Intervention strategies to curb spread of pandemic flu

The four-day conference and workshop - June 25-28 - is zeroing in on lessons learned from past outbreaks by reviewing the course of the current Influenza A/H1N1 pandemic (swine flu) and evaluating a vast number of intervention strategies under different scenarios.

The scientists and public health officials travelling to Arizona State University will advance the level of preparedness for pandemic events as a result of the synergistic interactions that result from shared access to real-time data, the latest knowledge in mathematical modelling, and a century of scientific and computational advances, according to Carlos Castillo-Chavez, a mathematical theoretical biologist who specializes in the study of disease evolution and one of the event's organizers.

Castillo-Chavez, an ASU Regents' Professor and the Joaquin Bustoz Jr. Professor of Mathematical Biology, is the director of ASU's new Mathematical, Computational and Modelling Sciences Centre in the College of Liberal Arts and Sciences.

"North American cooperation is essential to ensure the well being and vitality of our region. Public health issues recognize no boundaries and must be addressed globally," Castillo-Chavez says. He adds: "ASU has close ties to groups in Mexico and Canada. It is only natural that we would bring them together on this important topic."

Questions

Among the questions to be addressed at the conference are:

• What is the impact of mass transportation systems (air-traffic and other) on disease dynamics?
• What is our current state of preparedness?
• Does the region have enough vaccines and antiviral drugs?
• Is our current use/management of antiviral drugs sustainable?
• How can we use information technology to facilitate flu monitoring and surveillance in real time?
• How useful has past knowledge been in dealing with current outbreaks?

Some similarities have been highlighted between the 1918 flu pandemic and the current outbreak, including the apparent higher susceptibility of specific age groups, Castillo-Chavez notes. Whether or not the course of this pandemic will resemble the patterns of past ones is the subject of public discussion, he says.

"We have a lot working in our favour right now including the ability to quickly identify new strains of flu and the benefit of vaccines and antiviral drugs," says Gerardo Chowell-Puente, an assistant professor in ASU's School of Human Evolution and Social Change. "In terms of infrastructure, we have already seen the impact that public health practices and surveillance can have from the SARS epidemic and others."

Chowell, an expert flu epidemic modeller, was called to his country of birth by Mexico's Ministry of Health as soon as the H1N1 outbreak was identified to help assess its impact. His talk, on the first day of the conference, will address the transmissibility and age-specific impact of the influenza outbreak in Mexico earlier this year.

The conference opens at 9:15 a.m. June 25 with remarks by Carlos Flores Vizcarra, the consul general of Mexico in Phoenix, who is an economist and former Mexican congressman. Two keynote presentations are scheduled at the ASU event. Dr. Miguel Angel Lezana, the director of epidemiological surveillance for Mexico's Ministry of Health, will discuss lessons learned from the recent epidemic in Mexico. His talk is scheduled to begin at 10:10 a.m. June 25 in the Carson Ballroom in Old Main on ASU's Tempe campus.

Turning a foe into a friend

Another keynote address will be delivered by Roy Curtiss, an ASU professor who leads an international team that hopes to turn a foe into a friend by enlisting Salmonella, the leading cause of food poisoning, in the fight against bacterial pneumonia and influenza. Curtiss is director of the Centre for Infectious Diseases and Vaccinology at ASU's Biodesign Institute and a professor in the School of Life Sciences. His talk is scheduled to begin at 10:40 a.m. June 27 in the South Room of the University Club on ASU's Tempe campus.

This week's conference program includes nearly 25 individuals who will address varied issues. Among them, Ping Yan, research manager for modelling and projection at the Public Health Agency of Canada, will discuss the use of stochastic models in the transmission and control of infectious diseases. Carlos Hernández Suárez, former dean of the School of Sciences, Universidad de Colima, will speak on the impact of school closings, drug treatment and education in mitigating the impact of influenza outbreaks. D. Rick Van Schoik, director of ASU's North American Centre for Transborder Studies will present a preliminary cost-benefit analysis on Transborder Risk Assessment for Pandemic (TRAP).

On Thursday evening, tabletop exercises and games that are used by public health organizations and first responders to test their plans and capabilities to respond to pandemic influenza will be demonstrated at Arizona State University's Decision Theatre, a facility that provides visualization, simulation and collaborative decision-making tools. It is the only non-military facility of its kind in the U.S.

The goal

In addition to participants from Canada, Mexico and Arizona State University, also in attendance will be researchers from Purdue University, North Carolina State University, the Centres for Disease Control, Los Alamos National Laboratory, Cedars-Sinai Medical Centre, Entropy Research Institute, University of California at Los Angeles and Yale University.

A list of conference participants and their presentation topics, along with the agenda and other details are at mcmsc.asu.edu/conferences/h1n1.

The goal of the four-day conference at ASU "is to begin to expand the repertoire of scientific models that policymakers can use to test the impact of intervention efforts," says Castillo-Chavez. "It will take a global effort to contain a pandemic such as this. It will test not only our scientific capabilities, but our capacity to work together toward a common goal."

A follow-up conference already is planned for Sept. 14-16 in Canada. It is being organized by the Mathematics for Information Technology and Complex Systems, Centre for Disease Modelling and Public Health Agency of Canada.

mcmsc.asu.edu