Reproductive numbers, epidemic spread and control in a community of households
Reproductive numbers, epidemic spread and control in a community of households
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DOI：
10.1016/j.mbs.2009.06.002
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发表时间：
2009-09-01
影响因子：
4.3
通讯作者：
Lipsitch, M.
中科院分区：
文献类型：
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作者：
Goldstein, E.;Paur, K.;Lipsitch, M.
许多关于新出现的流行病（如SARS和大流行性流感）的研究使用群体行动模型来估计生殖数量和所需的控制措施。实际上，由于存在各种社交网络，传播模式更加复杂。一个复杂的层次可以通过考虑一个家庭社区来解决。我们的传播动力学研究在一个社区的家庭强调五种类型的生殖数的流行病传播：家庭间的生殖数，漏疫苗相关的生殖数，完美的疫苗生殖数，增长率生殖数，和个人的生殖数。每一个都携带着关于传输动态和所需控制措施的不同信息，并且通常其中一些可以从数据中估计出来，而另一些则不能。模拟表明，在某些情况下，这些再生数有一个顺序。我们已经证明了一些订购的一般假设下的个人传染性配置文件的不平等。例如，这些不等式使人们能够在不知道模型中各种传播参数的情况下估计所需的疫苗覆盖率和其他控制措施。沿着这一过程，我们还表明，在以相同的因素在提高疫苗效力和提高覆盖率之间进行选择时，优先考虑效力。(C)2009爱思唯尔公司All rights reserved.
Many of the studies on emerging epidemics (such as SARS and pandemic flu) use mass action models to estimate reproductive numbers and the needed control measures. In reality, transmission patterns are more complex due to the presence of various social networks. One level of complexity can be accommodated by considering a community of households. Our study of transmission dynamics in a community of households emphasizes five types of reproductive numbers for the epidemic spread: household-to-household reproductive number, leaky vaccine-associated reproductive numbers, perfect vaccine reproductive number, growth rate reproductive number, and the individual reproductive number. Each of those carries different information about the transmission dynamics and the required control measures, and often some of those can be estimated from the data while others cannot. Simulations have shown that under certain scenarios there is an ordering for those reproductive numbers. We have proven a number of ordering inequalities under general assumptions about the individual infectiousness profiles. Those inequalities allow, for instance, to estimate the needed vaccine coverage and other control measures without knowing the various transmission parameters in the models. Along the way, we have also shown that in choosing between increasing vaccine efficacy and increasing coverage levels by the same factor, preference should go to efficacy. (C) 2009 Elsevier Inc. All rights reserved.