Evaluating the effectiveness of early vaccination in the control and eradication of equine influenza--a modelling approach.

In August 2007, Australia which had previously been free of equine influenza, experienced a large outbreak that lasted approximately 4 months before it was eradicated. The outbreak required a significant national response by government and the horse industries. The main components of the response were movement controls, biosecurity measures, risk-based zoning and, subsequently, vaccination to contain the outbreak. Although not initially used, vaccination became a key element in the eradication program, with approximately 140000 horses vaccinated. Vaccination is recognised as a valuable tool for managing EI in endemically infected countries but there is little experience using it in situations where the objective is disease eradication. Vaccination was undoubtedly an important factor in 2007 as it enabled movements of some horses and associated industry activities to recommence. However, its contribution to containment and eradication is less clear. A premises-level equine influenza model, based on an epidemiological analysis of the 2007 outbreak, was developed to evaluate effectiveness of the mitigation strategies used and to investigate whether vaccination, if applied earlier, would have had an effect on the course of the outbreak. The results indicate that early use of strategic vaccination could have significantly reduced the size of the outbreak. The four vaccination strategies evaluated had, by 1 month into the control program, reduced the number of new infections on average by 60% and the size of the infected area by 8-9%. If resources are limited, a 1 km suppressive ring vaccination around infected premises gave the best results, but with greater vaccination capacity, a 3 km ring vaccination was the most effective strategy. The findings suggest that as well as reducing clinical and economic impacts, vaccination when used with biosecurity measures and movement controls could play an important role in the containment and eradication of equine influenza. Crown