{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,4]],"date-time":"2026-05-04T13:44:39Z","timestamp":1777902279163,"version":"3.51.4"},"reference-count":44,"publisher":"SAGE Publications","issue":"11","license":[{"start":{"date-parts":[[2013,10,23]],"date-time":"2013-10-23T00:00:00Z","timestamp":1382486400000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["SIMULATION"],"published-print":{"date-parts":[[2013,11]]},"abstract":"<jats:p>Mathematical models have been developed to simulate influenza epidemics to help public health officials evaluate different control policies. In these models, often severe influenza epidemics with a considerable mortality rate are considered. However, as was the case for the 2009 H1N1 pandemic, some of the influenza epidemics are mild with insignificant mortality rates. In the case of a mild epidemic, the cost of different control policies becomes an important decision factor in addition to disease-related outcomes such as the attack rate.<\/jats:p>\n                  <jats:p>We develop a continuous-time simulation model for the spread of a mild influenza epidemic based on the SEIR model (an epidemiological model with four classes: susceptible, exposed, infective, and recovered) which includes different interventions. To determine the epidemic mitigation policy with the minimum cost, we also develop an optimization model with two decision variables, vaccination and self-isolation fractions, and an upper-bound constraint for the attack rate. We use this model to evaluate the cost-effectiveness of different mitigation policies. Furthermore, we integrate the simulation and optimization models to identify the optimal mitigation policy. Finally, we conduct sensitivity analysis on the key input parameters to ensure robust results.<\/jats:p>\n                  <jats:p>The optimal policy depends on the target population and, as our results show, in general is a combination of vaccination and self-isolation. Further, for low (high) levels of intervention, vaccination (self-isolation) is incrementally more cost-effective. Therefore, public health officials should concentrate on vaccination at the beginning of the epidemic. However, if the epidemic continues to spread, they should promote self-isolation as a more effective intervention.<\/jats:p>","DOI":"10.1177\/0037549713505334","type":"journal-article","created":{"date-parts":[[2013,10,24]],"date-time":"2013-10-24T00:29:35Z","timestamp":1382574575000},"page":"1400-1415","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":3,"title":["Identifying optimal mitigation strategies for responding to a mild influenza epidemic"],"prefix":"10.1177","volume":"89","author":[{"given":"Hamed","family":"Yarmand","sequence":"first","affiliation":[{"name":"Department of Industrial and Systems Engineering, North Carolina State University, Raleigh, North Carolina, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Julie S","family":"Ivy","sequence":"additional","affiliation":[{"name":"Department of Industrial and Systems Engineering, North Carolina State University, Raleigh, North Carolina, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Stephen D","family":"Roberts","sequence":"additional","affiliation":[{"name":"Department of Industrial and Systems Engineering, North Carolina State University, Raleigh, North Carolina, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"179","published-online":{"date-parts":[[2013,10,23]]},"reference":[{"key":"bibr1-0037549713505334","unstructured":"Hampton Roads Utilities & Heavy Contractors Association. Economic impact of the H1N1 virus (the swine flu), http:\/\/www.hruhca.com. Accessed July 20, 2011."},{"key":"bibr2-0037549713505334","unstructured":"Institute of Medicine of The National Academies, Committee on Modeling Community Containment for Pandemic Influenza. Modeling community containment for pandemic influenza: a letter report, 2006."},{"key":"bibr3-0037549713505334","doi-asserted-by":"publisher","DOI":"10.1186\/1471-2458-10-168"},{"key":"bibr4-0037549713505334","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pmed.1000207"},{"key":"bibr5-0037549713505334","unstructured":"Centers for Disease Control and Prevention. Centers for Disease Control and Prevention. Novel H1N1 flu (swine flu) and you, http:\/\/www.cdc.gov\/h1n1flu\/qa.htm. Accessed September 24, 2009."},{"key":"bibr6-0037549713505334","unstructured":"World Health Organization. Pandemic (H1N1) 2009 - update 112, http:\/\/www.who.int\/csr\/don\/2010_08_06\/en\/index.html. Accessed December 17, 2010."},{"key":"bibr7-0037549713505334","unstructured":"Centers for Disease Control and Prevention. Questions & answers: Antiviral drugs, 2009-2010 flu season, http:\/\/www.cdc.gov\/H1N1flu\/antiviral.htm. Accessed September 30, 2009."},{"key":"bibr8-0037549713505334","doi-asserted-by":"publisher","DOI":"10.1007\/s11538-010-9623-3"},{"key":"bibr9-0037549713505334","doi-asserted-by":"publisher","DOI":"10.1287\/mnsc.1070.0787"},{"key":"bibr10-0037549713505334","unstructured":"Bengtson M. North Carolina State University Student Health Services. H1N1 influenza (flu) update, http:\/\/healthcenter.ncsu.edu. Accessed September 30, 2009."