Role of Antiviral

Toronto, Canada 17 - 23 June, 2007
Symposium highlights: From seasonal to pandemic
influenza: antiviral strategies for effective control⁸

The strategy for nations looking cautiously towards an influenza pandemic is fairly simple: stockpile antivirals and use them until the vaccine is ready, at least six months after the first efficient human-to-human transmission of the pandemic virus. That is the scenario that Professor Arnold Monto, professor of epidemiology at the University of Michigan believes is the best to handle the pandemic. "An influenza pandemic is inevitable," Professor Monto said. "We don't know when it will come, or even if it will be an H5N1 influenza strain derived from the virus circulating now among birds around the world." The question is what coverage of the population with antiviral medication would provide the best strategy to control a pandemic.

In Professor Monto's presentation entitled Update on antiviral therapy in pandemic influenza management, he noted that current concerns of a pandemic stem from the 1997 H5N1 outbreak in Hong Kong when influenza killed six of the 18 people who contracted the virus in a poultry market. Since then the virus has re-emerged in Vietnam, China, Indonesia, Turkey, Egypt and elsewhere, killing about 60% of the people who become infected. He said that governments are determining what levels of stockpiling must be maintained to control the pandemic and the size of the stockpile will determine what can be done in controlling the early phase of the pandemic.

If a pandemic strikes, Dr Neil Ferguson, a pandemic modelling expert and Director of the MRC Centre for Outbreak Analysis and Modelling at Imperial College London, estimated that from the first case to enter the US, it would take 2 to 3 months for the pandemic to peak, at which point up to 5 million people a day might be becoming ill. Overall around a third of the population might become ill in the first wave. "Antivirals will be a key component of containment and mitigation."

The symposium was chaired by Professor John Oxford, professor of virology at St Bartholomew's and the Royal London School of Medicine and Dentistry. He added, "The seriousness of an influenza pandemic cannot be over emphasised. It attacks people of all ages and of all races and of all nationalities. The pandemic will spare no one and no nation will escape it."

Reference:
8.	Options for the Control of Influenza VI conference: Conference Highlight. OPTION VI, Toronto, Canada, 17-23 June, 2007.