Downgrading disease transmission risk estimates using terminal importations
Downgrading disease transmission risk estimates using terminal importations
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DOI：
10.1371/journal.pntd.0007395
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发表时间：
2018-02
影响因子：
3.8
通讯作者：
S. Fox;S. Bellan;T. Perkins;M. Johansson;L. Meyers
中科院分区：
文献类型：
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作者：
S. Fox;S. Bellan;T. Perkins;M. Johansson;L. Meyers
随着登革热、埃博拉、基孔肯雅热和寨卡等新出现和重新出现的传染病威胁到全球新的人口，官员们争先恐后地评估当地的严重程度和传染性，几乎没有流行病学史可供借鉴。评估本土（当地）传播风险的标准方法要么根据生态适宜性进行间接估计，要么仅在当地病例积累后进行直接估计。然而，一个被忽视的流行病学数据来源是没有输入性病例的传播，而这些数据可以在疫情出现之前为风险评估提供有意义的信息。在这里，我们提出了一种方法更新先验生态估计的传输风险，使用实时进口数据。我们使用2016年德克萨斯州的寨卡进口和传播数据来证明我们的方法，德克萨斯州是美国南部的一个高风险地区。我们更新的风险估计低于先前报告的风险估计，德克萨斯州只有六个县可能持续寨卡疫情，与2017年发现的本土病例数量一致。因此，随着传染病扩大其全球范围，输入性事件可以为当地传播风险提供关键的早期洞察力。
As emerging and re-emerging infectious diseases like dengue, Ebola, chikungunya, and Zika threaten new populations worldwide, officials scramble to assess local severity and transmissibility, with little to no epidemiological history to draw upon. Standard methods for assessing autochthonous (local) transmission risk make either indirect estimates based on ecological suitability or direct estimates only after local cases accumulate. However, an overlooked source of epidemiological data that can meaningfully inform risk assessments prior to outbreak emergence is the absence of transmission by imported cases. Here, we present a method for updating a priori ecological estimates of transmission risk using real-time importation data. We demonstrate our method using Zika importation and transmission data from Texas in 2016, a high-risk region in the southern United States. Our updated risk estimates are lower than previously reported, with only six counties in Texas likely to sustain a Zika epidemic, and consistent with the number of autochthonous cases detected in 2017. Importation events can thereby provide critical, early insight into local transmission risks as infectious diseases expand their global reach.