O'Hagan Justin J, Wong Karen K, Campbell Angela P, Patel Anita, Swerdlow David L, Fry Alicia M, Koonin Lisa M, Meltzer Martin I
National Center for Immunization and Respiratory Diseases (NCIRD), Centers for Disease Control and Prevention (CDC) IHRC Inc.
Epidemic Intelligence Service assigned to Influenza Division.
Clin Infect Dis. 2015 May 1;60 Suppl 1(0 1):S30-41. doi: 10.1093/cid/civ084.
Following the detection of a novel influenza strain A(H7N9), we modeled the use of antiviral treatment in the United States to mitigate severe disease across a range of hypothetical pandemic scenarios. Our outcomes were total demand for antiviral (neuraminidase inhibitor) treatment and the number of hospitalizations and deaths averted. The model included estimates of attack rate, healthcare-seeking behavior, prescription rates, adherence, disease severity, and the potential effect of antivirals on the risks of hospitalization and death. Based on these inputs, the total antiviral regimens estimated to be available in the United States (as of April 2013) were sufficient to meet treatment needs for the scenarios considered. However, distribution logistics were not examined and should be addressed in future work. Treatment was estimated to avert many severe outcomes (5200-248,000 deaths; 4800-504,000 hospitalizations); however, large numbers remained (25,000-425,000 deaths; 580,000-3,700,000 hospitalizations), suggesting that the impact of combinations of interventions should be examined.
在检测到一种新型甲型（H7N9）流感毒株后，我们对美国使用抗病毒治疗以减轻一系列假设大流行情况下的严重疾病进行了建模。我们的结果是抗病毒（神经氨酸酶抑制剂）治疗的总需求量以及避免的住院和死亡人数。该模型包括对发病率、就医行为、处方率、依从性、疾病严重程度以及抗病毒药物对住院和死亡风险的潜在影响的估计。基于这些输入数据，估计美国（截至2013年4月）可获得的抗病毒治疗方案总数足以满足所考虑情景下的治疗需求。然而，未对配送物流进行研究，未来工作中应予以解决。据估计，治疗可避免许多严重后果（5200 - 248,000例死亡；4800 - 504,000例住院）；然而，仍有大量病例（25,000 - 425,000例死亡；580,000 - 3,700,000例住院），这表明应研究多种干预措施组合的影响。
