Showing papers by "Keiji Fukuda published in 2006"
TL;DR: Recommendations vary by transmission pattern, pandemic phase, and disease severity, so as to not overwhelm efforts to protect against disease severity.
Abstract: The World Health Organization’s recommended pandemic influenza interventions, based on limited data, vary by transmission pattern, pandemic phase, and illness severity and extent. In the pandemic alert period, recommendations include isolation of patients and quarantine of contacts, accompanied by antiviral therapy. During the pandemic period, the focus shifts to delaying spread and reducing effects through population-based measures. Ill persons should remain home when they first became symptomatic, but forced isolation and quarantine are ineffective and impractical. If the pandemic is severe, social distancing measures such as school closures should be considered. Nonessential domestic travel to affected areas should be deferred. Hand and respiratory hygiene should be routine; mask use should be based on setting and risk, and contaminated household surfaces should be disinfected. Additional research and field assessments during pandemics are essential to update recommendations. Legal authority and procedures for implementing interventions should be understood in advance and should respect cultural differences and human rights.
425 citations
TL;DR: Closing international borders was usually ineffective in past pandemics and would be less effective today.
Abstract: Since global availability of vaccine and antiviral agents against influenza caused by novel human subtypes is insufficient, the World Health Organization (WHO) recommends nonpharmaceutical public health interventions to contain infection, delay spread, and reduce the impact of pandemic disease. Virus transmission characteristics will not be completely known in advance, but difficulties in influenza control typically include peak infectivity early in illness, a short interval between cases, and to a lesser extent, transmission from persons with incubating or asymptomatic infection. Screening and quarantining entering travelers at international borders did not substantially delay virus introduction in past pandemics, except in some island countries, and will likely be even less effective in the modern era. Instead, WHO recommends providing information to international travelers and possibly screening travelers departing countries with transmissible human infection. The principal focus of interventions against pandemic influenza spread should be at national and community levels rather than international borders.
314 citations
TL;DR: Vaccinating children aged 6–23 months, plus all other children at high-risk, will likely be more effective than vaccinating all children against influenza.
Abstract: We estimated cost-effectiveness of annually vaccinating children not at high risk with inactivated influenza vaccine (IIV) to range from US $12,000 per quality-adjusted life year (QALY) saved for children ages 6-23 months to $119,000 per QALY saved for children ages 12-17 years. For children at high risk (preexisting medical conditions) ages 6-35 months, vaccination with IIV was cost saving. For children at high risk ages 3-17 years, vaccination cost $1,000-$10,000 per QALY. Among children notat high risk ages 5-17 years, live, attenuated influenza vaccine had a similar cost-effectiveness as IIV. Risk status was more important than age in determining the economic effects of annual vaccination, and vaccination was less cost-effective as the child's age increased. Thus, routine vaccination of all children is likely less cost-effective than vaccination of all children ages 6-23 months plus all other children at high risk.
116 citations
TL;DR: A consultation of all stakeholders in influenza vaccines and immunization in Geneva in 2006 resulted in a global action plan outlining promising specific strategies to increase influenza vaccine production and surge-capacity before and during an influenza pandemic.
88 citations
TL;DR: This issue of the Journal addresses basic questions related to the use and performance of influenza vaccines and investigates whether the vaccination of children 5 years of age or older with a live attenuated influenza vaccine reduced the spread of influenza to households and the community through.
Abstract: In this issue of the Journal, two important and timely studies address basic questions related to the use and performance of influenza vaccines.1,2 The findings are also informative because both studies were conducted in the 2004–2005 influenza season when the influenza A (H3N2) components in both the inactivated and the live attenuated influenza vaccines were not optimally matched to the circulating strains. In one of the studies, King et al. investigated whether the vaccination of children 5 years of age or older with a live attenuated influenza vaccine reduced the spread of influenza to households and the community through . . .
12 citations