Comparing Effectiveness of Top-Down and Bottom-Up Strategies in Containing Influenza

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Public Library of Science


This research compares the performance of bottom-up, self-motivated behavioral interventions with top-down interventions targeted at controlling an “Influenza-like-illness”. Both types of interventions use a variant of the ring strategy. In the first case, when the fraction of a person's direct contacts who are diagnosed exceeds a threshold, that person decides to seek prophylaxis, e.g. vaccine or antivirals; in the second case, we consider two intervention protocols, denoted Block and School: when a fraction of people who are diagnosed in a Census Block (resp., School) exceeds the threshold, prophylax the entire Block (resp., School). Results show that the bottom-up strategy outperforms the top-down strategies under our parameter settings. Even in situations where the Block strategy reduces the overall attack rate well, it incurs a much higher cost. These findings lend credence to the notion that if people used antivirals effectively, making them available quickly on demand to private citizens could be a very effective way to control an outbreak.



Antiviral therapeutics, Diagnostic medicine, Prophylaxis, Public and occupational health, Public policy, Schools, Social networks, Vaccines


Marathe A, Lewis B, Barrett C, Chen J, Marathe M, et al. (2011) Comparing Effectiveness of Top-Down and Bottom-Up Strategies in Containing Influenza. PLoS ONE 6(9): e25149.