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在塞拉利昂一种埃博拉预防性疫苗的潜在影响。

The potential impact of a prophylactic vaccine for Ebola in Sierra Leone.

作者信息

Bodine Erin N, Cook Connor, Shorten Mikayla

机构信息

Rhodes College, Department of Mathematics and Computer Science, 2000 N. Parkway, Memphis, TN 38112, United States email:

出版信息

Math Biosci Eng. 2018 Apr 1;15(2):337-359. doi: 10.3934/mbe.2018015.

Abstract

The 2014 outbreak of Ebola virus disease (EVD) in West Africa was multinational and of an unprecedented scale primarily affecting the countries of Guinea, Liberia, and Sierra Leone. One of the qualities that makes EVD of high public concern is its potential for extremely high mortality rates (up to 90%). A prophylactic vaccine for ebolavirus (rVSV-ZEBOV) has been developed, and clinical trials show near-perfect efficacy. We have developed an ordinary differential equations model that simulates an EVD epidemic and takes into account (1) transmission through contact with infectious EVD individuals and deceased EVD bodies, (2) the heterogeneity of the risk of becoming infected with EVD, and (3) the increased survival rate of infected EVD patients due to greater access to trained healthcare providers. Using fitted parameter values that closely simulate the dynamics of the 2014 outbreak in Sierra Leone, we utilize our model to predict the potential impact of a prophylactic vaccine for the ebolavirus using various vaccination strategies including ring vaccination. Our results show that an rVSV-ZEBOV vaccination coverage as low as 40% in the general population and 95% in healthcare workers will prevent another catastrophic outbreak like the 2014 outbreak from occurring.

摘要

2014年西非爆发的埃博拉病毒病(EVD)疫情跨国且规模空前,主要影响几内亚、利比里亚和塞拉利昂等国。埃博拉病毒病引发公众高度关注的一个特性是其极高的死亡率(高达90%)。一种针对埃博拉病毒的预防性疫苗(rVSV-ZEBOV)已研发出来,临床试验显示其疗效近乎完美。我们构建了一个常微分方程模型来模拟埃博拉病毒病疫情,并考虑了以下因素:(1)通过接触感染埃博拉病毒病的个体和埃博拉病毒病死者遗体进行传播;(2)感染埃博拉病毒病风险的异质性;(3)由于有更多机会获得训练有素的医护人员的治疗,感染埃博拉病毒病患者的存活率有所提高。利用紧密模拟2014年塞拉利昂疫情动态的拟合参数值,我们运用该模型预测了使用包括环型疫苗接种在内的各种疫苗接种策略对埃博拉病毒预防性疫苗的潜在影响。我们的结果表明,在普通人群中rVSV-ZEBOV疫苗接种覆盖率低至40%,在医护人员中为95%,将防止类似2014年那样的灾难性疫情再次发生。

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