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Health Systems Institute
Georgia Institute of Technology
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Lecture :: Dr. Joseph Wu to present at the Health Systems Institute

Early combination chemotherapy would be effective in reducing the spread of antiviral resistance during the next influenza pandemic

DATE: Friday, November 9, 2007
TIME: 11:00 AM – 12:00 PM
LOCATION: Molecular Science and Engineering Building, Suite 4100

In the event of a human influenza pandemic, the effectiveness of antiviral interventions in mitigating morbidity and mortality will be reduced substantially if strains emerge which are resistant to stockpiled antivirals and also transmissible. One key parameter, the de novo rate of emergence of resistance to the yet-to-evolve pandemic strain, cannot be known in advance. However, here, we use a multi-strain transmission model to predict the benefits of targeted deployment of a combination of two antivirals (TDCA, for a limited initial period during national outbreaks) assuming zero fitness cost for the resistant strains and a wide range of rates of emergence of resistance. We show that in populations that have antiviral stockpiles and seeded entirely by wild-type virus (upstream populations), the benefits of TDCA are substantial when the risk of emergence is high. Further, we embed our single-population multi-strain model in a global transmission model to demonstrate that TDCA can also have substantial benefits for populations whose epidemic is partially seeded by resistant strains (downstream populations) if upstream populations use TDCA. The effective cost of switching strategies is very low for populations already stockpiling a single antiviral: TDCA is an inexpensive hedge against high de novo emergence rates. Our results suggest that (i) populations that are already planning to implement large-scale antiviral intervention should adopt TDCA and (ii) it is in the interests of likely downstream populations to help likely upstream populations adopt TDCA.

Dr. Joseph WuBiosketch
Dr. Wu's research focuses on mathematical modeling of infectious diseases and cancer therapies, with current projects involving devising mitigation strategies for pandemic and endemic influenza. Joseph earned a Ph.D. in operations research from MIT in 2003 and was an assistant professor in the School of Industrial and System Engineering at Georgia Tech from 2003 to 2005. Dr. Wu is currently with the Department of Community Medicine at the University of Hong Kong.

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