Using household-based measures to reduce the impact of a flu pandemic
Levels of death and disease during a flu pandemic could be dramatically reduced by household interventions such as voluntary quarantine, according to new research published this week. With the ongoing outbreak of H5N1 strain influenza in birds, there is real concern that the next flu epidemic in humans could be just around the corner. Currently much attention is on the development of flu vaccines and treatments. However, complete control of the pandemic is unlikely to be feasible with mass vaccination and antiviral treatment alone. Joseph Wu of the University of Hong Kong, together with colleagues from the UK and the US, looked at how altering human behaviour could help to reduce the spread of the disease. They set up a computer model to see what would happen if a flu virus similar to the 1918 strain were to arise. Their findings are published in the journal PLoS Medicine. Their aim was to see what measures would bring down the proportion of the population infected during the first wave of a flu pandemic. This is regulated by the average number of people infected by one contagious person. Measures studied by the team were quarantine and isolation. Under quarantine, household contacts of a suspected case remain in the home, cut off from the rest of the community. Under isolation, individuals with symptoms are removed from the home to a separate facility. The researchers assumed that 50 per cent of the population would comply with these measures. Even at this relatively conservative rate, the measures had a clear impact on the pandemic. They found that a combination of quarantine, isolation and targeted prophylactic use of anti-virals could reduce the proportion of people falling ill during the first year of the pandemic from 49 per cent to 27 per cent. In a city the size of Hong Kong (6.8 million people), this corresponds to a reduction in the number of deaths by 16,000. As the researchers point out, these policies will entail disruptions - at the peak of the pandemic 6.2 per cent of the population will be in quarantine in their homes, meaning authorities will have to find a way of getting food, drink and medicines to these people. They will also need to ensure isolation facilities are available to take in just under 0.8 per cent of the population, and oversee the effective distribution of anti-viral drugs. The researchers suggest that although these measures would entail disruptions to society, this would be preferable to the collapse of vital services which could occur if the pandemic is not controlled. The researchers hope that their work will help authorities to draw up flu pandemic preparedness plans.
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Hong Kong