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Volume 23, Number 1—January 2017


Modeling Tool for Decision Support during Early Days of an Anthrax Event

Gabriel RainischComments to Author , Martin I. Meltzer1, Sean Shadomy, William A. Bower, and Nathaniel Hupert1
Author affiliations: Centers for Disease Control and Prevention, Atlanta, Georgia, USA (G. Rainisch, M.I. Meltzer, S. Shadomy, W.A. Bower, N. Hupert); Weill Cornell Medical College and New York–Presbyterian Hospital, New York, New York, USA (N. Hupert)

Main Article

Table 3

PEP scenarios, by campaign logistics and antimicrobial drug use components*

Scenario (description) Logistics components   Drug-use components
Scenario 1 (no PEP) Not applicable   Not applicable
Scenario 2 (ideal) 1-day delay,† 1-day campaign   90% uptake,‡ 80% adherence§
Scenario 3 (practical: logistics follow CRI guidance, and utilization data based on the Amerithrax attacks) 2-day delay,† 2-day campaign   65% uptake,‡ 40% adherence§
Scenario 4 (constrained) 2-day delay,† 4-day campaign   40% uptake,‡ 25% adherence§

*Amerithrax, anthrax attacks in the United States during 2001; CRI, Cities Readiness Initiative; PEP, postexposure prophylaxis.
†Delay days are determined by counting the days from the date of earliest illness onset (i.e., event day 1). Public health messaging also begins on the same day as the campaign. The delay dictates the number of days of case data potentially available as input. Two days of case data are available as input in Scenario 2, and 3 days are available as input in Scenarios 3 and 4.
‡Proportion of the population targeted by public health officials to receive PEP who actually obtain and start PEP (11).
§Proportion fully adhering to the PEP regimen on event day 60 (18).

Main Article

1These senior authors contributed equally to this article.