Predictive models of control strategies involved in containing indoor airborne infections
Predictive models of control strategies involved in containing indoor airborne infections
复制标题
DOI：
10.1111/j.1600-0668.2006.00443.x
复制
发表时间：
2006-12-01
期刊：
影响因子：
5.8
通讯作者：
Liao, C-M.
中科院分区：
文献类型：
--
作者：
Chen, S-C.;Chang, C-F.;Liao, C-M.
最近开发的控制措施的建模方法，包含空气传播的感染，包括工程控制与呼吸保护和公共卫生干预措施，很容易服从一个集成的规模分析。在这里，我们表明，这样的模型可以从三种不同类型的功能关系：韦尔斯-莱利数学模型，竞争风险模型，冯Foerster方程，两个关键的流行病学决定因素和它们之间的功能连接所产生的综合规模分析。我们从数学上研究了工程控制措施的影响，如加强空气交换和空气过滤率与个人掩蔽相结合的公共卫生干预措施，如疫苗接种，隔离和接触者追踪，以遏制室内空气传播的感染，包括流感，水痘，麻疹和严重急性呼吸系统综合征（SARS）。如果加强工程控制可以减少基本生殖数（R-0）低于1.60水痘和3麻疹，我们的模拟表明，在这样一个有准备的响应与公共卫生干预措施将有很高的概率包含室内空气传播的感染。工程控制措施和公共卫生干预措施相结合，可以适度控制R-0高达4的流感毒株。我们的分析表明，有效隔离有症状的患者，低效率的接触者追踪足以控制SARS爆发。我们认为，通过系统地量化室内空气传播感染的传播率和无症状感染的比例，可以为公共卫生发明提供一个有价值的附加维度。
Recently developed control measure modeling approaches for containing airborne infections, including engineering controls with respiratory protection and public health interventions, are readily amenable to an integrated-scale analysis. Here we show that such models can be derived from an integrated-scale analysis generated from three different types of functional relationship: Wells-Riley mathematical model, competing-risks model, and Von Foerster equation, both of the key epidemiological determinants involved and of the functional connections between them. We examine mathematically the impact of engineering control measures such as enhanced air exchange and air filtration rates with personal masking combined with public health interventions such as vaccination, isolation, and contact tracing in containing the spread of indoor airborne infections including influenza, chickenpox, measles, and severe acute respiratory syndrome (SARS). If enhanced engineering controls could reduce the basic reproductive number (R-0) below 1.60 for chickenpox and 3 for measles, our simulations show that in such a prepared response with public health interventions would have a high probability of containing the indoor airborne infections. Combinations of engineering control measures and public health interventions could moderately contain influenza strains with an R-0 as high as 4. Our analysis indicates that effective isolation of symptomatic patients with low-efficacy contact tracing is sufficient to control a SARS outbreak. We suggest that a valuable added dimension to public health inventions could be provided by systematically quantifying transmissibility and proportion of asymptomatic infection of indoor airborne infection.