The effectiveness of wide-spread use of antivirals in preventing or mitigating influenza outbreaks depends on both their ability to reduce the number of infections and the risk of drug resistance. We extended a previously developed mathematical model to investigate the impact of various mitigation strategies, including mono or combination antiviral treatment or chemoprophylaxis and vaccination, on influenza transmission dynamics. Our findings indicate that chemoprophylaxis is more effective than treatment in reducing influenza burden, except when the resistant viral strain has a high transmission rate, in which case chemoprophylaxis may trigger a resistance-driven secondary wave of infections. Combination therapy significantly reduces resistance emergence, although it yields similar infection numbers as mono-therapy. Vaccination coverage of at least 80% is required to prevent outbreaks; otherwise, antivirals, particularly chemoprophylaxis, can contribute to outbreak control provided drug resistance emergence is low. This analysis could inform public health decision-making by providing guidance on effective prevention and mitigation strategies for influenza outbreaks, considering the benefits of antiviral use against the risk of drug resistance.

SCHUH Lea;  STILIANAKIS Nikolaos; 

2026-01-14

Oxford University Press (OUP)

JRC141530

https://academic.oup.com/ajeadvances/article/1/3/uuaf014/8284766,    https://doi.org/10.1093/ajeadv/uuaf014,    https://publications.jrc.ec.europa.eu/repository/handle/JRC141530,   

10.1093/ajeadv/uuaf014 (online),