Interventions targeting non-symptomatic cases can be important to prevent local outbreaks: SARS-CoV-2 as a case study.
Interventions targeting non-symptomatic cases can be important to prevent local outbreaks: SARS-CoV-2 as a case study.
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DOI：
10.1098/rsif.2020.1014
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发表时间：
2021-05
期刊：
影响因子：
--
通讯作者：
Thompson RN
中科院分区：
文献类型：
--
作者：
Lovell-Read FA;Funk S;Obolski U;Donnelly CA;Thompson RN
在传染病流行期间，一个重要的问题是，病例传播到新的地点是否会引发局部暴发。发生这种情况的风险取决于病原体的传播性、宿主群体的易感性，以及至关重要的是，监测在发现病例和防止进一步传播方面的有效性。对于许多病原体来说，可能会发生来自无症状和/或无症状(统称为无症状)感染宿主的传播，这使得有效的监测具有挑战性。在这里，通过使用SARS-CoV-2作为案例研究，我们展示了当可能发生无症状传播时，如何评估局部暴发的风险。我们构建了一个包括无症状传播的分支过程模型，并探讨了在监测资源有限的情况下，针对无症状或有症状宿主的干预效果。我们考虑，最大限度地降低局部暴发风险是通过加强对无症状或有症状病例的监测和控制，还是两者兼而有之。我们发现，仅寻求增加对有症状宿主的监测通常不是降低暴发风险的最佳战略。采取将加强对有症状病例的监测与努力发现和隔离无症状感染宿主相结合的战略，可以最大程度地降低输入性病例在当地引发暴发的可能性。
During infectious disease epidemics, an important question is whether cases travelling to new locations will trigger local outbreaks. The risk of this occurring depends on the transmissibility of the pathogen, the susceptibility of the host population and, crucially, the effectiveness of surveillance in detecting cases and preventing onward spread. For many pathogens, transmission from pre-symptomatic and/or asymptomatic (together referred to as non-symptomatic) infectious hosts can occur, making effective surveillance challenging. Here, by using SARS-CoV-2 as a case study, we show how the risk of local outbreaks can be assessed when non-symptomatic transmission can occur. We construct a branching process model that includes non-symptomatic transmission and explore the effects of interventions targeting non-symptomatic or symptomatic hosts when surveillance resources are limited. We consider whether the greatest reductions in local outbreak risks are achieved by increasing surveillance and control targeting non-symptomatic or symptomatic cases, or a combination of both. We find that seeking to increase surveillance of symptomatic hosts alone is typically not the optimal strategy for reducing outbreak risks. Adopting a strategy that combines an enhancement of surveillance of symptomatic cases with efforts to find and isolate non-symptomatic infected hosts leads to the largest reduction in the probability that imported cases will initiate a local outbreak.
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DOI：
10.1126/science.1199884
发表时间：
2011-05-06
期刊：
Science (New York, N.Y.)
影响因子：
--
作者：
Charleston B;Bankowski BM;Gubbins S;Chase-Topping ME;Schley D;Howey R;Barnett PV;Gibson D;Juleff ND;Woolhouse ME
通讯作者：
Woolhouse ME
影响因子：
25.7
作者：
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通讯作者：
Cook, Alex R.
影响因子：
3.7
作者：
Craft, Meggan E.;Beyer, Hawthorne L.;Haydon, Daniel T.
通讯作者：
Haydon, Daniel T.
影响因子：
11.8
作者：
Bullard, Jared;Dust, Kerry;Poliquin, Guillaume
通讯作者：
Poliquin, Guillaume
影响因子：
11.8
作者：
Furukawa, Nathan W;Brooks, John T;Sobel, Jeremy
通讯作者：
Sobel, Jeremy