Targeted post-exposure prophylaxis represents a more efficient use of the stockpile than treatment alone
With the emergence of H1N1 influenza 09 (novel human swine influenza A[H1N1] 2009), efforts to control the spread and mitigate the impact of this virus have been implemented. The Australian health management plan for pandemic influenza (2008)1 (AHMPPI) outlines a range of strategies aimed at eliminating an outbreak where possible (the “Contain” response), or reducing transmission sufficiently to allow distribution of a targeted vaccine (the “Sustain” response). Following evidence of sustained transmission within Victoria in May 2009, state and territory health departments began implementing the Contain response, with a switch to a modified Sustain response in Victoria within weeks.
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We thank Julie Hall (World Health Organization Regional Office for the Western Pacific), Niels Becker (National Centre for Epidemiology and Population Health, Australian National University), John Mathews, Chris McCaw and Paul Pallaghy (Melbourne School of Population Health, University of Melbourne) for discussions and comments during development of the modelling approaches that underpin this article, and members of the Scientific Influenza Advisory Group of the Chief Medical Officer of Australia for their comments. The outlined modelling studies were funded by the Australian Government Department of Health and Ageing, the National Health and Medical Research Council (NHMRC) and the United States National Institutes of Health (Models of Infectious Disease Agent Study).
Marc Lipsitch has received consulting fees from the Avian/Pandemic Flu Registry, which is partly supported by Roche.