},{"key":"bibr11-0037549713505334","doi-asserted-by":"publisher","DOI":"10.1093\/aje\/kwh092"},{"key":"bibr12-0037549713505334","doi-asserted-by":"publisher","DOI":"10.1038\/nature04795"},{"key":"bibr13-0037549713505334","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pmed.0030361"},{"key":"bibr14-0037549713505334","doi-asserted-by":"publisher","DOI":"10.1080\/07408170802165856"},{"key":"bibr15-0037549713505334","doi-asserted-by":"publisher","DOI":"10.3201\/eid1211.060255"},{"key":"bibr16-0037549713505334","doi-asserted-by":"publisher","DOI":"10.1038\/nature04017"},{"key":"bibr17-0037549713505334","doi-asserted-by":"publisher","DOI":"10.1073\/pnas.0601266103"},{"key":"bibr18-0037549713505334","doi-asserted-by":"publisher","DOI":"10.1016\/j.jtbi.2004.11.032"},{"key":"bibr19-0037549713505334","doi-asserted-by":"publisher","DOI":"10.3201\/eid1602.090571"},{"key":"bibr20-0037549713505334","doi-asserted-by":"publisher","DOI":"10.1086\/649867"},{"key":"bibr21-0037549713505334","doi-asserted-by":"publisher","DOI":"10.1111\/j.1524-4733.2008.00437.x"},{"key":"bibr22-0037549713505334","doi-asserted-by":"publisher","DOI":"10.7326\/0000605-200912150-00157"},{"key":"bibr23-0037549713505334","doi-asserted-by":"crossref","unstructured":"Yarmand H. Cost-effectiveness analysis of vaccination and self-isolation in case of an H1N1 outbreak [master\u2019s thesis], North Carolina State University. 2010.","DOI":"10.1109\/WSC.2010.5678918"},{"key":"bibr24-0037549713505334","volume-title":"Cost-effectiveness analysis of different interventions for H1N1: what is the optimal level of vaccination and self-isolation in case of an H1N1 outbreak","author":"Yarmand H","year":"2010"},{"key":"bibr25-0037549713505334","volume-title":"proceedings of the industrial engineering research conference","author":"Yarmand H"},{"key":"bibr26-0037549713505334","volume-title":"proceedings of the winter simulation conference","author":"Yarmand H"},{"key":"bibr27-0037549713505334","doi-asserted-by":"publisher","DOI":"10.1177\/0037549713479052"},{"key":"bibr28-0037549713505334","doi-asserted-by":"publisher","DOI":"10.1016\/j.ejor.2013.08.027"},{"key":"bibr29-0037549713505334","doi-asserted-by":"publisher","DOI":"10.1586\/erp.09.56"},{"key":"bibr30-0037549713505334","unstructured":"Centers for Disease Control and Prevention. Interim guidance on antiviral recommendations for patients with novel influenza A (H1N1) virus infection and their close contacts, http:\/\/www.cdc.gov\/h1n1flu\/recommendations.htm. Accessed October 14, 2009."},{"key":"bibr31-0037549713505334","doi-asserted-by":"publisher","DOI":"10.1016\/j.vaccine.2010.05.002"},{"key":"bibr32-0037549713505334","unstructured":"Centers for Disease Control and Prevention. 2009 H1N1 influenza vaccine, http:\/\/www.cdc.gov\/h1n1flu\/vaccination\/public\/vaccination_qa_pub.htm. Accessed September 30, 2009."},{"key":"bibr33-0037549713505334","unstructured":"Sanofi Pasteur Corporation. Influenza A (H1N1) 2009 monovalent vaccine, http:\/\/www.fda.gov\/downloads\/biologicsbloodvaccines\/vaccines\/approvedproducts\/ucm182404.pdf. Accessed November 18, 2009."},{"key":"bibr34-0037549713505334","unstructured":"Washington State Department of Health. H1N1 vaccination frequently asked questions, http:\/\/www.doh.wa.gov. Accessed January 12, 2010."},{"key":"bibr35-0037549713505334","doi-asserted-by":"publisher","DOI":"10.3201\/eid1304.060828"},{"key":"bibr36-0037549713505334","first-page":"9","author":"Kelso JK","year":"2009","journal-title":"BMC Publ Health"},{"key":"bibr37-0037549713505334","unstructured":"Centers for Disease Control and Prevention. CDC recommendations for the amount of time persons with influenza-like illness should be away from others, http:\/\/www.cdc.gov\/h1n1flu\/guidance\/exclusion.htm. Accessed November 18, 2009."},{"key":"bibr38-0037549713505334","volume-title":"proceedings of the winter simulation conference","author":"Ekici A"},{"key":"bibr39-0037549713505334","doi-asserted-by":"publisher","DOI":"10.1016\/j.vaccine.2006.05.079"},{"key":"bibr40-0037549713505334","doi-asserted-by":"publisher","DOI":"10.1126\/science.1115717"},{"key":"bibr41-0037549713505334","doi-asserted-by":"publisher","DOI":"10.1287\/opre.1070.0399"},{"key":"bibr42-0037549713505334","doi-asserted-by":"publisher","DOI":"10.1137\/S0036144500371907"},{"key":"bibr43-0037549713505334","unstructured":"Health Grades Inc. Type A influenza subtype H1N1: introduction, http:\/\/www.wrongdiagnosis.com\/t\/type_a_influenza_subtype_h1n1\/intro.htm. Accessed March 25, 2010."},{"key":"bibr44-0037549713505334","unstructured":"Centers for Disease Control and Prevention. Cost effectiveness analysis, http:\/\/www.cdc.gov\/owcd\/eet\/CostEffect2\/Fixed\/4.html#costeffectivenessratios. Accessed February 19, 2010."}],"container-title":["SIMULATION"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/0037549713505334","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/full-xml\/10.1177\/0037549713505334","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/0037549713505334","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,5,1]],"date-time":"2026-05-01T11:24:59Z","timestamp":1777634699000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.sagepub.com\/doi\/10.1177\/0037549713505334"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2013,10,23]]},"references-count":44,"journal-issue":{"issue":"11","published-print":{"date-parts":[[2013,11]]}},"alternative-id":["10.1177\/0037549713505334"],"URL":"https:\/\/doi.org\/10.1177\/0037549713505334","relation":{},"ISSN":["0037-5497","1741-3133"],"issn-type":[{"value":"0037-5497","type":"print"},{"value":"1741-3133","type":"electronic"}],"subject":[],"published":{"date-parts":[[2013,10,23]]}}}