Potential for large outbreaks of Ebola virus disease.
Potential for large outbreaks of Ebola virus disease.
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DOI：
10.1016/j.epidem.2014.09.003
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发表时间：
2014-12
期刊：
影响因子：
3.8
通讯作者：
Edmunds, W. J.
中科院分区：
文献类型：
--
作者：
Camacho, A.;Kucharski, A. J.;Funk, S.;Breman, J.;Piot, P.;Edmunds, W. J.
我们重新研究了1976年扎伊尔第一次埃博拉疫情的数据。使用数学模型，我们估计在不同的设置传输速率。分析表明人与人之间的R 0为1.34（95% CI：0.92-2.11）。1976年的流行病学条件可能会导致更大规模的爆发。埃博拉病毒的爆发可在受影响地区造成严重的发病率和死亡率。迄今为止最大规模的埃博拉疫情目前正在西非爆发，截至2014年9月5日报告了3944例病例。为了更好地了解埃博拉病毒的传播动态，我们重新审视了1976年在扎伊尔（现为刚果民主共和国）发生的第一次已知埃博拉疫情的数据。通过将一个数学模型拟合到按疾病发作、结果和感染源分层的时间序列，我们能够估计几个以前被证明具有挑战性的流行病学数量，包括医院和社区感染对传播的贡献。我们发现有证据表明，在医院关闭之前，传播大大减少，这表明疫情的下降很可能是宿主行为变化的结果。我们的分析表明，在暴发的早期，人与人之间的繁殖数为1.34（95%CI：0.92-2.11）。使用随机模拟，我们证明，在1976年出现的相同的流行病学条件下，可以产生一个大的爆发纯粹是偶然的。与此同时，相对较高的人与人之间的基本繁殖数表明，仅通过医院感染控制措施很难控制埃博拉病毒。
We revisited data from the first known Ebola outbreak in Zaire in 1976. Using a mathematical model, we estimated transmission rates in different settings. Analysis suggests the person-to-person R0 was 1.34 (95% CI: 0.92–2.11). Epidemiological conditions in 1976 could have generated a larger outbreak. Outbreaks of Ebola virus can cause substantial morbidity and mortality in affected regions. The largest outbreak of Ebola to date is currently underway in West Africa, with 3944 cases reported as of 5th September 2014. To develop a better understanding of Ebola transmission dynamics, we revisited data from the first known Ebola outbreak, which occurred in 1976 in Zaire (now Democratic Republic of Congo). By fitting a mathematical model to time series stratified by disease onset, outcome and source of infection, we were able to estimate several epidemiological quantities that have previously proved challenging to measure, including the contribution of hospital and community infection to transmission. We found evidence that transmission decreased considerably before the closure of the hospital, suggesting that the decline of the outbreak was most likely the result of changes in host behaviour. Our analysis suggests that the person-to-person reproduction number was 1.34 (95% CI: 0.92–2.11) in the early part of the outbreak. Using stochastic simulations we demonstrate that the same epidemiological conditions that were present in 1976 could have generated a large outbreak purely by chance. At the same time, the relatively high person-to-person basic reproduction number suggests that Ebola would have been difficult to control through hospital-based infection control measures alone.
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影响因子：
2.4
作者：
Roberts, Gareth O.;Rosenthal, Jeffrey S.
通讯作者：
Rosenthal, Jeffrey S.
DOI：
10.1073/pnas.0810762106
发表时间：
2009-04-21
影响因子：
11.1
作者：
Funk, Sebastian;Gilad, Erez;Jansen, Vincent A. A.
通讯作者：
Jansen, Vincent A. A.
影响因子：
2
作者：
White, L. Forsberg;Pagano, M.
通讯作者：
Pagano, M.
影响因子：
6.4
作者：
Khan, AS;Tshioko, FK;Ksiazek, TG
通讯作者：
Ksiazek, TG
影响因子：
4.3
作者：
Ferrari, MJ;Bjornstad, ON;Dobson, AP
通讯作者：
Dobson, AP