Skip Navigation



American Journal of Epidemiology Advance Access published online on November 6, 2006
American Journal of Epidemiology, doi:10.1093/aje/kwj362
This Article
Right arrow FREE Full Text (PDF) Freely available
Right arrow All Versions of this Article:
165/2/212    most recent
kwj362v1
Right arrow Alert me when this article is cited
Right arrow Alert me if a correction is posted
Services
Right arrow Email this article to a friend
Right arrow Similar articles in this journal
Right arrow Similar articles in PubMed
Right arrow Alert me to new issues of the journal
Right arrow Add to My Personal Archive
Right arrow Download to citation manager
Right arrowRequest Permissions
Right arrow Disclaimer
Google Scholar
Right arrow Articles by Halloran, M. E.
Right arrow Articles by Monto, A. S.
Right arrow Search for Related Content
PubMed
Right arrow PubMed Citation
Right arrow Articles by Halloran, M. E.
Right arrow Articles by Monto, A. S.
Social Bookmarking
Add to CiteULike   Add to Connotea   Add to Del.icio.us  
What's this?

American Journal of Epidemiology Copyright © 2006 by the Johns Hopkins Bloomberg School of Public Health All rights reserved; printed in U.S.A.
Received April 12, 2006
Accepted June 5, 2006

ORIGINAL CONTRIBUTIONS

Antiviral Effects on Influenza Viral Transmission and Pathogenicity: Observations from Household-based Trials

M. Elizabeth Halloran 1 *, Frederick G. Hayden 2, Yang Yang 3, Ira M. Longini Jr. 1, and Arnold S. Monto 4

1 Program in Biostatistics and Biomathematics, Fred Hutchinson Cancer Research Center, Seattle, WA; Department of Biostatistics, School of Public Health and Community Medicine, University of Washington, Seattle, WA
2 Department of Internal Medicine, University of Virginia, Charlottesville, VA
3 Program in Biostatistics and Biomathematics, Fred Hutchinson Cancer Research Center, Seattle, WA
4 Department of Epidemiology, University of Michigan School of Public Health, Ann Arbor, MI

* To whom correspondence should be addressed.
M. Elizabeth Halloran, E-mail: halloran{at}fhcrc.org


  Abstract

Four household-based, randomized clinical trials, two each of zanamivir and oseltamivir, were designed primarily to estimate the effect of postexposure prophylaxis on preventing influenza illness in household contacts. However, the effect of influenza antivirals on infectiousness as well as on the ability of the virus to cause disease--the pathogenicity--have important public health consequences. The authors show how such studies can provide estimates of pathogenicity, antiviral efficacy for pathogenicity, and the antiviral effect on infectiousness. Analysis of the four studies confirmed the high prophylactic efficacy against illness of both zanamivir (75%, 95% confidence interval (CI): 54, 86) and oseltamivir (81%, 95% CI: 35, 94). The effect on reducing infectiousness was 19% (95% CI: -160, 75) for zanamivir and 80% (95% CI: 43, 93) for oseltamivir. Pathogenicity in controls ranged from 44% (95% CI: 33, 55) to 66% (95% CI: 48, 72). Efficacy in reducing pathogenicity for zanamivir was 52% (95% CI: 19, 72) and 56% (95% CI: 14, 77) in the two studies; for oseltamivir, it was 56% (95% CI: 10, 73) and 79% (95% CI: 45, 92). Studies of influenza antivirals in transmission units would be improved if randomization schemes were used that allow estimation of the antiviral effect on infectiousness from individual studies.

Keywords: antiviral agents; disease transmission; family characteristics; influenza, human; randomized controlled trials; treatment outcome.
Add to CiteULike CiteULike   Add to Connotea Connotea   Add to Del.icio.us Del.icio.us    What's this?


This article has been cited by other articles:


Home page
 Am J EpidemiolHome page
N. E. Basta, D. L. Chao, M. E. Halloran, L. Matrajt, and I. M. Longini Jr
Strategies for Pandemic and Seasonal Influenza Vaccination of Schoolchildren in the United States
Am. J. Epidemiol., September 15, 2009; 170(6): 679 - 686.
[Abstract] [Full Text] [PDF]

Home page
 BMJHome page
B. J Cowling, S. Ng, and I. M Longini Jr
Antiviral drugs: distinguish treatment from prophylaxis
BMJ, September 8, 2009; 339(sep08_1): b3620 - b3620.
[Full Text]

Home page
 Am J EpidemiolHome page
J. Wood, J. McCaw, N. Becker, T. Nolan, and C. R. MacIntyre
Optimal Dosing and Dynamic Distribution of Vaccines in an Influenza Pandemic
Am. J. Epidemiol., June 15, 2009; 169(12): 1517 - 1524.
[Abstract] [Full Text] [PDF]

Home page
 BiostatisticsHome page
Y. Yang, M. E. Halloran, and I. M. Longini Jr
A Bayesian model for evaluating influenza antiviral efficacy in household studies with asymptomatic infections
Biostat., April 1, 2009; 10(2): 390 - 403.
[Abstract] [Full Text] [PDF]

Home page
 Am J EpidemiolHome page
N. E. Basta, M. E. Halloran, L. Matrajt, and I. M. Longini Jr.
Estimating Influenza Vaccine Efficacy From Challenge and Community-based Study Data
Am. J. Epidemiol., December 15, 2008; 168(12): 1343 - 1352.
[Abstract] [Full Text] [PDF]

Home page
 NEJMHome page
W. P. Glezen
Prevention and Treatment of Seasonal Influenza
N. Engl. J. Med., December 11, 2008; 359(24): 2579 - 2585.
[Full Text] [PDF]

Home page
 Arch. Dis. Child.Home page
A Nicoll
Children, avian influenza H5N1 and preparing for the next pandemic
Arch. Dis. Child., May 1, 2008; 93(5): 433 - 438.
[Abstract] [Full Text] [PDF]

Home page
 Proc. Natl. Acad. Sci. USAHome page
M. E. Halloran, N. M. Ferguson, S. Eubank, I. M. Longini Jr., D. A. T. Cummings, B. Lewis, S. Xu, C. Fraser, A. Vullikanti, T. C. Germann, et al.
Modeling targeted layered containment of an influenza pandemic in the United States
PNAS, March 25, 2008; 105(12): 4639 - 4644.
[Abstract] [Full Text] [PDF]


Disclaimer: Please note that abstracts for content published before 1996 were created through digital scanning and may therefore not exactly replicate the text of the original print issues. All efforts have been made to ensure accuracy, but the Publisher will not be held responsible for any remaining inaccuracies. If you require any further clarification, please contact our Customer Services Department.