Choi B C K, Pak A W P
Department of Epidemiology and Community Medicine, Faculty of Medicine, University of Ottawa, Ottawa, Ontario, Canada K1H 5N1.
J Epidemiol Community Health. 2003 Oct;57(10):831-5. doi: 10.1136/jech.57.10.831.
Severe acute respiratory syndrome (SARS) is currently spreading in many countries. This paper proposes a simple approximate mathematical model for public health practitioners to predict the number of SARS cases and deaths.
The model is based on four parameters: R(o) (basic reproductive number), F (case-fatality rate), i (incubation period), and d (duration of disease). The calculations can be done by hand or by using a computer spreadsheet.
The best parameters to fit Canadian data as of 6 April 2003 (before infection controls took effect) are R(o) = 1.5, F = 30%, i = 5 days, d = 14 days. On 6 April (day 40) there were 74 cases and 7 deaths. If this trend continues, SARS numbers in Canada are predicted to be as follows: 387 cases and 34 deaths by 26 April (day 60), 4432 cases and 394 deaths by 26 May (day 90), and 50 500 cases and 4489 deaths by 25 June (day 120). By comparison, the best parameters to fit Hong Kong data as of 10 April 2003 are R(o) = 2.0, F = 20%, i = 5 days, d = 14 days.
Using the proposed mathematical model, it was estimated that about 1.5 to 2 new infectious cases were produced per infectious case every five days. Also, about 20% to 30% of the cases die within 14 days. The case-fatality may therefore be considerably higher than initially thought. The model indicates that SARS can spread very fast when there are no interventions.
严重急性呼吸综合征(SARS)目前正在许多国家蔓延。本文提出了一个简单的近似数学模型,供公共卫生从业者预测SARS病例数和死亡人数。
该模型基于四个参数:R(o)(基本繁殖数)、F(病死率)、i(潜伏期)和d(疾病持续时间)。计算可以手动完成,也可以使用计算机电子表格。
拟合2003年4月6日(感染控制生效前)加拿大数据的最佳参数为R(o)=1.5、F=30%、i=5天、d=14天。4月6日(第40天)有74例病例和7例死亡。如果这种趋势持续下去,预计加拿大的SARS病例数如下:4月26日(第60天)为387例病例和34例死亡,5月26日(第90天)为4432例病例和394例死亡,6月25日(第120天)为50500例病例和4489例死亡。相比之下,拟合2003年4月10日香港数据的最佳参数为R(o)=2.0、F=20%、i=5天、d=14天。
使用所提出的数学模型估计,每5天每个感染病例产生约1.5至2个新感染病例。此外,约20%至30%的病例在14天内死亡。因此,病死率可能比最初认为的要高得多。该模型表明,在没有干预措施的情况下,SARS可以非常迅速地传播。