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口蹄疫群体内传播的模拟模型:参考临床诊断前后的疾病传播情况

A simulation model of intraherd transmission of foot and mouth disease with reference to disease spread before and after clinical diagnosis.

作者信息

Carpenter Tim E, Thurmond Mark C, Bates Thomas W

机构信息

Department of Medicine and Epidemiology, School of Veterinary Medicine, University of California, Davis, CA 95616, USA.

出版信息

J Vet Diagn Invest. 2004 Jan;16(1):11-6. doi: 10.1177/104063870401600103.

Abstract

Intraherd transmission of foot and mouth disease virus (FMDV) was examined using a simulation model for a hypothetical 1,000-cow dairy, assuming clinical diagnosis was made when at least 1% (10 cows) or 5% (50 cows) had clinical signs of FMD, I index case cow, and transition state distributions for the latent, subclinically infectious, and clinically infectious periods of FMD calculated from published data. Estimates assumed for the number of animal-to-animal contacts (k) adequate for transmission ranged from 0.6 to 9.0 per hour (13.7-216.0 per day). A total of 40,000 iterations (5,000 for each scenario, assessing 4 adequate contact rates and 2 detection criteria) were run. The model predicted that FMD would not be diagnosed in the herd until 10.0-13.5 days after the index case cow had become infected, at which time between 65% and 97% of the cows (646-967 cows) to nearly 100% (978-996 cows) would already have become infected with the virus, if the number of cows showing clinical signs of FMD at the time of diagnosis were 10 or 50, respectively. At the time of diagnosis, the simulated number of infectious cattle varied substantially from 82-472 to 476-537 cows, depending on adequate contact rate and whether the diagnosis was made when 10 or 50 animals were showing clinical signs, respectively. The simulated number of infectious cows increased rapidly during the first few days after diagnosis. In the scenario where at least 10 cows showing clinical signs was necessary before a clinical diagnosis was made, each day after diagnosis, the number of infectious animals increased by nearly 100 to more than 200 cases per day up to day 5, assuming 0.57-9.0 animal-to-animal contacts per hour, respectively. Results obtained when it was assumed that at least 50 clinical cases were present at the time of diagnosis showed smaller relative increases because nearly one-half of the herd was projected to be infected at the time of diagnosis. From these results, it is clear that once an individual in a herd becomes infected with FMDV, herd infectivity is not static, rather it accelerates as would be expected as long as there are sufficient susceptible animals to sustain the increasing transmission rate, after which time the rate at which new infections occurs will diminish. Results indicate that biosecurity strategies aimed at minimizing both intraherd and interherd contact will be critical in minimizing the spread of FMD before the initial diagnosis is made. In addition, simulations suggest that very early clinical diagnosis of FMD and effective isolation or depopulation and disposal will be critical in limiting the number of infectious animals capable of transmitting the virus to other herds and thus in timely control of an epidemic. Early diagnosis will rely on early virus detection from animals in the preclinical phase of infection, rather than waiting for clinical signs to manifest in sufficient numbers to be noticed and to warrant investigation.

摘要

利用一个针对假想的1000头奶牛场的模拟模型,研究了口蹄疫病毒(FMDV)在牛群内的传播情况。假设当至少1%(10头奶牛)或5%(50头奶牛)出现口蹄疫临床症状时进行临床诊断,设定1头指示病例奶牛,并根据已发表的数据计算口蹄疫潜伏期、亚临床感染期和临床感染期的过渡状态分布。假定足以实现传播的动物间接触次数(k)估计范围为每小时0.6至9.0次(每天13.7至216.0次)。总共进行了40000次迭代(每个场景5000次,评估4种充足接触率和2种检测标准)。该模型预测,在指示病例奶牛感染后10.0至13.5天之前,牛群中不会诊断出口蹄疫。此时,如果诊断时出现口蹄疫临床症状的奶牛数量分别为10头或50头,那么65%至97%的奶牛(646至967头奶牛)到几乎100%(978至996头奶牛)已经感染了病毒。在诊断时,模拟的感染牛数量根据充足接触率以及诊断时是10头还是50头动物出现临床症状而有很大差异,分别为82至472头奶牛和476至537头奶牛。诊断后的头几天,模拟的感染奶牛数量迅速增加。在需要至少10头奶牛出现临床症状才能做出临床诊断的场景中,诊断后的每一天,假设每小时动物间接触次数分别为0.57至9.0次,感染动物数量每天增加近100至超过200例,直至第5天。当假设诊断时至少有50例临床病例时获得的结果显示相对增加幅度较小,因为预计诊断时近一半的牛群已经感染。从这些结果可以清楚地看出,一旦牛群中的个体感染了口蹄疫病毒,牛群的传染性并非一成不变,而是只要有足够的易感动物来维持不断上升的传播率,就会如预期那样加速,此后新感染发生的速率将会降低。结果表明,旨在尽量减少牛群内和牛群间接触的生物安全策略对于在做出初步诊断之前尽量减少口蹄疫的传播至关重要。此外,模拟结果表明,口蹄疫的极早期临床诊断以及有效的隔离或扑杀和处置对于限制能够将病毒传播到其他牛群的感染动物数量从而及时控制疫情至关重要。早期诊断将依赖于在感染的临床前期从动物中早期检测病毒,而不是等待临床症状大量出现才被注意到并进行调查。

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