Factors that make an infectious disease outbreak controllable
Factors that make an infectious disease outbreak controllable
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DOI：
10.1073/pnas.0307506101
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发表时间：
2004-04-20
影响因子：
11.1
通讯作者：
Ferguson, NM
中科院分区：
文献类型：
--
作者：
Fraser, C;Riley, S;Ferguson, NM
本研究的目的是确定新出现的传染源的一般特性，这些特性决定了两种简单的公共卫生措施在控制疫情方面可能成功的可能性，即（1）隔离有症状的个体以及（它）追踪和隔离他们的接触者。由于这些措施取决于对特定疾病症状的识别，因此我们通过使用数学模型来研究传染性和症状出现的相对时间。我们表明，这些控制措施的成功与否取决于明显临床症状出现之前（或通过无症状感染）发生的传播比例，以及病原体的固有传播率（通过再生数 R-0 衡量）。根据已发表的研究，我们估计了两种中度传播病毒（严重急性呼吸综合征冠状病毒和艾滋病毒）以及两种高度传播病毒（天花和大流行性流感）的数量。我们的结论是，使用这些简单的公共卫生措施更容易控制严重急性呼吸道综合症和天花。通过接触者追踪可以直接估计无症状和症状前感染的比例，并且应该成为新型传染源爆发期间的优先事项。
The aim of this study is to identify general properties of emerging infectious agents that determine the likely success of two simple public health measures in controlling outbreaks, namely (1) isolating symptomatic individuals and (it) tracing and quarantining their contacts. Because these measures depend on the recognition of specific disease symptoms, we investigate the relative timing of infectiousness and the appearance of symptoms by using a mathematical model. We show that the success of these control measures is determined as much by the proportion of transmission occurring prior to the onset of overt clinical symptoms (or via asymptomatic infection) as the inherent transmissibility of the etiological agent (measured by the reproductive number R-0). From published studies, we estimate these quantities for two moderately transmissible viruses, severe acute respiratory syndrome coronavirus and HIV, and for two highly transmissible viruses, smallpox and pandemic influenza. We conclude that severe acute respiratory syndrome and smallpox are easier to control using these simple public health measures. Direct estimation of the proportion of asymptomatic and presymptomatic infections is achievable by contact tracing and should be a priority during an outbreak of a novel infectious agent.