contacts of cases could have received prophylaxis was 4 days (95% CI 4-5 days).
The logistical difficulties of delivering 'containment' according to the national algorithms meant there were significant time delays involved and that this was likely to have reduced the effectiveness of the strategy. This would be important to consider if a 'containment' strategy was to be employed in any future emergency.
在 2009 年甲型 H1N1 流感大流行的“遏制”阶段，使用了抗病毒药物进行治疗和预防。本次审计旨在审查提供抗病毒药物的速度，并评估其是否足以符合降低传播速度的目标。
每个地区的流感应对中心都负责协调当地的供应，所有病例数据都输入 Fluzone（一种电子病例管理系统）。审查了约克郡和亨伯地区 6 月 1 日至 7 月 2 日之间的数据。将发病后 2 天（95%置信区间为 2-3 天）作为治疗和预防的参考标准。
最早可以接受治疗的病例中位数估计为 2 天（95%置信区间为 2-3 天），最早可以接受预防的病例接触者中位数估计为 4 天（95%置信区间为 4-5 天）。
根据国家算法进行“遏制”的后勤困难意味着存在明显的时间延迟，这可能降低了该策略的有效性。如果未来发生任何紧急情况，需要考虑采用“遏制”策略，这一点非常重要。
