School Closure is currently the main . . .

Concerns about an imminent influenza pandemic have been intensified after the emergence of the new influenza A(H1N1) v strain. Mathematical modeling was employed on recent epidemiological data from Mexico in order to assess the impact of intervention strategies on the spread of influenza A(H1N1)v in the setting of the European region. When initiating the intervention of 100% school closure in a community of 2,000 people at a threshold of 1% cumulative attack rate, the total number of symptomatic cases is predicted to decrease by 89.3%, as compared to the non-intervention scenario. When this measure is coupled with treatment and home isolation of symptomatic cases as well as a 50% reduction of social contacts, a 94.8% decline in the cumulative attack rate is predicted along with a much shorter duration of influenza A(H1N1)v transmission. Active surveillance that will ensure timely treatment and home isolation of symptomatic cases in combination with school closure seem to form an efficient strategy to control the spread of influenza A(H1N1)v. Introduction The emergence of the new influenza A(H1N1)v strain in March-April 2009 prompted the World Health Organisation (WHO) to raise the pandemic alert level. Influenza A(H1N1)v has to date spread to 76 countries and has infected 35,928 individuals (confirmed cases as of 15 June 2009) [1]. Currently, there is uncertainty about key epidemiological parameters such as the age-specific attack rates, the case fatality rate and the basic reproductive number R 0 (i.e. the number of secondary cases attributed to one infected individual in a susceptible population) [2-4]. Since the epidemic in Mexico provides the most advanced insight into key epidemiological parameters [2], we used those parameters to simulate the potential spread of influenza A(H1N1)v in a model community situated in Greece and explored the effectiveness of various intervention strategies that could inform policies and decisions in the setting of the European region.