Hincapié Palacio Doracelly, Ospina Giraldo Juan Fernando
Grupo de Epidemiología, Facultad Nacional de Salud Pública, Universidad de Antioquia, Medellín, Colombia.
Rev Saude Publica. 2006 Aug;40(4):656-62. doi: 10.1590/s0034-89102006000500015.
To estimate the basic reproductive rate of a chickenpox outbreak, to apply the stochastic threshold theorem to estimate the probability of an outbreak occurrence and to identify preventive measures.
The study was carried out in a daycare center comprising 16 children, 13 susceptible, one infected and two children with acquired immunity by previous disease. A stochastic susceptible - infected - removed model was applied. The basic reproductive rate (R0) was estimated using the maximum likelihood method based on probability distribution for the total size of the epidemic and making an approach of almost complete epidemic. Based on R0, the theorem was applied to establish some preventive measures for preventing a chickenpox outbreak.
Each initially infected subject produced three new cases of infection requiring minimum vaccination coverage of 62% to prevent the outbreak or to reduce in 62% the contact among members of the group or to increase in 170% removal of infected subjects.
The stochastic threshold theorem allows to identifying measures that could be implemented to prevent and control chickenpox outbreaks. Although the distribution of the epidemic size showed similar probability of occurrence of large and small outbreaks in a typical bimodal pattern, it illustrates the uncertainty of epidemic process in small groups, requiring close detection of outbreaks in such groups.
估计水痘暴发的基本繁殖率,应用随机阈值定理估计暴发发生的概率并确定预防措施。
该研究在一个日托中心进行,该中心有16名儿童,其中13名易感,1名感染,2名儿童因既往患病获得免疫力。应用了一个随机易感-感染-清除模型。基于疫情总规模的概率分布并采用接近完全流行的方法,使用最大似然法估计基本繁殖率(R0)。基于R0,应用该定理制定了一些预防水痘暴发的预防措施。
每个初始感染个体产生3例新感染病例,需要至少62%的疫苗接种覆盖率来预防暴发,或减少62%的群体成员之间的接触,或增加170%的感染个体清除率。
随机阈值定理有助于确定可实施的预防和控制水痘暴发的措施。尽管疫情规模分布呈现典型的双峰模式,大小暴发发生的概率相似,但它说明了小群体中疫情过程的不确定性,需要密切监测此类群体中的暴发情况。