Impact of Emerging Antiviral Drug Resistance on Influenza Containment and Spread: Influence of Subclinical Infection and Strategic Use of a Stockpile Containing One or Two Drugs
2008

Impact of Antiviral Drug Resistance on Influenza Control

publication Evidence: moderate

Author Information

Author(s): James M. McCaw, James G. Wood, Christopher T. McCaw, Jodie McVernon

Primary Institution: Murdoch Childrens Research Institute and Melbourne School of Population Health, The University of Melbourne

Hypothesis

How do subclinical infections and strategic use of antiviral stockpiles influence the emergence of drug resistance during influenza outbreaks?

Conclusion

Using different antiviral drugs for treatment and prophylaxis can effectively control influenza transmission while minimizing drug resistance.

Supporting Evidence

  • Combined treatment and prophylaxis strategies are optimal for controlling transmission.
  • Using separate drugs for treatment and prophylaxis reduces the emergence of resistant strains.
  • High fitness costs in resistant strains provide some reassurance for health policy planners.

Takeaway

When there's an outbreak of flu, using two different medicines can help stop the spread and make it harder for the virus to become resistant to the drugs.

Methodology

A deterministic model of influenza transmission was developed to simulate treatment and prophylaxis using a limited stockpile of antiviral agents, incorporating factors like subclinical infections and drug resistance.

Potential Biases

The model assumes resistance arises only within treated hosts, which may not reflect real-world scenarios where resistance can develop in untreated populations.

Limitations

The model makes several simplifying assumptions and does not account for the stochastic nature of early epidemic stages or resistance emergence outside treated hosts.

Participant Demographics

The model considers a large population of 20 million people but does not specify detailed demographics.

Digital Object Identifier (DOI)

10.1371/journal.pone.0002362

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