Optimal reactive vaccination strategies for a foot-and-mouth outbreak in the UK
Optimal reactive vaccination strategies for a foot-and-mouth outbreak in the UK
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DOI：
10.1038/nature04324
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发表时间：
2006-03-02
期刊：
影响因子：
64.8
通讯作者：
Keeling, MJ
中科院分区：
文献类型：
--
作者：
Tildesley, MJ;Savill, NJ;Keeling, MJ
英国的口蹄疫（FMD）为探索传染病的最佳控制措施提供了一个理想的机会。有了2001年流行病的精细尺度时空数据，可以建立比一般为其他流行病建立的模型更准确的流行病学模型（1-5），并为探索各种替代控制措施提供了机会。2001年流行期间未使用疫苗接种；然而，最近的DEFRA（环境食品和农村事务部）应急计划(6)详细说明了未来如何考虑反应性疫苗接种。在这里，我们使用2001年疫情的数据，考虑在复杂的异构环境中有限的疫苗接种能力的最佳部署。我们使用口蹄疫传播模型来研究受后勤资源限制的牛的反应性环疫苗的最佳部署。预测的最佳环大小高度依赖于后勤约束，但对流行病学参数更为稳健。其他针对性反应性疫苗接种方法可显著降低疫情规模；特别是，忽略报告感染的顺序，并为离以前报告病例最近的农场接种疫苗，可以大大减少流行病。这种策略的优点是它能迅速针对新的感染病灶，而且不需要确定最佳环的大小。
Foot-and-mouth disease (FMD) in the UK provides an ideal opportunity to explore optimal control measures for an infectious disease. The presence of fine-scale spatio-temporal data for the 2001 epidemic has allowed the development of epidemiological models that are more accurate than those generally created for other epidemics(1-5) and provide the opportunity to explore a variety of alternative control measures. Vaccination was not used during the 2001 epidemic; however, the recent DEFRA ( Department for Environment Food and Rural Affairs) contingency plan(6) details how reactive vaccination would be considered in future. Here, using the data from the 2001 epidemic, we consider the optimal deployment of limited vaccination capacity in a complex heterogeneous environment. We use a model of FMD spread to investigate the optimal deployment of reactive ring vaccination of cattle constrained by logistical resources. The predicted optimal ring size is highly dependent upon logistical constraints but is more robust to epidemiological parameters. Other ways of targeting reactive vaccination can significantly reduce the epidemic size; in particular, ignoring the order in which infections are reported and vaccinating those farms closest to any previously reported case can substantially reduce the epidemic. This strategy has the advantage that it rapidly targets new foci of infection and that determining an optimal ring size is unnecessary.