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Mitigation Measures for Pandemic Influenza in Italy: An Individual Based Model Considering Different Scenarios

Author

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  • Marta Luisa Ciofi degli Atti
  • Stefano Merler
  • Caterina Rizzo
  • Marco Ajelli
  • Marco Massari
  • Piero Manfredi
  • Cesare Furlanello
  • Gianpaolo Scalia Tomba
  • Mimmo Iannelli

Abstract

Background: Individual-based models can provide the most reliable estimates of the spread of infectious diseases. In the present study, we evaluated the diffusion of pandemic influenza in Italy and the impact of various control measures, coupling a global SEIR model for importation of cases with an individual based model (IBM) describing the Italian epidemic. Methodology/Principal Findings: We co-located the Italian population (57 million inhabitants) to households, schools and workplaces and we assigned travel destinations to match the 2001 census data. We considered different R0 values (1.4; 1.7; 2), evaluating the impact of control measures (vaccination, antiviral prophylaxis -AVP-, international air travel restrictions and increased social distancing). The administration of two vaccine doses was considered, assuming that first dose would be administered 1-6 months after the first world case, and different values for vaccine effectiveness (VE). With no interventions, importation would occur 37–77 days after the first world case. Air travel restrictions would delay the importation of the pandemic by 7–37 days. With an R0 of 1.4 or 1.7, the use of combined measures would reduce clinical attack rates (AR) from 21–31% to 0.3–4%. Assuming an R0 of 2, the AR would decrease from 38% to 8%, yet only if vaccination were started within 2 months of the first world case, in combination with a 90% reduction in international air traffic, closure of schools/workplaces for 4 weeks and AVP of household and school/work close contacts of clinical cases. Varying VE would not substantially affect the results. Conclusions: This IBM, which is based on country-specific demographic data, could be suitable for the real-time evaluation of measures to be undertaken in the event of the emergence of a new pandemic influenza virus. All preventive measures considered should be implemented to mitigate the pandemic.

Suggested Citation

  • Marta Luisa Ciofi degli Atti & Stefano Merler & Caterina Rizzo & Marco Ajelli & Marco Massari & Piero Manfredi & Cesare Furlanello & Gianpaolo Scalia Tomba & Mimmo Iannelli, 2008. "Mitigation Measures for Pandemic Influenza in Italy: An Individual Based Model Considering Different Scenarios," PLOS ONE, Public Library of Science, vol. 3(3), pages 1-11, March.
    • Handle: RePEc:plo:pone00:0001790
    DOI: 10.1371/journal.pone.0001790
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    References listed on IDEAS

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    1. Fabrizio Iozzi & Francesco Trusiano & Matteo Chinazzi & Francesco C Billari & Emilio Zagheni & Stefano Merler & Marco Ajelli & Emanuele Del Fava & Piero Manfredi, 2010. "Little Italy: An Agent-Based Approach to the Estimation of Contact Patterns- Fitting Predicted Matrices to Serological Data," PLOS Computational Biology, Public Library of Science, vol. 6(12), pages 1-10, December.
    2. Michele Tizzoni & Paolo Bajardi & Adeline Decuyper & Guillaume Kon Kam King & Christian M Schneider & Vincent Blondel & Zbigniew Smoreda & Marta C González & Vittoria Colizza, 2014. "On the Use of Human Mobility Proxies for Modeling Epidemics," PLOS Computational Biology, Public Library of Science, vol. 10(7), pages 1-15, July.
    3. Joel K Kelso & Nilimesh Halder & George J Milne, 2010. "The Impact of Case Diagnosis Coverage and Diagnosis Delays on the Effectiveness of Antiviral Strategies in Mitigating Pandemic Influenza A/H1N1 2009," PLOS ONE, Public Library of Science, vol. 5(11), pages 1-13, November.
    4. Stefano Merler & Marco Ajelli & Andrea Pugliese & Neil M Ferguson, 2011. "Determinants of the Spatiotemporal Dynamics of the 2009 H1N1 Pandemic in Europe: Implications for Real-Time Modelling," PLOS Computational Biology, Public Library of Science, vol. 7(9), pages 1-13, September.
    5. Marco Ajelli & Stefano Merler, 2012. "Transmission Potential and Design of Adequate Control Measures for Marburg Hemorrhagic Fever," PLOS ONE, Public Library of Science, vol. 7(12), pages 1-8, December.

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