A Quantitative Framework for Defining the End of an Infectious Disease Outbreak: Application to Ebola Virus Disease
A Quantitative Framework for Defining the End of an Infectious Disease Outbreak: Application to Ebola Virus Disease
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定义传染病爆发结束的定量框架：应用于埃博拉病毒病
DOI：
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发表时间：
2021
期刊：
影响因子：
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通讯作者：
A. Cori
中科院分区：
文献类型：
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作者：
B. Djaafara;N. Imai;E. Hamblion;B. Impouma;C. Donnelly;A. Cori
宣布疫情结束是控制传染病疫情的重要一步。客观估计疫情结束的置信水平对于减少宣布后突然爆发的风险很重要。我们开发了一个基于模拟的模型来量化这种信心，并在模拟的埃博拉病毒疾病数据上进行了测试。我们发现，这些置信度估计是最敏感的瞬时再现数，报告率，症状发作和死亡或恢复的最后检测到的情况下之间的时间。对于埃博拉病毒病，我们的研究结果表明，世界卫生组织目前的标准是自最后一个发现病例康复或死亡后42天太短，对漏报太敏感。因此，我们建议改为在最后发现病例出现症状之日起63天后初步宣布疫情结束。在初步宣布之后，还应进行90天的加强监测，以捕捉潜在的病例突发，然后才能宣布疫情正式结束。这一顺序对应于95%以上的置信度，即在所研究的大多数情况下，爆发已经结束。我们的框架是通用的，因此可以适用于估计其他传染病疫情结束的信心。
The end-of-outbreak declaration is an important step in controlling infectious disease outbreaks. Objective estimation of the confidence level that an outbreak is over is important to reduce the risk of postdeclaration flare-ups. We developed a simulation-based model with which to quantify that confidence and tested it on simulated Ebola virus disease data. We found that these confidence estimates were most sensitive to the instantaneous reproduction number, the reporting rate, and the time between the symptom onset and death or recovery of the last detected case. For Ebola virus disease, our results suggested that the current World Health Organization criterion of 42 days since the recovery or death of the last detected case is too short and too sensitive to underreporting. Therefore, we suggest a shift to a preliminary end-of-outbreak declaration after 63 days from the symptom onset day of the last detected case. This preliminary declaration should still be followed by 90 days of enhanced surveillance to capture potential flare-ups of cases, after which the official end of the outbreak can be declared. This sequence corresponds to more than 95% confidence that an outbreak is over in most of the scenarios examined. Our framework is generic and therefore could be adapted to estimate end-of-outbreak confidence for other infectious diseases.
影响因子：
6.4
作者：
Vetter, Pauline;Fischer, William A., II;Kaiser, Laurent
通讯作者：
Kaiser, Laurent