Mathematical Modelling of Infectious Diseases Unit, Institut Pasteur, Unité Mixte de Recherche 2000, Centre National de la Recherche Scientifique, Paris, France.
Service de Maladies Infectieuses et Tropicales, Centre Hospitalier Universitaire de Martinique, Fort-de-France, Martinique.
Am J Epidemiol. 2019 Jul 1;188(7):1389-1396. doi: 10.1093/aje/kwz091.
Since 2015, Zika virus (ZIKV) has caused large epidemics in the Americas. Households are natural targets for control interventions, but quantification of the contribution of household transmission to overall spread is needed to guide policy. We developed a modeling framework to evaluate this contribution and key epidemic features of the ZIKV epidemic in Martinique in 2015-2016 from the joint analysis of a household transmission study (n = 68 households), a study among symptomatic pregnant women (n = 281), and seroprevalence surveys of blood donors (n = 457). We estimated that the probability of mosquito-mediated within-household transmission (from an infected member to a susceptible one) was 21% (95% credible interval (CrI): 5, 51), and the overall probability of infection from outside the household (i.e., in the community) was 39% (95% CrI: 27, 50). Overall, 50% (95% CrI: 43, 58) of the population was infected, with 22% (95% CrI: 5, 46) of infections acquired in households and 40% (95% CrI: 23, 56) being asymptomatic. The probability of presenting with Zika-like symptoms due to another cause was 16% (95% CrI: 10, 23). This study characterized the contribution of household transmission in ZIKV epidemics, demonstrating the benefits of integrating multiple data sets to gain more insight into epidemic dynamics.
自 2015 年以来，寨卡病毒（ZIKV）在美洲引发了大规模疫情。家庭是控制干预的自然目标，但需要量化家庭传播对整体传播的贡献，以指导政策。我们开发了一个建模框架，从家庭传播研究（n=68 户）、有症状孕妇研究（n=281 例）和献血者血清流行率调查（n=457 例）的联合分析中，评估了寨卡病毒 2015-2016 年在马提尼克岛的流行情况及其对家庭传播的贡献和关键流行特征。我们估计，蚊子介导的家庭内传播（从感染成员到易感成员）的概率为 21%（95%可信区间[CrI]：5，51），而从家庭外（即社区内）感染的总概率为 39%（95% CrI：27，50）。总体而言，50%（95% CrI：43，58）的人群被感染，22%（95% CrI：5，46）的感染是在家庭中获得的，40%（95% CrI：23，56）是无症状的。由于其他原因出现寨卡样症状的概率为 16%（95% CrI：10，23）。本研究描述了家庭传播在寨卡病毒流行中的作用，证明了整合多个数据集以更深入了解流行动态的益处。
