Kaplan Edward H
Yale School of Management and Yale Medical School, New Haven, Connecticut, USA.
Emerg Infect Dis. 2003 Aug;9(8):909-14. doi: 10.3201/eid0908.030079.
To assess whether screening blood donors could provide early warning of a bioterror attack, we combined stochastic models of blood donation and the workings of blood tests with an epidemic model to derive the probability distribution of the time to detect an attack under assumptions favorable to blood donor screening. Comparing the attack detection delay to the incubation times of the most feared bioterror agents shows that even under such optimistic conditions, victims of a bioterror attack would likely exhibit symptoms before the attack was detected through blood donor screening. For example, an attack infecting 100 persons with a noncontagious agent such as Bacillus anthracis would only have a 26% chance of being detected within 25 days; yet, at an assumed additional charge of $10 per test, donor screening would cost $139 million per year. Furthermore, even if screening tests were 99.99% specific, 1,390 false-positive results would occur each year. Therefore, screening blood donors for bioterror agents should not be used to detect a bioterror attack.
为评估筛查献血者是否能为生物恐怖袭击提供早期预警，我们将献血的随机模型、血液检测流程与一个流行病模型相结合，以便在有利于献血者筛查的假设条件下，推导出检测到袭击的时间的概率分布。将袭击检测延迟与最令人恐惧的生物恐怖制剂的潜伏期进行比较后发现，即便在如此乐观的条件下，生物恐怖袭击的受害者在通过献血者筛查检测到袭击之前，可能就已出现症状。例如，用炭疽杆菌等非传染性制剂感染100人的袭击事件，在25天内被检测到的概率仅为26%；然而，假设每次检测额外收费10美元，那么每年的献血者筛查成本将达1.39亿美元。此外，即便筛查检测的特异性为99.99%，每年仍会出现1390例假阳性结果。因此，不应通过筛查献血者来检测生物恐怖袭击。
