Logistics of community smallpox control through contact tracing and ring vaccination: a stochastic network model.
Logistics of community smallpox control through contact tracing and ring vaccination: a stochastic network model.
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DOI：
10.1186/1471-2458-4-34
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发表时间：
2004-08-06
影响因子：
4.5
通讯作者：
Aragón TJ
中科院分区：
文献类型：
--
作者：
Porco TC;Holbrook KA;Fernyak SE;Portnoy DL;Reiter R;Aragón TJ
以前的天花环形疫苗接种模型的基础上接触跟踪网络表明，环形疫苗接种将是有效的，但没有明确包括响应物流和有限数量的疫苗接种者。我们开发了一个天花传播的连续时间随机模拟，包括网络结构、暴露后接种疫苗、接触者的接触者接种疫苗、有限的反应能力、症状和传染性的异质性、常规疫苗接种停止前的接种、由于公众意识而更快速的诊断、无症状接触者的监测和病例的隔离。我们发现，即使在天花传播非常迅速的情况下，环接种（与监测相结合）在大多数情况下也足以迅速消除天花，假设95%的家庭接触者被追踪，80%的工作场所或社会接触者被追踪，并且没有偶然接触者被追踪，并且在大多数情况下，每天追踪1-5个指示病例就足够了。如果假定天花很快传播给接触者，它有时可能通过环形接种而逃脱控制，但在这种情况下可以通过大规模接种来控制。如果接触者追踪是可行的，天花的小规模传入可能很容易通过环形接种得到控制。生物恐怖分子天花的性质（传染性、疫苗效力）不明确，支持继续计划进行环形疫苗接种和大规模疫苗接种。如果开始接种，应在不延迟接种的情况下进行环形接种，应包括接触者的接触（只要有足够的能力），并应伴随着提高公众意识和监测。
Previous smallpox ring vaccination models based on contact tracing over a network suggest that ring vaccination would be effective, but have not explicitly included response logistics and limited numbers of vaccinators. We developed a continuous-time stochastic simulation of smallpox transmission, including network structure, post-exposure vaccination, vaccination of contacts of contacts, limited response capacity, heterogeneity in symptoms and infectiousness, vaccination prior to the discontinuation of routine vaccination, more rapid diagnosis due to public awareness, surveillance of asymptomatic contacts, and isolation of cases. We found that even in cases of very rapidly spreading smallpox, ring vaccination (when coupled with surveillance) is sufficient in most cases to eliminate smallpox quickly, assuming that 95% of household contacts are traced, 80% of workplace or social contacts are traced, and no casual contacts are traced, and that in most cases the ability to trace 1–5 individuals per day per index case is sufficient. If smallpox is assumed to be transmitted very quickly to contacts, it may at times escape containment by ring vaccination, but could be controlled in these circumstances by mass vaccination. Small introductions of smallpox are likely to be easily contained by ring vaccination, provided contact tracing is feasible. Uncertainties in the nature of bioterrorist smallpox (infectiousness, vaccine efficacy) support continued planning for ring vaccination as well as mass vaccination. If initiated, ring vaccination should be conducted without delays in vaccination, should include contacts of contacts (whenever there is sufficient capacity) and should be accompanied by increased public awareness and surveillance.
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影响因子：
56.9
作者：
Halloran, ME;Longini, IM;Yang, Y
通讯作者：
Yang, Y
影响因子：
4.5
作者：
Arag贸n, TJ;Ulrich, S;Fernyak, S;Rutherford, GW
通讯作者：
Rutherford, GW
影响因子：
5
作者：
Eichner, M
通讯作者：
Eichner, M
影响因子：
5
作者：
HEINER, GG;FATIMA, N;MCCRUMB, FR
通讯作者：
MCCRUMB, FR
影响因子：
56.9
作者：
BLOWER, SM;MCLEAN, AR
通讯作者：
MCLEAN, AR