Model-based projections of Zika virus infections in childbearing women in the Americas
Model-based projections of Zika virus infections in childbearing women in the Americas
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DOI：
10.1038/nmicrobiol.2016.126
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发表时间：
2016-09-01
影响因子：
28.3
通讯作者：
Tatem, Andrew J.
中科院分区：
文献类型：
--
作者：
Perkins, T. Alex;Siraj, Amir S.;Tatem, Andrew J.
寨卡病毒是一种蚊子传播的病原体，正在美洲迅速蔓延。由于寨卡病毒感染与一系列胎儿疾病之间存在关联（1，2），这种病毒感染的流行轨迹对每年在美洲出生的近1500万儿童构成了重大关切。确定这一人口中真正处于危险之中的部分是一个重要的优先事项。最近的一项估计（3）表明，542万育龄妇女生活在美洲适合寨卡病毒发生的地区。为了改进这种估计，它没有考虑群体免疫的保护作用，我们开发了一种新的方法，将流行病学理论的经典结果与血清阳性率数据和关于传播驱动因素的高度空间分辨率数据相结合，以进行特定地点的流行病发病率预测。我们的研究结果表明，在第一波疫情结束之前，总共有165万（145 - 206）育龄妇女和9340万（8160 - 11710）人可能被感染。根据目前对受感染妇女中不良胎儿结局发生率的估计（2，4，5），这些结果表明，第一波流行病可能会对成千上万的怀孕产生负面影响。这些预测构成了当前寨卡疫情中风险人群的修订上限，我们的方法提供了一种新的方法来快速评估新出现的传染病所构成的威胁。
Zika virus is a mosquito-borne pathogen that is rapidly spreading across the Americas. Due to associations between Zika virus infection and a range of fetal maladies(1,2), the epidemic trajectory of this viral infection poses a significant concern for the nearly 15 million children born in the Americas each year. Ascertaining the portion of this population that is truly at risk is an important priority. One recent estimate(3) suggested that 5.42 million childbearing women live in areas of the Americas that are suitable for Zika occurrence. To improve on that estimate, which did not take into account the protective effects of herd immunity, we developed a new approach that combines classic results from epidemiological theory with seroprevalence data and highly spatially resolved data about drivers of transmission to make location-specific projections of epidemic attack rates. Our results suggest that 1.65 (1.45-2.06) million childbearing women and 93.4 (81.6-117.1) million people in total could become infected before the first wave of the epidemic concludes. Based on current estimates of rates of adverse fetal outcomes among infected women(2,4,5), these results suggest that tens of thousands of pregnancies could be negatively impacted by the first wave of the epidemic. These projections constitute a revised upper limit of populations at risk in the current Zika epidemic, and our approach offers a new way to make rapid assessments of the threat posed by emerging infectious diseases more generally.