Evaluating the combined effectiveness of influenza control strategies and human preventive behavior

Abstract

Control strategies enforced by health agencies are a major type of practice to contain influenza outbreaks. Another type of practice is the voluntary preventive behavior of individuals, such as receiving vaccination, taking antiviral drugs, and wearing face masks. These two types of practices take effects concurrently in influenza containment, but little attention has been paid to their combined effectiveness. This article estimates this combined effectiveness using established simulation models in the urbanized area of Buffalo, NY, USA. Three control strategies are investigated, including: Targeted Antiviral Prophylaxis (TAP), workplace/school closure, community travel restriction, as well as the combination of the three. All control strategies are simulated with and without regard to individual preventive behavior, and the resulting effectiveness are compared. The simulation outcomes suggest that weaker control strategies could suffice to contain influenza epidemics, because individuals voluntarily adopt preventive behavior, rendering these weaker strategies more effective than would otherwise have been expected. The preventive behavior of individuals could save medical resources for control strategies and avoid unnecessary socio-economic interruptions. This research adds a human behavioral dimension into the simulation of control strategies and offers new insights into disease containment. Health policy makers are recommended to review current control strategies and comprehend preventive behavior patterns of local populations before making decisions on influenza containment.

Figure 1. Simulated epidemic curves resulting from control scenarios with/without considering preventive behavior (PB).

The curve depicts the number of daily new influenza cases during the course of an epidemic. (A) 60%TAP; (B) 80% TAP; (C) 10% WC; (D) 33% WC; (E) 10% TR; (F) 50% TR; (G) Combined-Low; (H) Combined-High.

Figure 2. Intensity maps of cumulative infections for the entire epidemic.

(A) Baseline scenario, (B) 60% TAP+PB, (C) 10% WC+PB, (D) 50% TR+PB, and (E) Combined Low+PB. The color ramp represents the 150-day cumulative number of infections per sq km² at a 50 m×50 m cell location. The infection intensity is further categorized into 6 levels, i.e., very low (0–50 infections/km²), low (50–100), moderate (100–200), high (200–500), very high (500–1,000), and extremely high (>1,000).