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抗病毒药物与学校停课的大流行模拟:争取时间直至有针对特定毒株的疫苗可用。

Pandemic simulation of antivirals + school closures: buying time until strain-specific vaccine is available.

作者信息

Mniszewski S M, Del Valle S Y, Stroud P D, Riese J M, Sydoriak S J

机构信息

Los Alamos National Laboratory, Los Alamos, NM 87545 USA.

出版信息

Comput Math Organ Theory. 2008;14(3):209-221. doi: 10.1007/s10588-008-9027-1. Epub 2008 Apr 11.

Abstract

A strain-specific vaccine is unlikely to be available in the early phases of a potential H5N1 avian influenza pandemic. It could be months and at the current production rate may not provide timely protection to the population. Intervention strategies that control the spread of infection will be necessary in this situation, such as the use of the US stockpile of antiviral medication coupled with a 6-month school closure. The agent-based simulation model, , was used to assess the impact of this intervention strategy followed by three different vaccine approaches: (1) 2-dose, 80% effective, (2) 1-dose, 30% effective, and (3) 1 dose, 80% effective. Simulations show that the combination of antivirals, school closures, and a strain-specific vaccine can reduce morbidity and mortality while in effect. A significant second infection wave can occur with current vaccine technology once school closures are relaxed, though an ideal vaccine is able to contain it. In our simulations, worker absenteeism increases in all cases mostly attributed to household adults staying home with children due to the school closures.

摘要

在潜在的H5N1禽流感大流行早期,不太可能获得针对特定毒株的疫苗。可能需要数月时间,而且按照目前的生产速度,可能无法及时为民众提供保护。在这种情况下,控制感染传播的干预策略将是必要的,例如使用美国的抗病毒药物储备并关闭学校6个月。基于主体的模拟模型 被用于评估这种干预策略以及三种不同疫苗接种方法的影响:(1)两剂,有效性为80%;(2)一剂,有效性为30%;(3)一剂,有效性为80%。模拟结果表明,抗病毒药物、学校关闭和针对特定毒株的疫苗相结合,可以在起效期间降低发病率和死亡率。一旦学校关闭措施放宽,当前的疫苗技术可能会引发显著的第二轮感染浪潮,不过理想的疫苗能够控制住这一情况。在我们的模拟中,所有情况下工人缺勤率都会上升,这主要归因于学校关闭后家庭中的成年人留在家中照顾孩子。

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