Vaccination strategies for epidemic cholera in Haiti with implications for the developing world
Vaccination strategies for epidemic cholera in Haiti with implications for the developing world
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DOI：
10.1073/pnas.1102149108
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发表时间：
2011-04-26
影响因子：
11.1
通讯作者：
Longini, Ira M., Jr.
中科院分区：
文献类型：
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作者：
Chao, Dennis L.;Halloran, M. Elizabeth;Longini, Ira M., Jr.
2010年10月，一种致命的南亚El Tor霍乱菌株开始在海地传播。干预措施包括治疗病例和改善卫生条件。使用霍乱疫苗可能会进一步降低发病率和死亡率，但这种疫苗供不应求，对霍乱疫情的有效疫苗接种策略知之甚少。我们使用一个数学霍乱传播模型来评估不同的疫苗接种策略。在疫苗数量有限的情况下，将疫苗集中在高危地区总是最有效的。我们表明，将100万剂疫苗对准霍乱弧菌高暴露地区，足以为5%的人口接种两剂疫苗，将使病例数量减少11%。同样的战略为30%的人口提供足够的疫苗，并适度改善卫生条件，可以减少55%的病例，拯救3320人的生命。对于流行性霍乱，我们建议建立足够覆盖该国30%人口的大规模流动疫苗储备，以反应性地针对高暴露风险人群。
In October 2010, a virulent South Asian strain of El Tor cholera began to spread in Haiti. Interventions have included treatment of cases and improved sanitation. Use of cholera vaccines would likely have further reduced morbidity and mortality, but such vaccines are in short supply and little is known about effective vaccination strategies for epidemic cholera. We use a mathematical cholera transmission model to assess different vaccination strategies. With limited vaccine quantities, concentrating vaccine in high-risk areas is always most efficient. We show that targeting one million doses of vaccine to areas with high exposure to Vibrio cholerae, enough for two doses for 5% of the population, would reduce the number of cases by 11%. The same strategy with enough vaccine for 30% of the population with modest hygienic improvement could reduce cases by 55% and save 3,320 lives. For epidemic cholera, we recommend a large mobile stockpile of enough vaccine to cover 30% of a country's population to be reactively targeted to populations at high risk of exposure.