Emerg Infect Dis. 2020 Apr;26(4):700-710. doi: 10.3201/eid2604.181739. Epub 2020 Apr 17.
Zika virus is transitioning to become a long-term public health challenge, and countries should remain informed of the risk for emergence. We developed a stochastic epidemiologic model to profile risk for Zika virus emergence, including trimester-specific fetal risk across time, in all 3,208 counties in the United States, including Puerto Rico. Validation against known transmission in North America demonstrated accuracy to predict epidemic dynamics and absolute case counts across scales (R = 0.98). We found that, although sporadic single transmission events could occur in most US counties, outbreaks will likely be restricted to the Gulf Coast region and to late spring through autumn. Seasonal fluctuations in birth rates will confer natural population-level protection against early-trimester infections. Overall, outbreak control will be more effective and efficient than prevention, and vaccination will be most effective at >70% coverage. Our county-level risk profiles should serve as a critical resource for resource allocation.
寨卡病毒正在逐渐成为一个长期的公共卫生挑战，各国应随时了解其出现的风险。我们开发了一个随机流行病学模型来分析寨卡病毒出现的风险，包括美国所有 3208 个县（包括波多黎各）在各个孕期的特定胎儿风险。针对北美的已知传播情况进行验证，证明了该模型可以准确预测流行动力学和各规模的绝对病例数（R=0.98）。我们发现，尽管大多数美国县可能会发生零星的单一传播事件，但疫情可能仅限于墨西哥湾沿岸地区以及春末至秋季。出生率的季节性波动将为早期孕期感染提供自然的人群水平保护。总体而言，疫情控制将比预防更有效和高效，而疫苗接种在覆盖率超过 70%时效果最佳。我们的县一级风险概况应作为资源分配的重要依据。
