Health Officials Could Contain Outbreak at Source, Studies Find
A plan that includes travel restrictions, quarantines and distribution of antiviral medications could contain an avian flu outbreak at the source in Southeast Asia, according to two new studies based on computer models that recently appeared in the journals Nature and Science, the AP/Long Island Newsday reports.
However, health officials would have to implement the plan within two days and limit the spread of avian flu to a few dozen cases -- a "challenge for an area where communications are often rudimentary and entire economies and transportation networks could be disrupted," the AP/Newsday reports (Verrengia, AP/Long Island Newsday, 8/3).
According to a study published in Nature, a plan that includes an international stockpile of three million doses of antiviral medications used to treat individuals infected with avian flu and those in the area of an outbreak, as well as school and workplace closures and other measures, would contain an outbreak 90% of the time. For the study, researchers simulated an outbreak of avian flu in Thailand amid a population of 85 million individuals in that nation and other regions in the area (CQ HealthBeat, 8/3).
The study found that health officials would have to identify the avian flu outbreak after as few as 30 individuals became infected to limit the spread of the disease to 200 cases. Health officials also would have to distribute antiviral medications to 20,000 individuals in the area, according to the study.
Neil Ferguson of Imperial College in London and lead author of the study said, "We just can't cherry-pick the more easily implemented solutions." He added that, after an avian flu outbreak spreads to mobile, urban nations such as the U.S. or Britain, the "chances of stamping out the pandemic are poor."
The study published in Science focused on urban transmission of avian flu and found that vaccination of 50% of an affected neighborhood would reduce the spread of an outbreak to one case per 1,000 individuals within two weeks.
For the study, Ira Longini, a biostatistician at Emory University, and colleagues simulated an outbreak of avian flu in Thailand among a population of 500,000 individuals in places such as households, neighborhoods, schools, workplaces, a hospital, markets and a temple (AP/Long Island Newsday, 8/3).
"Basically you contain it at the source or you fail," Longini said.
"The models show that if you combine well-directed, targeted treatment with some social interventions like closing schools -- ideally together with some vaccination -- it's conceivable you'd be able to stop the epidemic," Anthony Fauci -- director of the National Institute of Allergy and Infectious Diseases at NIH, which funded much of the studies through the National Institute of General Medical Sciences -- said. However, Fauci and other health officials said that containment of an avian flu outbreak involves many "ifs" (Weiss, Washington Post, 8/4).
In a statement, the World Health Organization said that nations worldwide must improve disease surveillance and early reporting programs to help prevent an avian flu outbreak. Margaret Chan, director of infectious disease surveillance and response at WHO, added that the studies assume the effectiveness of antiviral medications against avian flu. "It's possible that we end up with a strain that doesn't respond to the type of drug stockpiled," she said (AP/Long Island Newsday, 8/3).
C-SPAN's "Washington Journal" on Thursday included an interview with Laurie Garrett, senior fellow for global health at the Council on Foreign Relations, about the potential for an avian flu outbreak ("Washington Journal," C-SPAN, 8/4). The complete segment will be available online in RealPlayer and Windows Media after the broadcast.