Effects of behavioral changes in a smallpox attack model
Effects of behavioral changes in a smallpox attack model
复制标题
DOI：
10.1016/j.mbs.2005.03.006
复制
发表时间：
2005-06-01
影响因子：
4.3
通讯作者：
Castillo-Chavez, C
中科院分区：
文献类型：
--
作者：
Del Valle, S;Hethcote, H;Castillo-Chavez, C
个人和社区在应对高死亡率疾病爆发时的行为变化的影响往往没有得到重视。应对天花生物恐怖袭击的战略重点是采取干预措施，如隔离感染者、追踪接触者、隔离接触者、环形疫苗接种和大规模疫苗接种。我们制定和分析一个数学模型，其中一些人降低他们的日常接触活动率，一旦流行病已被确定在一个社区。根据数据估计传输参数，并推导出有效再现数的表达式。我们使用计算机模拟来分析行为改变单独和与其他控制措施相结合的影响。我们证明，疾病的传播是高度敏感的人如何迅速减少他们的接触活动率和预防措施，人口采取减少疾病的传播。即使是渐进和温和的行为变化也会对减缓流行病产生巨大影响。当行为改变与其他干预措施相结合时，流行时间缩短，天花病例数量减少。我们的结论是，天花爆发的模拟是有用的，他们必须考虑行为变化的影响。如果模型预测被用来指导公共卫生政策，这一点尤其正确。(c)2005年爱思唯尔公司All rights reserved.
The impact of individual and community behavioral changes in response to an outbreak of a disease with high mortality is often not appreciated. Response strategies to a smallpox bioterrorist attack have focused on interventions such as isolation of infectives, contact tracing, quarantine of contacts, ring vaccination, and mass vaccination. We formulate and analyze a mathematical model in which some individuals lower their daily contact activity rates once an epidemic has been identified in a community. Transmission parameters are estimated from data and an expression is derived for the effective reproduction number. We use computer simulations to analyze the effects of behavior change alone and in combination with other control measures. We demonstrate that the spread of the disease is highly sensitive to how rapidly people reduce their contact activity rates and to the precautions that the population takes to reduce the transmission of the disease. Even gradual and mild behavioral changes can have a dramatic impact in slowing an epidemic. When behavioral changes are combined with other interventions, the epidemic is shortened and the number of smallpox cases is reduced. We conclude that for simulations of a smallpox outbreak to be useful, they must consider the impact of behavioral changes. This is especially true if the model predictions are being used to guide public health policy. (c) 2005 Elsevier Inc. All rights reserved.