The impact of prophylaxis of healthcare workers on influenza pandemic burden.

Several models have rationalized the use of antiviral drugs as an early control measure for delaying the progression and limiting the size of outbreaks during an influenza pandemic. However, the strategy for use of these drugs is still under debate. We evaluated the impact of prophylaxis of healthcare workers (HCWs) through a mathematical model that considers attack rates in a range of 25-35% in the general population and 25-50% among HCWs. Simulations and uncertainty analysis using the demographics of the province of Ontario, Canada show that increasing prophylaxis coverage of HCWs has little impact on reducing the reproduction number of disease transmission and may not prevent the occurrence of an outbreak if expected. However, it does enable a high level of treatment, which substantially reduces morbidity and mortality in the population as a whole. Therefore, prophylaxis of HCWs should be considered an important part of public health efforts for minimizing influenza pandemic burden and its socio-economic disruption.