Wallinga Jacco, Teunis Peter, Kretzschmar Mirjam
National Institute for Public Health and the Environment, Bilthoven, the Netherlands.
Am J Epidemiol. 2006 Nov 15;164(10):936-44. doi: 10.1093/aje/kwj317. Epub 2006 Sep 12.
The estimation of transmission parameters has been problematic for diseases that rely predominantly on transmission of pathogens from person to person through small infectious droplets. Age-specific transmission parameters determine how such respiratory agents will spread among different age groups in a human population. Estimating the values of these parameters is essential in planning an effective response to potentially devastating pandemics of smallpox or influenza and in designing control strategies for diseases such as measles or mumps. In this study, the authors estimated age-specific transmission parameters by augmenting infectious disease data with auxiliary data on self-reported numbers of conversational partners per person. They show that models that use transmission parameters based on these self-reported social contacts are better able to capture the observed patterns of infection of endemically circulating mumps, as well as observed patterns of spread of pandemic influenza. The estimated age-specific transmission parameters suggested that school-aged children and young adults will experience the highest incidence of infection and will contribute most to further spread of infections during the initial phase of an emerging respiratory-spread epidemic in a completely susceptible population. These findings have important implications for controlling future outbreaks of novel respiratory-spread infectious agents.
对于主要依靠病原体通过微小感染性飞沫在人与人之间传播的疾病而言,传播参数的估计一直存在问题。特定年龄的传播参数决定了此类呼吸道病原体在人群中不同年龄组之间的传播方式。估计这些参数的值对于规划应对天花或流感等潜在毁灭性大流行的有效措施以及设计针对麻疹或腮腺炎等疾病的控制策略至关重要。在本研究中,作者通过用关于每人自我报告的对话伙伴数量的辅助数据扩充传染病数据,来估计特定年龄的传播参数。他们表明,使用基于这些自我报告社交接触的传播参数的模型,能更好地捕捉到地方性流行腮腺炎的观察到的感染模式以及大流行性流感的传播模式。估计出的特定年龄传播参数表明,在一个完全易感人群中,学龄儿童和年轻人将经历最高的感染发病率,并且在新出现的呼吸道传播疫情的初始阶段对感染的进一步传播贡献最大。这些发现对于控制未来新型呼吸道传播感染因子的爆发具有重要意义。