Project Details
Introduction
The overarching objective of this project is to address a key requirement for Europe, which is to have systems in place for the development of coherent, evidence-based and publicly acceptable policy, planning and response procedures to mitigate the potentially devastating public health impacts of the next influenza pandemic.
In 1997, a novel highly pathogenic avian H5N1 virus emerged in Hong Kong which was capable of infecting humans. Of 18 people infected, 6 died and the entire poultry population of Hong Kong was culled to control the avian outbreak. In 2003 the virus re-emerged in SE Asia, and spread rapidly, apparently via a mixture of domesticated poultry and wild bird movements. By April 11 2007, some 291 human infections with H5N1 had been reported to WHO, of which 172 died. Transmission from person-to-person has been suspected in a handful of cases, usually within families or households, but as yet, the human to human transmissibility of the virus is far below that required to cause a human epidemic. However the H5N1 virus, like all other influenza strains, shows rapid evolution and poses a clear if unquantifiable pandemic risk – namely while human infections continue, there is a risk that the virus will adapt in an infected human host to be more transmissible to other people. Should the virus adapt enough to permit efficient transmission between humans, a devastating pandemic could result.
During the last century there were 3 influenza pandemics, the most devastating in 1918-20 which killed 20 to 50 million people worldwide. Considering that since 1918 the world’s population has more than tripled and that global travelling and urbanisation have increased dramatically, it is easy to understand the pessimistic scenarios predicted in many recent studies in case of a future pandemic, with huge human and economic losses. The lethality of the H5N1 virus has motivated intensive pandemic planning in many countries, with several intervention strategies being suggested by WHO (World Health Organisation), involving both medical and public health countermeasures.
Measures such as travel restrictions, school and workplaces closure, antiviral prophylaxis, vaccination, case isolation, quarantine may all be useful, but need careful and timely study to evaluate their effectiveness and feasibility. Antiviral and vaccine availability will be limited for most of the world’s population, vaccine production will need time and non-pharmaceutical interventions involving social distancing may have negative consequences.
In this context, mathematical models are powerful tools for simulating realistic pandemic spread scenarios and for evaluation of the potential impact of control policies. They may be useful to develop a strategy for use of public health interventions, to set priorities and to establish criteria for deployment and use of antivirals and vaccine. There has been much activity and some progress in such studies recently, aided by advances in computational power and data availability. More generally, recent work has illustrated the ability of mathematical models to predict the course of actual epidemics, and to help in the design of control measures, as shown in the 2001 foot-and-mouth disease (FMD) epidemic in UK cattle and in the global outbreak of severe acute respiratory syndrome (SARS). This project will develop a methodological framework, supporting data and computational tools for modelling the spread of an emerging influenza pandemic, and for advance planning and real-time refinement of containment and mitigation strategies. In doing so, it will build on the modelling tools and the knowledge of contact patterns developed in other projects (INFTRANS and POLYMOD in particular).
Steering Committee
The Steering Committee is composed by:
- Angus Nicoll , ECDC, Sweden
- Sylvie Briand, WHO
- Jean-Claude Desenclos, Institut de Veille Sanitaire, France
- Peter Grove, Department of Health, UK
- Nigel Lightfoot, Health Protection Agency, UK
- Sandro Bonfigli, Health Ministry, Italy