Division of Media Communication, Hankuk University of Foreign Studies, Seoul 02450, Korea.
Department of Applied Mathematics, Kyung Hee University, Yongin 446-701, Korea.
Int J Environ Res Public Health. 2018 Oct 26;15(11):2369. doi: 10.3390/ijerph15112369.
Super-spreading events have been observed in the transmission dynamics of many infectious diseases. The 2015 MERS-CoV outbreak in the Republic of Korea has also shown super-spreading events with a significantly high level of heterogeneity in generating secondary cases. It becomes critical to understand the mechanism for this high level of heterogeneity to develop effective intervention strategies and preventive plans for future emerging infectious diseases. In this regard, agent-based modeling is a useful tool for incorporating individual heterogeneity into the epidemic model. In the present work, a stochastic agent-based framework is developed in order to understand the underlying mechanism of heterogeneity. Clinical (i.e., an infectivity level) and social or environmental (i.e., a contact level) heterogeneity are modeled. These factors are incorporated in the transmission rate functions under assumptions that super-spreaders have stronger transmission and/or higher links. Our agent-based model has employed real MERS-CoV epidemic features based on the 2015 MERS-CoV epidemiological data. Monte Carlo simulations are carried out under various epidemic scenarios. Our findings highlight the roles of super-spreaders in a high level of heterogeneity, underscoring that the number of contacts combined with a higher level of infectivity are the most critical factors for substantial heterogeneity in generating secondary cases of the 2015 MERS-CoV transmission.
超级传播事件在许多传染病的传播动力学中都有观察到。2015 年在韩国发生的中东呼吸综合征冠状病毒（MERS-CoV）疫情也显示出具有显著异质性的二次感染事件。了解这种高度异质性的产生机制对于制定未来新发传染病的有效干预策略和预防计划至关重要。在这方面，基于主体的建模是将个体异质性纳入传染病模型的有用工具。在本工作中，开发了一个随机的基于主体的框架，以便了解异质性的潜在机制。对临床（即感染水平）和社会或环境（即接触水平）的异质性进行建模。在假设超级传播者具有更强的传播力和/或更高的联系的情况下，将这些因素纳入传播率函数中。我们的基于主体的模型采用了基于 2015 年 MERS-CoV 流行病学数据的真实 MERS-CoV 疫情特征。在各种疫情情景下进行了蒙特卡罗模拟。我们的研究结果强调了超级传播者在高度异质性中的作用，指出接触者数量加上更高的感染水平是产生 2015 年 MERS-CoV 传播大量二次感染事件的关键因素。
