A Model-based Assessment of Oseltamivir Prophylaxis Strategies to Prevent Influenza in Nursing Homes
Prophylaxis with neuraminidase inhibitors is important for controlling seasonal influenza outbreaks in long-term care settings. We used a stochastic individual-based model that simulates influenza virus transmission in a long-term care nursing home department to study the protection offered to patie...
| Main Authors: | , , , |
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| Format: | Article |
| Language: | English |
| Published: |
Centers for Disease Control and Prevention
2009-10-01
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| Series: | Emerging Infectious Diseases |
| Subjects: | |
| Online Access: | https://wwwnc.cdc.gov/eid/article/15/10/08-1129_article |
| _version_ | 1819263125600337920 |
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| author | Carline van den Dool Eelko Hak Marc J.M. Bonten Jacco Wallinga |
| author_facet | Carline van den Dool Eelko Hak Marc J.M. Bonten Jacco Wallinga |
| author_sort | Carline van den Dool |
| collection | DOAJ |
| description | Prophylaxis with neuraminidase inhibitors is important for controlling seasonal influenza outbreaks in long-term care settings. We used a stochastic individual-based model that simulates influenza virus transmission in a long-term care nursing home department to study the protection offered to patients by different strategies of prophylaxis with oseltamivir and determined the effect of emerging resistance. Without resistance, postexposure and continuous prophylaxis reduced the patient infection attack rate from 0.19 to 0.13 (relative risk [RR] 0.67) and 0.05 (RR 0.23), respectively. Postexposure prophylaxis prevented more infections per dose (118 and 323 daily doses needed to prevent 1 infection, respectively) and required fewer doses per season than continuous prophylaxis. If resistance to oseltamivir was increased, both prophylaxis strategies became less efficacious and efficient, but postexposure prophylaxis posed a lower selection pressure for resistant virus strains. Extension of prophylaxis to healthcare workers offered little additional protection to patients. |
| first_indexed | 2024-12-23T20:08:37Z |
| format | Article |
| id | doaj.art-a3c61807e2324a4b964bd82f3fb0abf2 |
| institution | Directory Open Access Journal |
| issn | 1080-6040 1080-6059 |
| language | English |
| last_indexed | 2024-12-23T20:08:37Z |
| publishDate | 2009-10-01 |
| publisher | Centers for Disease Control and Prevention |
| record_format | Article |
| series | Emerging Infectious Diseases |
| spelling | doaj.art-a3c61807e2324a4b964bd82f3fb0abf22022-12-21T17:32:52ZengCenters for Disease Control and PreventionEmerging Infectious Diseases1080-60401080-60592009-10-0115101547155510.3201/eid1510.081129A Model-based Assessment of Oseltamivir Prophylaxis Strategies to Prevent Influenza in Nursing HomesCarline van den DoolEelko HakMarc J.M. BontenJacco WallingaProphylaxis with neuraminidase inhibitors is important for controlling seasonal influenza outbreaks in long-term care settings. We used a stochastic individual-based model that simulates influenza virus transmission in a long-term care nursing home department to study the protection offered to patients by different strategies of prophylaxis with oseltamivir and determined the effect of emerging resistance. Without resistance, postexposure and continuous prophylaxis reduced the patient infection attack rate from 0.19 to 0.13 (relative risk [RR] 0.67) and 0.05 (RR 0.23), respectively. Postexposure prophylaxis prevented more infections per dose (118 and 323 daily doses needed to prevent 1 infection, respectively) and required fewer doses per season than continuous prophylaxis. If resistance to oseltamivir was increased, both prophylaxis strategies became less efficacious and efficient, but postexposure prophylaxis posed a lower selection pressure for resistant virus strains. Extension of prophylaxis to healthcare workers offered little additional protection to patients.https://wwwnc.cdc.gov/eid/article/15/10/08-1129_articleInfluenzaoseltamivirnursing homesoutbreak controlresistanceprophylaxis |
| spellingShingle | Carline van den Dool Eelko Hak Marc J.M. Bonten Jacco Wallinga A Model-based Assessment of Oseltamivir Prophylaxis Strategies to Prevent Influenza in Nursing Homes Emerging Infectious Diseases Influenza oseltamivir nursing homes outbreak control resistance prophylaxis |
| title | A Model-based Assessment of Oseltamivir Prophylaxis Strategies to Prevent Influenza in Nursing Homes |
| title_full | A Model-based Assessment of Oseltamivir Prophylaxis Strategies to Prevent Influenza in Nursing Homes |
| title_fullStr | A Model-based Assessment of Oseltamivir Prophylaxis Strategies to Prevent Influenza in Nursing Homes |
| title_full_unstemmed | A Model-based Assessment of Oseltamivir Prophylaxis Strategies to Prevent Influenza in Nursing Homes |
| title_short | A Model-based Assessment of Oseltamivir Prophylaxis Strategies to Prevent Influenza in Nursing Homes |
| title_sort | model based assessment of oseltamivir prophylaxis strategies to prevent influenza in nursing homes |
| topic | Influenza oseltamivir nursing homes outbreak control resistance prophylaxis |
| url | https://wwwnc.cdc.gov/eid/article/15/10/08-1129_article |
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