Department of Mechanical Engineering,The University of Hong Kong,Hong Kong SAR,China.
Clinical Microbiology,University Hospitals of Leicester NHS Trust,Leicester,UK.
Epidemiol Infect. 2018 Jul;146(9):1114-1122. doi: 10.1017/S0950268818001012. Epub 2018 May 6.
Influenza is a long-standing public health concern, but its transmission remains poorly understood. To have a better knowledge of influenza transmission, we carried out a detailed modelling investigation in a nosocomial influenza outbreak in Hong Kong. We identified three hypothesised transmission modes between index patient and other inpatients based on the long-range airborne and fomite routes. We considered three kinds of healthcare workers' routine round pathways in 1140 scenarios with various values of important parameters. In each scenario, we used a multi-agent modelling framework to estimate the infection risk for each hypothesis and conducted least-squares fitting to evaluate the hypotheses by comparing the distribution of the infection risk with that of the attack rates. Amongst the hypotheses tested in the 1140 scenarios, the prediction of modes involving the long-range airborne route fit better with the attack rates, and that of the two-route transmission mode had the best fit, with the long-range airborne route contributing about 94% and the fomite route contributing 6% to the infections. Under the assumed conditions, the influenza virus was likely to have spread via a combined long-range airborne and fomite routes, with the former predominant and the latter negligible.
流感一直是公共卫生关注的焦点，但它的传播仍未被很好地理解。为了更好地了解流感的传播，我们在香港的一次医院感染流感暴发中进行了详细的建模调查。我们根据长距离空气传播和接触传播途径，确定了指数病例与其他住院患者之间三种假设的传播模式。我们考虑了三种医护人员的日常查房路径，并在 1140 种不同重要参数值的情况下进行了分析。在每个场景中，我们使用多主体建模框架来估计每个假设的感染风险，并通过比较感染风险的分布与发病率的分布来进行最小二乘法拟合，从而对假设进行评估。在 1140 种情况下测试的假设中，涉及长距离空气传播途径的假设预测与发病率的拟合更好，而两途径传播模式的拟合最好，长距离空气传播途径约占 94%，接触传播途径约占 6%。在假设的条件下，流感病毒可能通过长距离空气传播和接触传播的混合途径传播，前者占主导地位，后者可忽略不计。
