Community-based measures for mitigating the 2009 H1N1 pandemic in China.

Since the emergence of influenza A/H1N1 pandemic virus in March-April 2009, very stringent interventions including Fengxiao were implemented to prevent importation of infected cases and decelerate the disease spread in mainland China. The extent to which these measures have been effective remains el...

Full description

Bibliographic Details
Main Authors: Sanyi Tang, Yanni Xiao, Youping Yang, Yicang Zhou, Jianhong Wu, Zhien Ma
Format: Article
Language:English
Published: Public Library of Science (PLoS) 2010-01-01
Series:PLoS ONE
Online Access:http://europepmc.org/articles/PMC2887838?pdf=render
id doaj-1753fa4e06444cafa1a2c8f599430fca
record_format Article
spelling doaj-1753fa4e06444cafa1a2c8f599430fca2020-11-25T01:57:54ZengPublic Library of Science (PLoS)PLoS ONE1932-62032010-01-0156e1091110.1371/journal.pone.0010911Community-based measures for mitigating the 2009 H1N1 pandemic in China.Sanyi TangYanni XiaoYouping YangYicang ZhouJianhong WuZhien MaSince the emergence of influenza A/H1N1 pandemic virus in March-April 2009, very stringent interventions including Fengxiao were implemented to prevent importation of infected cases and decelerate the disease spread in mainland China. The extent to which these measures have been effective remains elusive. We sought to investigate the effectiveness of Fengxiao that may inform policy decisions on improving community-based interventions for management of on-going outbreaks in China, in particular during the Spring Festival in mid-February 2010 when nationwide traveling will be substantially increased. We obtained data on initial laboratory-confirmed cases of H1N1 in the province of Shaanxi and used Markov-chain Monte-Carlo (MCMC) simulations to estimate the reproduction number. Given the estimates for the exposed and infectious periods of the novel H1N1 virus, we estimated a mean reproduction number of 1.68 (95% CI 1.45-1.92) and other A/H1N1 epidemiological parameters. Our results based on a spatially stratified population dynamical model show that the early implementation of Fengxiao can delay the epidemic peak significantly and prevent the disease spread to the general population but may also, if not implemented appropriately, cause more severe outbreak within universities/colleges, while late implementation of Fengxiao can achieve nothing more than no implementation. Strengthening local control strategies (quarantine and hygiene precaution) is much more effective in mitigating outbreaks and inhibiting the successive waves than implementing Fengxiao. Either strong mobility or high transport-related transmission rate during the Spring Festival holiday will not reverse the ongoing outbreak, but both will result in a large new wave. The findings suggest that Fengxiao and travel precautions should not be relaxed unless strict measures of quarantine, isolation, and hygiene precaution practices are put in place. Integration and prompt implementation of these interventions can significantly reduce the overall attack rate of pandemic outbreaks.http://europepmc.org/articles/PMC2887838?pdf=render
collection DOAJ
language English
format Article
sources DOAJ
author Sanyi Tang
Yanni Xiao
Youping Yang
Yicang Zhou
Jianhong Wu
Zhien Ma
spellingShingle Sanyi Tang
Yanni Xiao
Youping Yang
Yicang Zhou
Jianhong Wu
Zhien Ma
Community-based measures for mitigating the 2009 H1N1 pandemic in China.
PLoS ONE
author_facet Sanyi Tang
Yanni Xiao
Youping Yang
Yicang Zhou
Jianhong Wu
Zhien Ma
author_sort Sanyi Tang
title Community-based measures for mitigating the 2009 H1N1 pandemic in China.
title_short Community-based measures for mitigating the 2009 H1N1 pandemic in China.
title_full Community-based measures for mitigating the 2009 H1N1 pandemic in China.
title_fullStr Community-based measures for mitigating the 2009 H1N1 pandemic in China.
title_full_unstemmed Community-based measures for mitigating the 2009 H1N1 pandemic in China.
title_sort community-based measures for mitigating the 2009 h1n1 pandemic in china.
publisher Public Library of Science (PLoS)
series PLoS ONE
issn 1932-6203
publishDate 2010-01-01
description Since the emergence of influenza A/H1N1 pandemic virus in March-April 2009, very stringent interventions including Fengxiao were implemented to prevent importation of infected cases and decelerate the disease spread in mainland China. The extent to which these measures have been effective remains elusive. We sought to investigate the effectiveness of Fengxiao that may inform policy decisions on improving community-based interventions for management of on-going outbreaks in China, in particular during the Spring Festival in mid-February 2010 when nationwide traveling will be substantially increased. We obtained data on initial laboratory-confirmed cases of H1N1 in the province of Shaanxi and used Markov-chain Monte-Carlo (MCMC) simulations to estimate the reproduction number. Given the estimates for the exposed and infectious periods of the novel H1N1 virus, we estimated a mean reproduction number of 1.68 (95% CI 1.45-1.92) and other A/H1N1 epidemiological parameters. Our results based on a spatially stratified population dynamical model show that the early implementation of Fengxiao can delay the epidemic peak significantly and prevent the disease spread to the general population but may also, if not implemented appropriately, cause more severe outbreak within universities/colleges, while late implementation of Fengxiao can achieve nothing more than no implementation. Strengthening local control strategies (quarantine and hygiene precaution) is much more effective in mitigating outbreaks and inhibiting the successive waves than implementing Fengxiao. Either strong mobility or high transport-related transmission rate during the Spring Festival holiday will not reverse the ongoing outbreak, but both will result in a large new wave. The findings suggest that Fengxiao and travel precautions should not be relaxed unless strict measures of quarantine, isolation, and hygiene precaution practices are put in place. Integration and prompt implementation of these interventions can significantly reduce the overall attack rate of pandemic outbreaks.
url http://europepmc.org/articles/PMC2887838?pdf=render
work_keys_str_mv AT sanyitang communitybasedmeasuresformitigatingthe2009h1n1pandemicinchina
AT yannixiao communitybasedmeasuresformitigatingthe2009h1n1pandemicinchina
AT youpingyang communitybasedmeasuresformitigatingthe2009h1n1pandemicinchina
AT yicangzhou communitybasedmeasuresformitigatingthe2009h1n1pandemicinchina
AT jianhongwu communitybasedmeasuresformitigatingthe2009h1n1pandemicinchina
AT zhienma communitybasedmeasuresformitigatingthe2009h1n1pandemicinchina
_version_ 1724971817767010304