Quantifying the routes of transmission for pandemic influenza
Quantifying the routes of transmission for pandemic influenza
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DOI：
10.1007/s11538-007-9281-2
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发表时间：
2008-04-01
影响因子：
3.5
通讯作者：
Wein, Lawrence M.
中科院分区：
文献类型：
--
作者：
Atkinson, Michael P.;Wein, Lawrence M.
出于评估大流行性流感的非药物干预措施的愿望，我们在本研究中寻求量化这种疾病的传播途径。我们建立了一个数学模型的气溶胶（即，飞沫核）和接触传播的流感在一个家庭有一个感染者。结合流感和鼻病毒数据对该模型进行的分析表明，流感的气溶胶传播远比接触传播占主导地位。我们还考虑了近距离呼气事件的单独模型，并发现近距离咳嗽不太可能（大约1%的概率）产生传统的飞沫传播（即直接沉积在粘膜上），尽管近距离、无保护和水平方向的喷嚏足以导致飞沫传播。关于近距离呼气事件发生频率的数据不足，无法评估气溶胶传播和飞沫传播的相对重要性，谨慎的做法是，在得到证实之前，不排除飞沫传播很重要的可能性。然而，近距离、无保护和水平方向打喷嚏的罕见性，加上鼻病毒有明显的气溶胶和接触传播的证据，以及我们对鼻病毒和流感危险率的比较，使我们怀疑气溶胶传播是流感的主要传播方式。
Motivated by the desire to assess nonpharmaceutical interventions for pandemic influenza, we seek in this study to quantify the routes of transmission for this disease. We construct a mathematical model of aerosol (i.e., droplet-nuclei) and contact transmission of influenza within a household containing one infected. An analysis of this model in conjunction with influenza and rhinovirus data suggests that aerosol transmission is far more dominant than contact transmission for influenza. We also consider a separate model of a close expiratory event, and find that a close cough is unlikely (approximate to 1% probability) to generate traditional droplet transmission (i.e., direct deposition on the mucous membranes), although a close, unprotected and horizontally-directed sneeze is potent enough to cause droplet transmission. There are insufficient data on the frequency of close expiratory events to assess the relative importance of aerosol transmission and droplet transmission, and it is prudent to leave open the possibility that droplet transmission is important until proven otherwise. However, the rarity of close, unprotected and horizontally-directed sneezes-coupled with the evidence of significant aerosol and contact transmission for rhinovirus and our comparison of hazard rates for rhinovirus and influenza-leads us to suspect that aerosol transmission is the dominant mode of transmission for influenza.