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. 2007 Mar;13(3):449-57.
doi: 10.3201/eid1303.060309.

Effectiveness of neuraminidase inhibitors for preventing staff absenteeism during pandemic influenza

Vernon J Lee  1 , Mark I Chen
Affiliations

Effectiveness of neuraminidase inhibitors for preventing staff absenteeism during pandemic influenza

Vernon J Lee et al. Emerg Infect Dis. 2007 Mar.

Abstract

We used a deterministic SEIR (susceptible-exposed-infectious-removed) meta-population model, together with scenario, sensitivity, and simulation analyses, to determine stockpiling strategies for neuraminidase inhibitors that would minimize absenteeism among healthcare workers. A pandemic with a basic reproductive number (R0) of 2.5 resulted in peak absenteeism of 10%. Treatment decreased peak absenteeism to 8%, while 8 weeks' prophylaxis reduced it to 2%. For pandemics with higher R0, peak absenteeism exceeded 20% occasionally and 6 weeks' prophylaxis reduced peak absenteeism by 75%. Insufficient duration of prophylaxis increased peak absenteeism compared with treatment only. Earlier pandemic detection and initiation of prophylaxis may render shorter prophylaxis durations ineffective. Eight weeks' prophylaxis substantially reduced peak absenteeism under a broad range of assumptions for severe pandemics (peak absenteeism > 10%). Small investments in treatment and prophylaxis, if adequate and timely, can reduce absenteeism among essential staff.

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Figures

Figure 1
Figure 1
A) Modified SEIR (susceptible-exposed-infectious-removed) model for transmission of pandemic influenza within the general population and healthcare worker (HCW) subpopulation. B) Absenteeism among exposed HCWs.
Figure 2
Figure 2
Dynamics of population infections and the effect of different strategies on absenteeism among healthcare workers for a base-case pandemic.
Figure 3
Figure 3
Simulation analysis of the difference in mean peak absenteeism for different strategies in an R0 = 2.5 (base-case) pandemic (50th percentile shown in solid bars with the 5th and 95th percentiles shown in error bars).
Figure 4
Figure 4
Peak absenteeism with different treatment and prophylaxis strategies varying rates of growth (ζ)*, latent periods (α), and infectious duration (γ).† *ζ is the initial rate of growth of the epidemic curve and is determined by the reproductive potential and the infectious agent’s doubling time (Τ). The latter is related to the rate of growth by the following equation, 
formula image. 
†Tx refers to treatment; Rx refers to prophylaxis.
Figure 5
Figure 5
Peak absenteeism observed with different times of initiating prophylaxis, according to point of detection in a base-case pandemic.
See this image and copyright information in PMC

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