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Assessment Of Interventions For Controlling Pandemic Influenza And Determining Data Needs To Inform These Assessments
Funder
National Health and Medical Research Council
Funding Amount
$183,040.00
Summary
The aim of this study is to help us prepare for a pandemic of influenza by comparing how effective the various available control strategies are at reducing transmission of the disease. The available control interventions include: reducing the number of close contacts we make with others, isolating cases after they are diagnosed, closing schools, quarantining households, quarantining individuals who are known to have been exposed to a case, and using antiviral drugs treat and protect people at ri ....The aim of this study is to help us prepare for a pandemic of influenza by comparing how effective the various available control strategies are at reducing transmission of the disease. The available control interventions include: reducing the number of close contacts we make with others, isolating cases after they are diagnosed, closing schools, quarantining households, quarantining individuals who are known to have been exposed to a case, and using antiviral drugs treat and protect people at risk of being infected. We will compare these control measures by taking due account of the ability and resources available for these interventions, and with regard to the need to maintain essential services. The comparisons will be made using mathematical models that describe the transmission of the infection. All available data and advice from experts will be used to ensure that realistic models are used for the comparisons. We will also use the models to determine the best use of the limited antiviral drugs available, until a vaccine becomes available. We will consider how the control strategy should be changed if a strain develops that is resistant to the antiviral drugs. In addition, we will determine what data need to be collected during the early stages of a pandemic to help us to determine the best use of the antiviral drugs, the best use of a new vaccine and to check on the development of resistance to the antiviral drugs.Read moreRead less
Modelling The Biology And Transmission Of Influenza Virus - Learning From 1918-19 And Other Outbreaks
Funder
National Health and Medical Research Council
Funding Amount
$114,222.00
Summary
In preparing for a future pandemic of influenza, it is important to learn as much as possible from what happened in the past, particularly from the devastating pandemic of 1918-19. This project will collate detailed information about the spread of influenza in past outbreaks and create a publicly accessible data-base. Mathematical methods will be used to analyse historic and contemporary data, so as to provide better understanding of the spread of influenza, and of the likely effects of social a ....In preparing for a future pandemic of influenza, it is important to learn as much as possible from what happened in the past, particularly from the devastating pandemic of 1918-19. This project will collate detailed information about the spread of influenza in past outbreaks and create a publicly accessible data-base. Mathematical methods will be used to analyse historic and contemporary data, so as to provide better understanding of the spread of influenza, and of the likely effects of social and medical measures for its control. An important theme of the project is to consolidate our knowledge about how past exposure to non-pandemic influenza could provide short-lived protection against any new pandemic, and to explore the implications of this for prevention today. Another theme is to explore the severity of influenza during pandemics, and to identify social and medical factors that might reduce the dose of virus transmitted, or otherwise reduce the severity of infection. The insights from the modeling will also help to identify gaps in knowledge and understanding about the basic biology of influenza, stimulate new research to fill those gaps, and thus offer the prospect of more effective vaccines and treatments for the future control of influenza.Read moreRead less
Are Routine Healthcare Worker Hand Hygiene Protocols (soap/water, Alcohol-based Handrub) Effective Against Influenza?
