Case isolation and contact tracing can prevent the spread of smallpox
Case isolation and contact tracing can prevent the spread of smallpox
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DOI：
10.1093/aje/kwg104
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发表时间：
2003-07-15
影响因子：
5
通讯作者：
Eichner, M
中科院分区：
文献类型：
--
作者：
Eichner, M
由于担心恐怖组织可能已经获得了天花病毒，人们就如何通过接种疫苗来防止天花的再次传播以及能否获得足够数量的疫苗展开了广泛的讨论。在本文中，作者通过隔离公开病例并对其接触者进行长达3周的密切监测，研究了天花的传播是如何受到影响的。作者假设病例发现从最初的7天逐渐改善到3天。这种干预应伴随着疫苗接种，但其结果并不取决于疫苗的效力。因此，它在控制由免疫特性已被基因工程改变的病原体引起的疫情方面可能特别重要。作者利用随机计算机模拟证明，接触者追踪和病例隔离可以在不到半年的时间内消灭高度易感人群中的天花暴发，而不会造成每100例指示病例中550例以上的继发病例。作者还推导出简单的近似表达式，可以预测仅通过所描述的措施就能有效地控制疫情，并预测疫情中预计的病例数和必须接受监测的人数。
Fears that terrorist groups may have gained access to variola virus have led to widespread discussions on how to prevent the reintroduction of smallpox by vaccination and on the availability of sufficiently large amounts of vaccine. In this paper, the author examines how the spread of smallpox is affected by isolating overt cases and taking their contacts under close surveillance for up to 3 weeks. The author assumes that case detection gradually improves from initially 7 days to 3 days. This intervention should be accompanied by vaccination, but its outcome does not depend on the vaccines efficacy. It may, therefore, be especially important in controlling outbreaks caused by pathogens whose immunologic properties have been modified by genetic engineering. Using stochastic computer simulations, the author demonstrates that contact tracing and case isolation can extinguish smallpox outbreaks in highly susceptible populations within less than half a year without causing totals of more than 550 secondary cases per 100 index cases. The author also derives simple approximate expressions that allow prognostication on how efficiently an outbreak can be controlled by the described measures alone and prediction of the expected number of cases in an outbreak and the number of people that must be taken under surveillance.