Volume 13, Number 3—March 2007
Research
Effectiveness of Neuraminidase Inhibitors for Preventing Staff Absenteeism during Pandemic Influenza
Table 1
Parameter | Notation† | Minimum‡ | Base case‡ | Maximum‡ | Reference |
---|---|---|---|---|---|
Input | |||||
General population | Ng | 4,350,000 | (13) | ||
Healthcare staff | Nh | 20,000 | Estimated | ||
ILI rate, per day | ι | 2,800 | (2) | ||
Transmission dynamics | |||||
Incubation and latent period, d | α | 1.0 | 2.0 | 3.0 | (9,10) |
Infectious period, d | γ | 1.5 | 4.1 | 7.0 | (9,10) |
Reproductive number | R0 | 1.5 | 2.5 | 6.0 | (9,14) |
Transmission probability/d | β | 0.37 | 0.61 | 2.0 | Calculated, R/γ |
HCW-to-HCW transmission | ω | 0.2 | 0.5 | 0.8 | See text |
HCW infections caused by incident cases of clinical influenza (H/P) | δ | 0 | 2.0 | See text | |
Detection threshold, proportion of baseline ILI rate | ν | Introduction of 1st case | 0.1 | 1 | See text |
Disease severity and antiviral efficacy | |||||
Hospitalization rate (HCW)/100,000 infected§ | η | 12.4 | 88.6 | 186.7 | (2) |
Length of stay and medical leave if hospitalized, d | φ | 9.0 | 12.0 | 20.0 | (2) |
Case-fatality rate (HCW)/100,000 infected§ | μ | 1.9 | 20.3 | 65.1 | (2) |
Proportion of infected persons without prophylaxis who have symptoms | θ1 | 0.50 | 0.67 | 0.80 | (9,15) |
Oseltamivir efficacy for preventing infection in exposed persons | ε1 | 0.28 | 0.35 | 0.52 | (9,16,17) |
Oseltamivir efficacy for preventing disease in infected persons | ε2 | 0.5 | 0.6 | 0.9 | (2,9) |
Oseltamivir efficacy for preventing transmission of infection by infected persons | ε3 | 0.6 | 0.8 | 0.98 | (9) |
Proportion of infected persons receiving oseltamivir prophylaxis who have symptoms | θ2 | 0.07 | - | 0.2 | Calculated, θ2 = θ1(1−ε2) |
Medical leave without treatment, d | σ | 2 | 4 | 5 | (2) |
Reduction in medical leave with oseltamivir treatment, d | χ | 0.1 | 1.0 | 2.0 | (2) |
Reduction in hospitalization or case-fatality rate with treatment | ψ | 0.4 | 0.6 | 0.8 | (2,18) |
*HCW, healthcare workers, ILI, influenzalike illness.
†Notations are used in the equations listed in the Appendix.
‡Base case values are given with the minimum and maximum values used in the model where applicable.
§Based on hospitalizations and deaths among those with clinical influenza.
References
- World Health Organization. Avian influenza and human pandemic influenza: summary report. Meeting held in Geneva, Switzerland, 7–9 Nov 2005. [cited 2006 Jan 15]. Available from http://www.who.int/mediacentre/events/2005/avian_influenza/summary_report_Nov_2005_meeting.pdf
- Lee VJ, Phua KH, Chen MI, Chow A, Ma S, Goh KT, Economics of neuraminidase inhibitor stockpiling for pandemic influenza, Singapore.Emerg Infect Dis. 2006;12:95–102.PubMedGoogle Scholar
- Balicer RD, Huerta M, Davidovitch N, Grotto I. Cost-benefit of stockpiling drugs for influenza pandemic.Emerg Infect Dis. 2005;11:1280.PubMedGoogle Scholar
- Cinti S, Chenoweth C, Monto AS. Preparing for pandemic influenza: should hospitals stockpile oseltamivir?Infect Control Hosp Epidemiol. 2005;26:852–4. DOIPubMedGoogle Scholar
- Nicholson KG, Aoki FY, Osterhaus AD, Trottier S, Carewicz O, Mercier CH, Efficacy and safety of oseltamivir in treatment of acute influenza: a randomized controlled trial.Lancet. 2000;355:1845–50. DOIPubMedGoogle Scholar
- Kaiser L, Wat C, Mills T, Mahoney P, Ward P, Hayden F. Impact of oseltamivir treatment on influenza-related lower respiratory tract complications and hospitalizations.Arch Intern Med. 2003;163:1667–72. DOIPubMedGoogle Scholar
- Cooper NJ, Sutton AJ, Abrams KR, Wailoo A, Turner D, Nicholson KG. Effectiveness of neuraminidase inhibitors in treatment and prevention of influenza A and B: systematic review and meta-analyses of randomised controlled trials.BMJ. 2003;326:1235. DOIPubMedGoogle Scholar
- Moscona A. Neuraminidase inhibitors for influenza.N Engl J Med. 2005;353:1363–73. DOIPubMedGoogle Scholar
- Longini IMJr, Halloran ME, Nizam A, Yang Y. Containing pandemic influenza with antiviral agents.Am J Epidemiol. 2004;159:623–33. DOIPubMedGoogle Scholar
- Salgado CD, Farr BM, Hall KK, Hayden FG. Influenza in the acute hospital setting.Lancet Infect Dis. 2002;2:145–55. DOIPubMedGoogle Scholar
- Chow A, Ma S, Ling AE, Chew SK. Influenza-associated deaths in tropical Singapore.Emerg Infect Dis. 2006;12:114–21.PubMedGoogle Scholar
- Singapore Department of Statistics. Key statistics. [cited 2005 Dec 21]. Available from http://www.singstat.gov.sg/
- Mills CE, Robins JM, Lipsitch M. Transmissibility of 1918 pandemic influenza.Nature. 2004;432:904–6. DOIPubMedGoogle Scholar
- Fraser C, Riley S, Anderson RM, Ferguson NM. Factors that make an infectious disease outbreak controllable.Proc Natl Acad Sci U S A. 2004;101:6146–51. DOIPubMedGoogle Scholar
- Hayden FG, Treanor JJ, Fritz RS, Lobo M, Betts RF, Miller M, Use of the oral neuraminidase inhibitor oseltamivir in experimental human influenza: randomized controlled trials for prevention and treatment.JAMA. 1999;282:1240–6. DOIPubMedGoogle Scholar
- Welliver R, Monto AS, Carewicz O, Schatteman E, Hassman M, Hedrick J, Oseltamivir Post Exposure Prophylaxis Investigator Group. Effectiveness of oseltamivir in preventing influenza in household contacts: a randomized controlled trial.JAMA. 2001;285:748–54. DOIPubMedGoogle Scholar
- Moscona A. Neuraminidase inhibitors for influenza.N Engl J Med. 2005;353:1363–73. DOIPubMedGoogle Scholar
- Glezen WP. Emerging infections: pandemic influenza.Epidemiol Rev. 1996;18:64–76.PubMedGoogle Scholar
- Influenza pandemic planning. Business continuity planning guide. New Zealand Ministry of Economic Development. [cited 2006 Jul 1]. Available from http://www.med.govt.nz/upload/27552/planning-guide.pdf
- Gani R. Potential impact of antiviral drug use during influenza pandemic.Emerg Infect Dis. 2005;11:1355–62.PubMedGoogle Scholar
- Chik KW, Li CK, Chan PKS, Shing MMK, Lee V, Tam JSL, Oseltamivir prophylaxis during the influenza season in a paediatric cancer centre: prospective observational study.Hong Kong Med J. 2004;10:103–6.PubMedGoogle Scholar
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