Application of an individual based model with real data of transportation mode and location to pandemic influenza

虽然区域隔离已被提议为对抗大流行性流感的最佳快速控制策略之一，但检验各种干预措施在不同环境下的潜在有效性至关重要。这项研究旨在评估关闭运输系统的潜在有效性，并将其与设施关闭和区域隔离等其他措施的有效性进行比较。该分析采用了一个基于代理的模型，该模型明确地描述了一个拥有90万人口的社区的家庭分布和家庭结构。比较了各种措施的有效性和灭绝概率。在指定的累积病例数开始时关闭列车系统似乎有效2.16%(95%置信区间（CI）：[1.81, 2.84])，但在同一阈值关闭所有设施可以更有效地减少临床表观感染数量（有效25.6%,95% CI:[25.1, 26.5]）。此外，如果在疫情的早期阶段将这些措施结合起来（即，如果我们在临床报告的累积比例超过人口的1%时立即开始这两项措施），结果表明，交通系统的关闭对病例数量没有特别的影响。然而，研究也表明，如果列车内的传播概率比列车内没有传播的概率高，停机可以将成功遏制的概率提高20%。我们的研究表明，要有效减少大流行的传播，区域隔离比关闭火车更重要，但如果运输系统内的传播概率极高，并且该措施具有足够的成本效益，那么关闭火车可能是有价值的。

Though area quarantine has been proposed as one of the best rapid control strategies against pandemic influenza, it is of critical importance to examine the potential effectiveness of various interventions in different settings. This study was aimed at assessing the potential effectiveness of shutting down transportation systems and comparing this with the effectiveness of other measures, such as facility closure and area quarantine. An agent-based model, which explicitly depicts household distributions and family structures of a community populated with 900,000 individuals, was employed for this analysis. The effectiveness of each measure and probabilities of extinction were compared. Shutting down the train system starting at a specified cumulative number of cases appeared to be 2.16% (95% confidence interval (CI) : [1.81, 2.84]) effective, but closing all facilities at the same threshold reduced the number of clinically apparent infections more efficiently (25.6% effective, 95% CI : [25.1, 26.5]). Moreover, if these measures are combined at an early stage of the epidemic (i.e., if we start both measures immediately at the time a cumulative proportion of clinical reports exceeds 1% of the population), it was shown that the shutdown of transportation systems did not have particular influence on the number of cases. However, it was also demonstrated that the shutdown can increase the probability of successful containment by 20% if the transmission probability within trains is high compared to no transmission within trains. Our study implies that area quarantine is more important to effectively reduce the spread of a pandemic, rather than shutting down trains, but that it might be valuable to shut down trains if the transmission probability within the transportation system is extremely high and if the measure is sufficiently cost effective.