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里约热内卢的寨卡病毒:基本繁殖数评估及与登革热疫情的比较

Zika in Rio de Janeiro: Assessment of basic reproduction number and comparison with dengue outbreaks.

作者信息

Villela D A M, Bastos L S, DE Carvalho L M, Cruz O G, Gomes M F C, Durovni B, Lemos M C, Saraceni V, Coelho F C, Codeço C T

机构信息

Programa de Computação Científica, Fundação Oswaldo Cruz,Rio de Janeiro, RJ,Brazil.

Secretaria Municipal de Saúde do Rio de Janeiro,Rio de Janeiro, RJ,Brazil.

出版信息

Epidemiol Infect. 2017 Jun;145(8):1649-1657. doi: 10.1017/S0950268817000358. Epub 2017 Feb 27.

Abstract

Zika virus infection was declared a public health emergency of international concern in February 2016 in response to the outbreak in Brazil and its suspected link with congenital anomalies. In this study, we use notification data and disease natural history parameters to estimate the basic reproduction number (R 0) of Zika in Rio de Janeiro, Brazil. We also obtain estimates of R 0 of dengue from time series of dengue cases in the outbreaks registered in 2002 and 2012 in the city, when DENV-3 and DENV-4 serotypes, respectively, had just emerged. Our estimates of the basic reproduction number for Zika in Rio de Janeiro based on surveillance notifications (R 0 = 2·33, 95% CI: 1·97-2·97) were higher than those obtained for dengue in the city (year 2002: R 0 = 1·70 [1·50-2·02]; year 2012: R 0 = 1·25 [1·18-1·36]). Given the role of Aedes aegypti as vector of both the Zika and dengue viruses, we also derive R 0 of Zika as a function of both dengue reproduction number and entomological and epidemiological parameters for dengue and Zika. Using the dengue outbreaks from previous years allowed us to estimate the potential R 0 of Zika. Our estimates were closely in agreement with our first Zika's R 0 estimation from notification data. Hence, these results validate deriving the potential risk of Zika transmission in areas with recurring dengue outbreaks. Whether transmission routes other than vector-based can sustain a Zika epidemic still deserves attention, but our results suggest that the Zika outbreak in Rio de Janeiro emerged due to population susceptibility and ubiquitous presence of Ae. aegypti.

摘要

2016年2月,鉴于巴西的疫情爆发及其与先天性异常的疑似关联,寨卡病毒感染被宣布为国际关注的突发公共卫生事件。在本研究中,我们利用通报数据和疾病自然史参数来估计巴西里约热内卢寨卡病毒的基本繁殖数(R0)。我们还从该市2002年和2012年登记的登革热疫情的登革热病例时间序列中获得登革热R0的估计值,当时分别刚出现登革病毒3型(DENV-3)和登革病毒4型(DENV-4)血清型。我们基于监测通报得出的里约热内卢寨卡病毒基本繁殖数估计值(R0 = 2.33,95%可信区间:1.97 - 2.97)高于该市登革热的估计值(2002年:R0 = 1.70 [1.50 - 2.02];2012年:R0 = 1.25 [1.18 - 1.36])。鉴于埃及伊蚊作为寨卡病毒和登革热病毒两者的传播媒介的作用,我们还将寨卡病毒的R0推导为登革热繁殖数以及登革热和寨卡病毒的昆虫学和流行病学参数的函数。利用前几年的登革热疫情使我们能够估计寨卡病毒的潜在R0。我们的估计值与我们根据通报数据对寨卡病毒的首次R0估计值密切一致。因此,这些结果验证了在登革热疫情反复出现的地区推导寨卡病毒传播潜在风险的方法。除基于媒介的传播途径外,其他传播途径是否能维持寨卡病毒流行仍值得关注,但我们的结果表明,里约热内卢的寨卡病毒疫情是由于人群易感性和埃及伊蚊的普遍存在而出现的。

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