Modeling influenza epidemics and pandemics: insights into the future of swine flu (H1N1)
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BioMed Central
Open Access
Review
Modeling influenza epidemics and pandemics: insights into the future of swine flu (H1N1) Brian J Coburn, Bradley G Wagner and Sally Blower* Address: Biomedical Modeling Center, Semel Institute of Neuroscience & Human Behavior, David Geffen School of Medicine at UCLA, Los Angeles, CA, USA Email: Brian J Coburn - [email protected]; Bradley G Wagner - [email protected]; Sally Blower* - [email protected] * Corresponding author
Published: 22 June 2009 BMC Medicine 2009, 7:30
doi:10.1186/1741-7015-7-30
Received: 2 June 2009 Accepted: 22 June 2009
This article is available from: http://www.biomedcentral.com/1741-7015/7/30 © 2009 Blower et al.; licensee BioMed Central Ltd. This is an open access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
Abstract Here we present a review of the literature of influenza modeling studies, and discuss how these models can provide insights into the future of the currently circulating novel strain of influenza A (H1N1), formerly known as swine flu. We discuss how the feasibility of controlling an epidemic critically depends on the value of the Basic Reproduction Number (R0). The R0 for novel influenza A (H1N1) has recently been estimated to be between 1.4 and 1.6. This value is below values of R0 estimated for the 1918–1919 pandemic strain (mean R0~2: range 1.4 to 2.8) and is comparable to R0 values estimated for seasonal strains of influenza (mean R0 1.3: range 0.9 to 2.1). By reviewing results from previous modeling studies we conclude it is theoretically possible that a pandemic of H1N1 could be contained. However it may not be feasible, even in resource-rich countries, to achieve the necessary levels of vaccination and treatment for control. As a recent modeling study has shown, a global cooperative strategy will be essential in order to control a pandemic. This strategy will require resource-rich countries to share their vaccines and antivirals with resourceconstrained and resource-poor countries. We conclude our review by discussing the necessity of developing new biologically complex models. We suggest that these models should simultaneously track the transmission dynamics of multiple strains of influenza in bird, pig and human populations. Such models could be critical for identifying effective new interventions, and informing pandemic preparedness planning. Finally, we show that by modeling cross-species transmission it may be possible to predict the emergence of pandemic strains of influenza.
Introduction Mathematical models have been used to understand the spatial-temporal transmission dynamics of influenza. They have also been used as health policy tools to predict the effect of public health interventions on mitigating future epidemics or pandemics. The potential epidemiological impact of both behavioral and biomedical
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