Assessing the role of voluntary self-isolation in the control of pandemic influenza using a household epidemic model

Abstract

In the absence of effective vaccines, antiviral drugs and personal protective measures, such as voluntary self-isolation, have been a part of preparedness plans for the next influenza pandemic. We used a household model to assess the effect of voluntary self-isolation on outbreak control when antiviral drugs are not provided sufficiently early. We found that the early initiation of voluntary self-isolation can overcome the negative effects caused by a delay in antiviral drug distribution when enough symptomatic individuals comply with home confinement at symptom onset. For example, for the baseline household reproduction number RH0 = 2:5, if delays of one or two days occur between clinical symptom development and the start of antiviral prophylaxis, then compliance rates of q ≥ 0:41 and q ≥ 0:6, respectively, are required to achieve the same level of effectiveness as starting antiviral prophylaxis at symptom onset. When the time to beginning voluntary self-isolation after symptom onset increases from zero to two days, this strategy has a limited effect on reducing the transmission of influenza; therefore, this strategy should be implemented as soon as possible. In addition, the effect of voluntary self-isolation decreases substantially with the proportion of asymptomatic infections increasing.