Quantifying social distancing arising from pandemic influenza.
Quantifying social distancing arising from pandemic influenza.
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DOI：
10.1098/rsif.2007.1197
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发表时间：
2008-06-06
期刊：
影响因子：
--
通讯作者：
McCracken K
中科院分区：
文献类型：
--
作者：
Caley P;Philp DJ;McCracken K
1918-1919年流感大流行期间的地方流行曲线往往以多波流行为特征。找出这种浪潮的根本原因(S)可能有助于控制未来的大流行。我们调查了一种假设，即这些海浪是由人们避免潜在的传染性接触--一种被称为“社交距离”的行为--引起的。我们估计了疾病的有效复制数量，并由此推断了在澳大利亚悉尼多波疫情期间发生的社会距离的最大程度。我们估计，在整个城市，人们的传染性接触率平均降低了38%，这足以解释这种流行病的多次浪潮。基本繁殖数R0估计在1.6-2.0的范围内，首选估计为1.8，与最近对1918-1919年流感大流行的其他估计一致。这些数据也与高比例(90%以上)的人群最初易受临床感染的情况一致，而无症状(如果发生)的感染比例不高于约9%。观察到的36.6%的临床发病率大大低于基于R0值估计的59%的预期，这意味着大约22%的人口免于临床感染。临床发病率的这一下降相当于每10万 000人的生命中估计有260人获救，这表明社会距离干预可能在减轻未来流感大流行对公共卫生的影响方面发挥重要作用。
Local epidemic curves during the 1918–1919 influenza pandemic were often characterized by multiple epidemic waves. Identifying the underlying cause(s) of such waves may help manage future pandemics. We investigate the hypothesis that these waves were caused by people avoiding potentially infectious contacts—a behaviour termed ‘social distancing’. We estimate the effective disease reproduction number and from it infer the maximum degree of social distancing that occurred during the course of the multiple-wave epidemic in Sydney, Australia. We estimate that, on average across the city, people reduced their infectious contact rate by as much as 38%, and that this was sufficient to explain the multiple waves of this epidemic. The basic reproduction number, R0, was estimated to be in the range of 1.6–2.0 with a preferred estimate of 1.8, in line with other recent estimates for the 1918–1919 influenza pandemic. The data are also consistent with a high proportion (more than 90%) of the population being initially susceptible to clinical infection, and the proportion of infections that were asymptomatic (if this occurs) being no higher than approximately 9%. The observed clinical attack rate of 36.6% was substantially lower than the 59% expected based on the estimated value of R0, implying that approximately 22% of the population were spared from clinical infection. This reduction in the clinical attack rate translates to an estimated 260 per 100 000 lives having been saved, and suggests that social distancing interventions could play a major role in mitigating the public health impact of future influenza pandemics.
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影响因子：
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作者：
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通讯作者：
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影响因子：
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作者：
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DOI：
10.1073/pnas.0611071104
发表时间：
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影响因子：
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10.1073/pnas.0610941104
发表时间：
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影响因子：
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