Compliance to Oseltamivir among Two Populations in Oxfordshire, United Kingdom Affected by Influenza A(H1N1)pdm09, November 2009 – A Waste Water Epidemiology Study

• DOI: 10.1371/journal.pone.0060221
• Publication Date: 2013-04-15T22:09:51Z
• Authors: Andrew C. Singer; Josef D. Järhult; Roman Grabic; Ghazanfar A. Khan; Ganna Fedorova; Jerker Fick; Richard H. Lindberg; Michael J. Bowes; Björn Olsen; Hanna Söderström
• Keywords: Oseltamivir; Preparedness; Antiviral drug; Pandemic

Antiviral provision remains the focus of many pandemic preparedness plans, however, there is considerable uncertainty regarding antiviral compliance rates. Here we employ a waste water epidemiology approach to estimate oseltamivir (Tamiflu®) compliance. Oseltamivir carboxylate (oseltamivir's active metabolite) was recovered from two treatment plant (WWTP) catchments within United Kingdom at peak autumnal wave 2009 Influenza A (H1N1)pdm09 pandemic. Predictions consumption detected levels were compared with sources national government statistics derive Scenario and sensitivity analysis indicated between 3–4 120–154 people using during study period in WWTP rate 45–60%. With approximately half collected antivirals going unused, clear need alter public health messages improve We argue that near real-time understanding drug scale (hundreds millions people) can potentially help become more timely, targeted, demographically sensitive, while leading less mis- un-used antiviral, wastage ultimately robust efficacious plan.