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中国长沙学校季节性流感暴发控制关键干预措施的模拟研究

Simulation of key interventions for seasonal influenza outbreak control at school in Changsha, China.

作者信息

Chen Tianmu, Zhao Bin, Liu Ruchun, Zhang Xixing, Xie Zhi, Chen Shuilian

机构信息

Changsha Centre for Disease Control and Prevention, Changsha, Hunan Province, China.

State Key Laboratory of Molecular Vaccinology and Molecular Diagnostics, School of Public Health, Xiamen University, Xiamen, Fujian Province, China.

出版信息

J Int Med Res. 2020 Jan;48(1):300060518764268. doi: 10.1177/0300060518764268. Epub 2018 Mar 23.

Abstract

OBJECTIVE

To use a mathematical model to simulate an influenza outbreak in a school in order to assess the effectiveness of isolation (Iso), antiviral therapeutics, antiviral prophylactics (P), vaccination prior to the outbreak, and school closure (for 1 [S1w], 2 or 3 weeks).

METHODS

This study developed a susceptible–exposed–infectious/asymptomatic–recovered model to estimate the effectiveness of commonly used interventions for seasonal influenza outbreaks in school.

RESULTS

The most effective single-intervention strategy was isolation with a total attack rate of 1.99% and an outbreak duration of 30 days. The additional effectiveness of antiviral therapeutics and prophylactics and vaccination (prior to the outbreak) strategies were not obvious. Although Iso+P, P+Iso+S1w, four-, and five-combined intervention strategies had commendable effectiveness, total attack rate decreased only slightly, and outbreak duration was shortened by 9 days maximum, compared with the single-intervention isolation strategy. School closure for 1, 2 or 3 weeks was futile or even counterproductive.

CONCLUSION

Isolation, as a single intervention, was the most effective in terms of reducing the total attack rate and the duration of the outbreak.

摘要

目的

使用数学模型模拟学校中的流感暴发,以评估隔离(Iso)、抗病毒治疗、抗病毒预防(P)、暴发前接种疫苗以及学校关闭(1周 [S1w]、2周或3周)的效果。

方法

本研究建立了一个易感 - 暴露 - 感染/无症状 - 康复模型,以评估学校中季节性流感暴发常用干预措施的效果。

结果

最有效的单一干预策略是隔离,总发病率为1.99%,暴发持续时间为30天。抗病毒治疗、预防和(暴发前)接种疫苗策略的额外效果不明显。尽管Iso + P、P + Iso + S1w、四种和五种联合干预策略有值得称赞的效果,但与单一干预隔离策略相比,总发病率仅略有下降,暴发持续时间最多缩短9天。学校关闭1周、2周或3周是无效的,甚至会适得其反。

结论

作为单一干预措施,隔离在降低总发病率和暴发持续时间方面最为有效。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/027d/7113490/0d91d7a0dc9e/10.1177_0300060518764268-fig1.jpg

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