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Assessing the Best Way to Prevent Spread of Influenza FREE

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The summary below is from the full reports titled “Effectiveness and Cost-Effectiveness of Vaccination Against Pandemic Influenza (H1N1) 2009” and “Effectiveness and Cost-Effectiveness of Expanded Antiviral Prophylaxis and Adjuvanted Vaccination Strategies for an Influenza A (H5N1) Pandemic.” They are in the 15 December issue of Annals of Internal Medicine (volume 151, pages 829-839 and pages 840-853). The first report was written by N. Khazeni, D.W. Hutton, A.M. Garber, N. Hupert, and D.K. Owens; the second report was written by N. Khazeni, D.W. Hutton, A.M. Garber, and D.K. Owens.


Ann Intern Med. 2009;151(12):I-31. doi:10.7326/0000605-200912150-00161
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What is the problem and what is known about it so far?

Influenza is a virus that normally causes fever, sneezing, coughing, muscle aches, and exhaustion in colder months. The virus constantly changes, however, and the changes can make influenza spread more easily throughout the year or make it more dangerous.

Influenza that spreads so easily that it infects many people in many different places is called pandemic influenza. Pandemic influenza may cause mild illness or serious illness leading to death. Public health authorities around the world have been thinking about ways to use vaccines and drugs to prevent the spread of pandemic influenza. There are 2 kinds of influenza that authorities are worried about. The first kind, H1N1 influenza or “swine flu,” spreads easily in humans but is generally less dangerous. The second kind, H5N1 influenza or “bird flu,” has so far not spread that easily in humans. However, the second kind seems more dangerous, and people think it soon may spread easily in humans.

Why did the researchers do this particular study?

To assess the best way to prepare for pandemic influenza.

Who was studied?

The study involved computer calculations; no actual people participated.

How was the study done?

The researchers used a computer model to estimate what would happen to a group of people living in a city like New York during a swine flu and bird flu pandemic if they did or did not get vaccines and drugs at certain times. They used the estimates to assess the costs and benefits of different combinations of vaccines, drugs, and timing.

What did the researchers find?

In the study of bird flu, the researchers found that giving many people a vaccine that has an agent to boost their immune response is better than other combinations of vaccine and drugs. In the study of swine flu, the researchers found that vaccinating people even a few weeks sooner rather than later prevents more illness and deaths.

What were the limitations of the study?

The studies apply to large groups of people. They do not tell individual people what treatments they should want or request from doctors and clinics. The researchers did not compare vaccines and drugs to prevention strategies, such as handwashing and avoiding people with influenza, which may be sufficient to prevent influenza in many people. The vaccine that boosts the immune system is not yet widely available in the United States. The researchers made many assumptions that might not occur in a real pandemic.

What are the implications of the study?

The spread of influenza can be prevented with vaccines and drugs. The researchers' analyses give governments and public health authorities some guidance about how to use them most efficiently.

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