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Bird Flu Could Be Stopped -- If Everything Is Aligned Right
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That is where the new models come in. By mapping as precisely as possible how a newly contagious strain would spread from a single inaugural patient in rural Asia, scientists can see how best to deploy their few medications and initiate other strategies.
Both models used rural Thailand as their starting point -- not because it is the most likely place for an outbreak to begin but because sociologists have collected detailed information on "social networks" in that region. Such studies show age ranges and household sizes in rural Thai society and describe the frequency and nature of social interactions, including trips to shops, schools and temples, to estimate how many others these people are likely to come into contact with.
With that information as a foundation, and with added assumptions about viral behavior based on previous pandemics, the two studies came to similar conclusions.
Ferguson's program found, for example, that in the absence of emergency control measures, much of the country would be peppered with cases within a month after the first patient got sick, making containment virtually impossible.
By contrast, there would be about a 90 percent chance of stanching the epidemic if the outbreak were recognized at a point when only about 20 people had grown ill -- and if 10-day courses of Tamiflu were then quickly distributed to all the patients' classmates, workmates and household members.
Both models showed better odds of success if drugs were supplied more broadly to everyone living within a few miles of each case, if quarantines were imposed, and if even partially effective experimental vaccines were used.
All told, it might take 100,000 to 3 million 10-day courses of Tamiflu to achieve control, the models predict.
WHO has about 120,000 courses stockpiled and says it can get them anywhere in the world within a week. The United States has about 2.3 million courses but, like most countries, has not announced a clear policy on sharing.
Michael T. Osterholm, director of the Center for Infectious Disease Research and Policy at the University of Minnesota, expressed doubts that nations would be able to respond as quickly and efficiently as the models require.
Few countries in South Asia have the capacity to detect and verify cases quickly, he noted, adding that many send blood tests out of the country for processing.
