Estimating the duration of pertussis immunity using epidemiological signatures.
Estimating the duration of pertussis immunity using epidemiological signatures.
复制标题
DOI：
10.1371/journal.ppat.1000647
复制
发表时间：
2009-10
期刊：
影响因子：
6.7
通讯作者：
Rohani P
中科院分区：
文献类型：
--
作者：
Wearing HJ;Rohani P
在一些常规儿科免疫接种率较高的国家，百日咳病例报告有所增加。这导致了对百日咳可能再次出现的重大公共卫生担忧。对于观察到的发病率增加的一个主要解释是百日咳免疫力的丧失，已知百日咳在自然感染和疫苗接种后都会发生。然而，人们对免疫的典型持续时间及其流行病学影响知之甚少。在这里，我们分析一个简单的数学模型，具体探讨流行间期和淡出频率。然后将这些预测与英格兰和威尔士的详细发病率数据进行对比。我们发现模型输出对有关自然获得免疫力的假设最敏感，这使我们能够估计免疫力的平均持续时间。我们的结果支持一段自然免疫期，平均而言，该免疫期是持久的（至少 30 年），但本质上是可变的。根除疫苗可预防的传染病仍然是重要的公共卫生优先事项。为了实现这一目标，提供的免疫力需要高且持久。对于百日咳（婴儿死亡的主要原因之一），某些人的免疫力已被证明减弱。这一观察结果的流行病学影响主要取决于整个人群保护性免疫的持续时间，而这仍然很难估计。我们通过探索模型动态与英格兰和威尔士病例通知数据之间的一致性来解决这个问题。我们的估计表明，免疫力的平均持续时间比目前认为的要长得多（至少 30 年），但有些人会很快失去免疫力。
Case notifications of pertussis have shown an increase in a number of countries with high rates of routine pediatric immunization. This has led to significant public health concerns over a possible pertussis re-emergence. A leading proposed explanation for the observed increase in incidence is the loss of immunity to pertussis, which is known to occur after both natural infection and vaccination. Little is known, however, about the typical duration of immunity and its epidemiological implications. Here, we analyze a simple mathematical model, exploring specifically the inter-epidemic period and fade-out frequency. These predictions are then contrasted with detailed incidence data for England and Wales. We find model output to be most sensitive to assumptions concerning naturally acquired immunity, which allows us to estimate the average duration of immunity. Our results support a period of natural immunity that is, on average, long-lasting (at least 30 years) but inherently variable. The eradication of vaccine-preventable infectious diseases remains an important public health priority. To achieve this goal, the level of immunity afforded needs to be high and long-lasting. For pertussis, one of the leading causes of mortality in infants, immunity has been shown to wane in some individuals. The epidemiological impacts of this observation depend critically on the duration of protective immunity in the entire population, which remains notoriously difficult to estimate. We approach this problem by exploring the agreement between model dynamics and case notification data from England & Wales. Our estimates suggest the average duration of immunity is much longer than is currently thought (at least 30 years), but that some individuals would lose immunity quite rapidly.
登录
查看更多内容
影响因子：
1.9
作者：
Alexander, ME;Moghadas, SM;Summers, AR
通讯作者：
Summers, AR
影响因子：
15.3
作者：
Leef, M;Elkins, KL;Shahin, RD
通讯作者：
Shahin, RD
影响因子：
56.9
作者：
ANDERSON, RM;MAY, RM
通讯作者：
MAY, RM
DOI：
10.1098/rspb.2009.0057
发表时间：
2009-06-07
影响因子：
4.7
作者：
Heffernan, J. M.;Keeling, M. J.
通讯作者：
Keeling, M. J.
影响因子：
--
作者：
ANDERSON, RM;GRENFELL, BT;MAY, RM
通讯作者：
MAY, RM