Early efforts in modeling the incubation period of infectious diseases with an acute course of illness.
Early efforts in modeling the incubation period of infectious diseases with an acute course of illness.
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DOI：
10.1186/1742-7622-4-2
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发表时间：
2007-05-11
影响因子：
2.3
通讯作者：
Nishiura H
中科院分区：
文献类型：
--
作者：
Nishiura H
传染病的潜伏期，即从微生物感染到发病的时间，与防控直接相关。由于潜伏期的明确模型增强了我们对疾病传播的理解，因此重新审视了以前的经典研究，重点关注所采用的建模方法，并特别关注相对未知的历史努力。最早关于大流行性流感潜伏期的研究发表于 1919 年，利用从澳大利亚几个港口出发的船舶上每天的发病率来估计西班牙流感的潜伏期。尽管该研究明确涉及未知的暴露时间，但假设的感染概率相同的暴露时间太长，因此可能导致潜伏期略有低估。在提出潜伏期遵循对数正态分布的建议后，日本流行病学家将这一假设扩展到点源爆发期间的暴露时间估计。尽管急性传染病潜伏期呈现右偏分布的原因已被多次探讨，但对数正态假设的有效性尚未完全阐明。目前，假设了各种不同的分布，并且假设对数正态分布缺乏有效性在疾病缓慢进展的情况下尤其明显。本文指出：（1）当确切的暴露时间未知时，使用明确的短时间暴露和适当的统计方法进行分析至关重要；（2）在假设潜伏期的特定分布时，除了使用不同数据集的估计、分析潜伏期的决定因素以及了解潜在的疾病机制之外，还需要使用不同的分布进行比较。
The incubation period of infectious diseases, the time from infection with a microorganism to onset of disease, is directly relevant to prevention and control. Since explicit models of the incubation period enhance our understanding of the spread of disease, previous classic studies were revisited, focusing on the modeling methods employed and paying particular attention to relatively unknown historical efforts. The earliest study on the incubation period of pandemic influenza was published in 1919, providing estimates of the incubation period of Spanish flu using the daily incidence on ships departing from several ports in Australia. Although the study explicitly dealt with an unknown time of exposure, the assumed periods of exposure, which had an equal probability of infection, were too long, and thus, likely resulted in slight underestimates of the incubation period. After the suggestion that the incubation period follows lognormal distribution, Japanese epidemiologists extended this assumption to estimates of the time of exposure during a point source outbreak. Although the reason why the incubation period of acute infectious diseases tends to reveal a right-skewed distribution has been explored several times, the validity of the lognormal assumption is yet to be fully clarified. At present, various different distributions are assumed, and the lack of validity in assuming lognormal distribution is particularly apparent in the case of slowly progressing diseases. The present paper indicates that (1) analysis using well-defined short periods of exposure with appropriate statistical methods is critical when the exact time of exposure is unknown, and (2) when assuming a specific distribution for the incubation period, comparisons using different distributions are needed in addition to estimations using different datasets, analyses of the determinants of incubation period, and an understanding of the underlying disease mechanisms.