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Rescinding community mitigation strategies in an influenza pandemic.

Davey VJ, Glass RJ - Emerging Infect. Dis. (2008)

Bottom Line: An unmitigated epidemic or strategy continuation for the epidemic duration served as control scenarios.If cases recurred, strategies were resumed at a predefined 10-case trigger, and epidemic recurrence was thwarted.Strategies were most effective when used with high compliance and when combined with stringent rescinding thresholds.

View Article: PubMed Central - PubMed

Affiliation: Office of Public Health and Environmental Hazards, Department of Veterans Affairs, Veterans Health Administration, 810 Vermont Ave NW, Mailcode 13, Washington, DC 20420, USA. victoria.davey@va.gov

ABSTRACT
Using a networked, agent-based computational model of a stylized community, we evaluated thresholds for rescinding 2 community mitigation strategies after an influenza pandemic. We ended child sequestering or all-community sequestering when illness incidence waned to thresholds of 0, 1, 2, or 3 cases in 7 days in 2 levels of pandemic severity. An unmitigated epidemic or strategy continuation for the epidemic duration served as control scenarios. The 0-case per 7-day rescinding threshold was comparable to the continuation strategy on infection and illness rates but reduced the number of days strategies would be needed by 6% to 32% in mild or severe pandemics. If cases recurred, strategies were resumed at a predefined 10-case trigger, and epidemic recurrence was thwarted. Strategies were most effective when used with high compliance and when combined with stringent rescinding thresholds. The need for strategies implemented for control of an influenza pandemic was reduced, without increasing illness rates.

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Related in: MedlinePlus

Severe epidemic (no. illness cases in a community of 10,000 by day) using 10 randomly selected simulations from 100 conducted for each scenario. Top panel shows unmitigated base case epidemic curves. Remaining panels show child sequestering strategy (dark lines) and community sequestering strategy (light lines). Each mitigation strategy is implemented at 90% compliance. (Note change in y-axis scale.)
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Figure 2: Severe epidemic (no. illness cases in a community of 10,000 by day) using 10 randomly selected simulations from 100 conducted for each scenario. Top panel shows unmitigated base case epidemic curves. Remaining panels show child sequestering strategy (dark lines) and community sequestering strategy (light lines). Each mitigation strategy is implemented at 90% compliance. (Note change in y-axis scale.)

Mentions: We provide scenario outcomes for mild (Appendix Table 1) and severe (online Appendix Table, available from Appendix Table 2) epidemics that compare the unmitigated base case, continuation strategies, and rescinding thresholds of 0, 1, 2, or 3 cases in 7 days (hereafter rescinding thresholds assume cases/7 days). Results are displayed for 50%–90% compliance in 10% increments. We also provide epidemic curves for mild (Figure 1) and severe (Figure 2) epidemics beginning with unmitigated epidemics, then with rescinding thresholds under varying conditions, and ending with continuation strategy plots. Both mitigation strategies (child sequestering and community sequestering) are plotted on each graph.


Rescinding community mitigation strategies in an influenza pandemic.

Davey VJ, Glass RJ - Emerging Infect. Dis. (2008)

Severe epidemic (no. illness cases in a community of 10,000 by day) using 10 randomly selected simulations from 100 conducted for each scenario. Top panel shows unmitigated base case epidemic curves. Remaining panels show child sequestering strategy (dark lines) and community sequestering strategy (light lines). Each mitigation strategy is implemented at 90% compliance. (Note change in y-axis scale.)
© Copyright Policy
Related In: Results  -  Collection

Show All Figures
getmorefigures.php?uid=PMC2570828&req=5

Figure 2: Severe epidemic (no. illness cases in a community of 10,000 by day) using 10 randomly selected simulations from 100 conducted for each scenario. Top panel shows unmitigated base case epidemic curves. Remaining panels show child sequestering strategy (dark lines) and community sequestering strategy (light lines). Each mitigation strategy is implemented at 90% compliance. (Note change in y-axis scale.)
Mentions: We provide scenario outcomes for mild (Appendix Table 1) and severe (online Appendix Table, available from Appendix Table 2) epidemics that compare the unmitigated base case, continuation strategies, and rescinding thresholds of 0, 1, 2, or 3 cases in 7 days (hereafter rescinding thresholds assume cases/7 days). Results are displayed for 50%–90% compliance in 10% increments. We also provide epidemic curves for mild (Figure 1) and severe (Figure 2) epidemics beginning with unmitigated epidemics, then with rescinding thresholds under varying conditions, and ending with continuation strategy plots. Both mitigation strategies (child sequestering and community sequestering) are plotted on each graph.

Bottom Line: An unmitigated epidemic or strategy continuation for the epidemic duration served as control scenarios.If cases recurred, strategies were resumed at a predefined 10-case trigger, and epidemic recurrence was thwarted.Strategies were most effective when used with high compliance and when combined with stringent rescinding thresholds.

View Article: PubMed Central - PubMed

Affiliation: Office of Public Health and Environmental Hazards, Department of Veterans Affairs, Veterans Health Administration, 810 Vermont Ave NW, Mailcode 13, Washington, DC 20420, USA. victoria.davey@va.gov

ABSTRACT
Using a networked, agent-based computational model of a stylized community, we evaluated thresholds for rescinding 2 community mitigation strategies after an influenza pandemic. We ended child sequestering or all-community sequestering when illness incidence waned to thresholds of 0, 1, 2, or 3 cases in 7 days in 2 levels of pandemic severity. An unmitigated epidemic or strategy continuation for the epidemic duration served as control scenarios. The 0-case per 7-day rescinding threshold was comparable to the continuation strategy on infection and illness rates but reduced the number of days strategies would be needed by 6% to 32% in mild or severe pandemics. If cases recurred, strategies were resumed at a predefined 10-case trigger, and epidemic recurrence was thwarted. Strategies were most effective when used with high compliance and when combined with stringent rescinding thresholds. The need for strategies implemented for control of an influenza pandemic was reduced, without increasing illness rates.

Show MeSH
Related in: MedlinePlus