Detecting differential transmissibilities that affect the size of self-limited outbreaks.
Detecting differential transmissibilities that affect the size of self-limited outbreaks.
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DOI：
10.1371/journal.ppat.1004452
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发表时间：
2014-10
期刊：
影响因子：
6.7
通讯作者：
Pulliam JR
中科院分区：
文献类型：
--
作者：
Blumberg S;Funk S;Pulliam JR
通过识别个体之间传播感染的可能性差异，我们对传染病作出适当反应的能力得到了加强。在这里，我们确定了自限性感染的流行病学特征（即有效繁殖数满足的感染）与传播性相关。我们的分析是基于一个分支过程模型，允许两种不同类型的情况下，传输的强度和异质性的统计比较。我们的方法提供了对各种情况的深入了解，包括中东呼吸综合征冠状病毒（MERS-CoV）在阿拉伯半岛的传播，北美的麻疹，欧洲消灭前的天花，以及刚果民主共和国的人猴痘。当应用于2014年之前MERS-CoV传播的链大小数据时，我们的方法表明，尽管有明显的控制改善趋势，但没有足够的统计证据表明随着时间的推移而下降。与此同时，美国和加拿大麻疹的连锁规模数据显示，在统计上存在显著的地理差异，这表明国家疫苗接种计划的时间和覆盖范围以及接触者追踪程序可能会影响观察到的感染群的规模分布。天花的感染源数据表明，原发病例比继发病例传播更多，并提供了控制干预措施有效性的定量评估。另一方面，人类猴痘没有证据表明与人类接触的动物、原发病例或继发病例之间存在差异传播，这缓解了人们对社会混合可能扩大继发病例传播的担忧。最后，我们评估监测要求，以检测猴痘的人际传播的变化，因为停止交叉保护性天花疫苗接种。我们的研究奠定了基础，为今后的调查如何感染源，疫苗接种状况或其他假定的传播特性可能会影响自限性传播。本文的目的是确定与传播特定疾病的风险增加或减少相关的流行病学因素。我们特别感兴趣的是确定自限性疾病（即感染往往发生在孤立的集群中）的这些因素，因为有针对性地控制这些疾病可以促进公共卫生目标，以最大限度地减少疾病发生的风险或促进疾病消除。例如，我们表明，美国和加拿大之间麻疹的传播存在显着差异。相比之下，我们发现，2013年下半年观察到的中东呼吸综合征冠状病毒传播减少的情况无法以足够的信心确定。然后，我们量化了控制在欧洲根除天花方面的有效程度。我们还考虑了猴痘在人类中的传播如何取决于感染源是动物还是人。最后，我们展示了我们的方法可以被监控程序用来检测随着时间的推移可能发生的传输变化。
Our ability to respond appropriately to infectious diseases is enhanced by identifying differences in the potential for transmitting infection between individuals. Here, we identify epidemiological traits of self-limited infections (i.e. infections with an effective reproduction number satisfying ) that correlate with transmissibility. Our analysis is based on a branching process model that permits statistical comparison of both the strength and heterogeneity of transmission for two distinct types of cases. Our approach provides insight into a variety of scenarios, including the transmission of Middle East Respiratory Syndrome Coronavirus (MERS-CoV) in the Arabian peninsula, measles in North America, pre-eradication smallpox in Europe, and human monkeypox in the Democratic Republic of the Congo. When applied to chain size data for MERS-CoV transmission before 2014, our method indicates that despite an apparent trend towards improved control, there is not enough statistical evidence to indicate that has declined with time. Meanwhile, chain size data for measles in the United States and Canada reveal statistically significant geographic variation in , suggesting that the timing and coverage of national vaccination programs, as well as contact tracing procedures, may shape the size distribution of observed infection clusters. Infection source data for smallpox suggests that primary cases transmitted more than secondary cases, and provides a quantitative assessment of the effectiveness of control interventions. Human monkeypox, on the other hand, does not show evidence of differential transmission between animals in contact with humans, primary cases, or secondary cases, which assuages the concern that social mixing can amplify transmission by secondary cases. Lastly, we evaluate surveillance requirements for detecting a change in the human-to-human transmission of monkeypox since the cessation of cross-protective smallpox vaccination. Our studies lay the foundation for future investigations regarding how infection source, vaccination status or other putative transmissibility traits may affect self-limited transmission. The goal of this paper is to identify epidemiological factors that correlate with either an increased or decreased risk of transmitting a particular disease. We are particularly interested in identifying such factors for diseases that are self-limited (meaning that infections tend to occur in isolated clusters), because targeted control of these diseases can facilitate public health goals for minimizing the risk of disease emergence or promoting disease elimination. For example, we show that there is a significant difference in the transmission of measles between the United States and Canada. In contrast, we find that an observed decrease in the transmission of Middle East respiratory syndrome coronavirus during the latter half of 2013 cannot be ascertained with sufficient confidence. We then quantify the degree to which control was effective in eradicating smallpox in Europe. We also consider how the transmission of monkeypox in humans depends on whether the infection source is an animal or a human. Finally, we demonstrate how our approach can be used by surveillance programs to detect changes in transmission that may occur over time.
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影响因子：
56.3
作者：
Cauchemez, Simon;Fraser, Christophe;Van Kerkhove, Maria D.;Donnelly, Christi A.;Riley, Steven;Rambaut, Andrew;Enouf, Vincent;van der Werf, Sylvie;Ferguson, Neil M.
通讯作者：
Ferguson, Neil M.
影响因子：
3.9
作者：
Alexander, H. K.;Day, T.
通讯作者：
Day, T.
影响因子：
2.1
作者：
Farrington, CP;Kanaan, MN;Gay, NJ
通讯作者：
Gay, NJ
DOI：
10.1016/s1473-3099(13)70691-1
发表时间：
2014-03
期刊：
The Lancet. Infectious diseases
影响因子：
--
作者：
Ferguson NM;Van Kerkhove MD
通讯作者：
Van Kerkhove MD
影响因子：
6.8
作者：
AKAIKE, H
通讯作者：
AKAIKE, H