TY - JOUR AU - van den Dool, Carline AU - Hak, Eelko AU - Bonten, Marc J.M. AU - Wallinga, Jacco T1 - A Model-based Assessment of Oseltamivir Prophylaxis Strategies to Prevent Influenza in Nursing Homes T2 - Emerging Infectious Disease journal PY - 2009 VL - 15 IS - 10 SP - 1547 SN - 1080-6059 AB - Prophylaxis with neuraminidase inhibitors is important for controlling seasonal influenza outbreaks in long-term care settings. We used a stochastic individual-based model that simulates influenza virus transmission in a long-term care nursing home department to study the protection offered to patients by different strategies of prophylaxis with oseltamivir and determined the effect of emerging resistance. Without resistance, postexposure and continuous prophylaxis reduced the patient infection attack rate from 0.19 to 0.13 (relative risk [RR] 0.67) and 0.05 (RR 0.23), respectively. Postexposure prophylaxis prevented more infections per dose (118 and 323 daily doses needed to prevent 1 infection, respectively) and required fewer doses per season than continuous prophylaxis. If resistance to oseltamivir was increased, both prophylaxis strategies became less efficacious and efficient, but postexposure prophylaxis posed a lower selection pressure for resistant virus strains. Extension of prophylaxis to healthcare workers offered little additional protection to patients. KW - Influenza KW - oseltamivir KW - nursing homes KW - outbreak control KW - resistance KW - prophylaxis KW - prevention KW - simulation model KW - research KW - expedited KW - the Netherlands DO - 10.3201/eid1510.081129 UR - https://wwwnc.cdc.gov/eid/article/15/10/08-1129_article ER - End of Reference