IMT School for Advanced Studies, Piazza S. Francesco 19, 55100, Lucca, Italy.
Department of Information Engineering (DIE), University of Pisa, Via G. Caruso 16, 56122, Pisa, Italy.
Med Biol Eng Comput. 2019 May;57(5):1121-1132. doi: 10.1007/s11517-018-1938-5. Epub 2019 Jan 16.
The introduction of mass vaccination against Varicella-Zoster-Virus (VZV) is being delayed in many European countries mainly because of the "fear" of a subsequent boom in natural herpes zoster (HZ) incidence in the first decades after the initiation of vaccination, caused by the expected decline in the protective effect of natural immunity boosting due to reduced virus circulation. Optimal control theory has proven to be a successful tool in understanding ways to curtail the spread of infectious diseases by devising the optimal disease intervention strategies. In this paper, we describe how a reduced 'toy' model can extract the essentials of the dynamics of the VZV transmission and reactivation in case of the study of optimal paths of varicella immunization programs. Results obtained using different optimization approaches are compared with the ones of a more realistic age-structured model. The reduced model shows some unreliable predictions in regards of model time scales about herpes zoster dynamic; nevertheless, it is able to reproduce the main qualitative dynamic of the more realistic model to the different optimization problems, while requiring a minimal number of parameters to be identified. Graphical abstract ᅟ.
大规模接种水痘带状疱疹病毒（VZV）疫苗在许多欧洲国家被推迟，主要是因为人们担心在接种疫苗后的最初几十年，由于自然免疫力增强的保护作用因病毒传播减少而预期下降，随后自然带状疱疹（HZ）的发病率会大幅增加。最优控制理论已被证明是一种成功的工具，可通过设计最佳疾病干预策略来理解控制传染病传播的方法。在本文中，我们描述了如何在研究水痘免疫接种计划的最佳路径时，使用简化的“玩具”模型提取 VZV 传播和再激活动力学的本质。使用不同优化方法获得的结果与更现实的年龄结构模型的结果进行了比较。简化模型在关于带状疱疹动力学的模型时间尺度方面存在一些不可靠的预测；然而，它能够再现更现实模型的主要定性动态，以适用于不同的优化问题，同时需要确定的参数最少。
