{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,11,11]],"date-time":"2025-11-11T13:03:39Z","timestamp":1762866219296},"reference-count":33,"publisher":"Wiley","issue":"6","license":[{"start":{"date-parts":[[2013,7,23]],"date-time":"2013-07-23T00:00:00Z","timestamp":1374537600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Influenza Resp Viruses"],"published-print":{"date-parts":[[2013,11]]},"abstract":"<jats:sec><jats:title>Background<\/jats:title><jats:p>The 2009 influenza <jats:styled-content style=\"fixed-case\">A<\/jats:styled-content> (<jats:styled-content style=\"fixed-case\">H<\/jats:styled-content>1<jats:styled-content style=\"fixed-case\">N<\/jats:styled-content>1) pandemic was mild by historical standards, but was more severe in isolated <jats:styled-content style=\"fixed-case\">C<\/jats:styled-content>anadian <jats:styled-content style=\"fixed-case\">I<\/jats:styled-content>ndigenous communities. <jats:styled-content style=\"fixed-case\">O<\/jats:styled-content>seltamivir was used aggressively for outbreak control in an isolated northern <jats:styled-content style=\"fixed-case\">O<\/jats:styled-content>ntario <jats:styled-content style=\"fixed-case\">F<\/jats:styled-content>irst <jats:styled-content style=\"fixed-case\">N<\/jats:styled-content>ations community. We used mathematical modeling to quantify the impact of antiviral therapy on the course of this outbreak.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>We used both a <jats:styled-content style=\"fixed-case\">R<\/jats:styled-content>ichards growth model and a compartmental model to evaluate the characteristics of the outbreak based on both respiratory visits and influenza\u2010like illness counts. Estimates of best\u2010fit model parameters, including basic reproductive number (<jats:italic>R<\/jats:italic><jats:sub>0<\/jats:sub>) and antiviral efficacy, and simulations, were used to estimate the impact of antiviral drugs compared to social distancing interventions alone.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Using both approaches, we found that a rapidly growing outbreak slowed markedly with aggressive antiviral therapy. <jats:styled-content style=\"fixed-case\">R<\/jats:styled-content>ichards model turning points occurred within 24\u00a0hours of antiviral implementation. Compartmental models estimated antiviral efficacy at 70\u201395%. Plausible estimates of <jats:italic>R<\/jats:italic> from both modeling approaches ranged from 4\u00b70 to 15\u00b78, higher than published estimates for southern <jats:styled-content style=\"fixed-case\">C<\/jats:styled-content>anada; utilization of aggressive antiviral therapy in this community prevented 962\u20131757 cases of symptomatic influenza and as many as 114 medical evacuations in this community.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Although not advocated in other settings in <jats:styled-content style=\"fixed-case\">C<\/jats:styled-content>anada, aggressive antiviral therapy markedly reduced the impact of a pandemic\u2010related influenza <jats:styled-content style=\"fixed-case\">A<\/jats:styled-content> (<jats:styled-content style=\"fixed-case\">H<\/jats:styled-content>1<jats:styled-content style=\"fixed-case\">N<\/jats:styled-content>1) outbreak in an isolated <jats:styled-content style=\"fixed-case\">C<\/jats:styled-content>anadian <jats:styled-content style=\"fixed-case\">F<\/jats:styled-content>irst <jats:styled-content style=\"fixed-case\">N<\/jats:styled-content>ations community in northern <jats:styled-content style=\"fixed-case\">O<\/jats:styled-content>ntario, <jats:styled-content style=\"fixed-case\">C<\/jats:styled-content>anada. The differential risk experienced by such communities makes tailored interventions that consider risk and lack of access to medical services, appropriate.<\/jats:p><\/jats:sec>","DOI":"10.1111\/irv.12141","type":"journal-article","created":{"date-parts":[[2013,7,24]],"date-time":"2013-07-24T13:22:12Z","timestamp":1374672132000},"page":"1409-1415","source":"Crossref","is-referenced-by-count":4,"title":["Estimated impact of aggressive empirical antiviral treatment in containing an outbreak of pandemic influenza <scp>H<\/scp>1<scp>N<\/scp>1 in an isolated <scp>F<\/scp>irst <scp>N<\/scp>ations community"],"prefix":"10.1111","volume":"7","author":[{"given":"Yanyu","family":"Xiao","sequence":"first","affiliation":[{"name":"Department of Applied Mathematics University of Western Ontario London ON Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Zeenat","family":"Patel","sequence":"additional","affiliation":[{"name":"First Nations and Inuit Health Branch Health Canada Toronto ON Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Adam","family":"Fiddler","sequence":"additional","affiliation":[{"name":"Sandy Lake First Nation Sandy Lake ON Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Lilian","family":"Yuan","sequence":"additional","affiliation":[{"name":"First Nations and Inuit Health Branch Health Canada Toronto ON Canada"},{"name":"The York Region Community and Health Services Newmarket ON Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Marie\u2010Elaine","family":"Delvin","sequence":"additional","affiliation":[{"name":"First Nations and Inuit Health Branch Health Canada Toronto ON Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"David N.","family":"Fisman","sequence":"additional","affiliation":[{"name":"The Dalla Lana School of Public Health University of Toronto Toronto ON Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2013,7,23]]},"reference":[{"key":"e_1_2_5_2_1","doi-asserted-by":"publisher","DOI":"10.1503\/cmaj.091807"},{"key":"e_1_2_5_3_1","doi-asserted-by":"publisher","DOI":"10.3201\/eid1512.091413"},{"key":"e_1_2_5_4_1","doi-asserted-by":"crossref","first-page":"19366","DOI":"10.2807\/ese.14.42.19366-en","article-title":"The 2009 pandemic H1N1 influenza and indigenous populations of the Americas and the Pacific","volume":"14","author":"Ruche G","year":"2009","journal-title":"Euro Surveill"},{"key":"e_1_2_5_5_1","doi-asserted-by":"publisher","DOI":"10.1001\/jama.2009.1496"},{"key":"e_1_2_5_6_1","doi-asserted-by":"publisher","DOI":"10.1503\/cmaj.090885"},{"key":"e_1_2_5_7_1","unstructured":"Statistics Canada.2006 Community profiles.20072006 Census. 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