Funder
National Health and Medical Research Council
Funding Amount
$99,950.00
Summary
Although influenza is mainly spread from person-to-person by aerosol transmission (coughing, sneezing etc), there is growing evidence that spread also occurs on the hands of infected patients and their carers (non-aerosol transmission). Because of this, health authorities now recommend the use of careful hand hygiene (HH: hand washing with soap-water or use of alcohol-based hand rub solutions [ABHRS]) by healthcare workers (HCWs) and patients. However, despite these recommendations, there are no ....Although influenza is mainly spread from person-to-person by aerosol transmission (coughing, sneezing etc), there is growing evidence that spread also occurs on the hands of infected patients and their carers (non-aerosol transmission). Because of this, health authorities now recommend the use of careful hand hygiene (HH: hand washing with soap-water or use of alcohol-based hand rub solutions [ABHRS]) by healthcare workers (HCWs) and patients. However, despite these recommendations, there are no data that demonstrate the effectiveness of such HH protocols. This project aims to assess the clinical effectiveness of four HH protocols (handwashing with soap-water, alcohol-only ABHRS, two alcohol-chlorhexidine ABHRS) in common use in Australian hospitals to see which protocol is best for killing influenza virus. We also plan to assess how long influenza virus remains infectious on HCWs hands if they fail to use appropriate HH. Since it could be dangerous to use live avian influenza virus in this study, we plan to use the H1N1 influenza A strain that was a component of the influenza vaccine administered to most HCWs in 2005. Thus, only HCWs with protective immunity to H1N1 will participate in a series of tests in which they will have their hands artificially contaminated with a known concentration of live H1N1 before using either no HH, or one of the four HH protocols, followed by an assessment (virus culture and molecular tests) or the amount of H1N1 surviving on their hands after each protocol. Some selected HCWs will also have the amount of surviving virus assessed 30 and 60 minutes after contamination to identify how long H1N1 survives on HCWs hands should they not use appropriate HH. Following all protocols, all HCWs will perform a detailed surgical scrub (similar to surgeons before an operation) to make certain that all H1N1 is killed to avoid any infection of themselves or their contacts. The study will be undertaken in special, secure, negative-pressure rooms at Austin Hospital away from patient care areas to provide maximum safety conditions. All virus culture and molecular tests will be performed in the virus Identification Laboratory at the Victorian Infectious Disease Reference Laboratory (VIDRL), Melbourne. Results of the study should help identify which HH protocol provides the most protection against influenza.Read moreRead less
Molecular Epidemiology Of Infection In Aboriginal Communities
Funder
National Health and Medical Research Council
Funding Amount
$149,103.00
Summary
Destructive diseases of the gum tissue are known to be profoundly affected by modifying factors including systemic diseases such as diabetes, socio-economic conditions and the lack of effective control of microbial accumulation at the gum margin. This investigation will examine the hypothesis that a limited number of pathogenic bacterial strains, defined by quantitative molecular probe analysis, persist in or re-infect individuals to maintain a high disease burden in the presence of adverse modi ....Destructive diseases of the gum tissue are known to be profoundly affected by modifying factors including systemic diseases such as diabetes, socio-economic conditions and the lack of effective control of microbial accumulation at the gum margin. This investigation will examine the hypothesis that a limited number of pathogenic bacterial strains, defined by quantitative molecular probe analysis, persist in or re-infect individuals to maintain a high disease burden in the presence of adverse modifying factors that prevail in isolated, disadvantaged Aboriginal communities.Read moreRead less
Injecting Drug Users: Social Networks And Molecular Epidemiology Of The Hepatitis C Virus
Funder
National Health and Medical Research Council
Funding Amount
$543,868.00
Summary
The hepatitis C virus (HCV) continues to spread among injecting drug users (IDUs) in Australia at a very high rate, despite success in preventing the spread of HIV in the same groups; the complete reasons for this remain unclear. There is an urgent need for the HCV epidemic among IDUs to be contained. To do so, we must better understand the ways in which it is spreading among IDUs. Much is known about risk behaviours of individual IDUs and how they contribute to HCV transmission; much less is kn ....The hepatitis C virus (HCV) continues to spread among injecting drug users (IDUs) in Australia at a very high rate, despite success in preventing the spread of HIV in the same groups; the complete reasons for this remain unclear. There is an urgent need for the HCV epidemic among IDUs to be contained. To do so, we must better understand the ways in which it is spreading among IDUs. Much is known about risk behaviours of individual IDUs and how they contribute to HCV transmission; much less is known about how these behaviours are modified by the influence of the IDUs peer group, especially their immediate and intimate social networks. Despite its importance in influencing attitudes and behaviours, and therefore HCV transmission, this has never been studied in Australia, nor, in relation to HCV, in the world. We hope that by studying social and risk networks of IDUs we shall discover new ways in which control of the HCV epidemic can be achieved in Australia. We intend to do this among two groups of young IDUs, one of Vietnamese ethnicity, located in the one suburb of Melbourne. By using field techniques for gathering information (ethnography), and sophisticated analytic techniques to understand how these networks are formed and influence behaviours, we hope to be able to identify interventions which work at the level of the social group rather than the individual in bringing about the behaviour change necessary to prevent HCV transmission. To ensure that the risk networks we describe are as influential as they appear, and to discover more about the variability of HCV, we will also be investigating the relationship between the various strains of HCV in members of the IDU networks, particularly as another measure of the connectedness of networks and network members. This will be done using sophisticated genetic analysis of the HCV obtained from network members by blood test.Read moreRead less