在新冠疫情中存在过度分散传播的情况下反向接触者追踪的意义。
Implication of backward contact tracing in the presence of overdispersed transmission in COVID-19 outbreaks.
作者信息
Endo Akira, Leclerc Quentin J, Knight Gwenan M, Medley Graham F, Atkins Katherine E, Funk Sebastian, Kucharski Adam J
机构信息
Department of Infectious Disease Epidemiology, London School of Hygiene & Tropical Medicine, London, WC1E 7HT, UK.
The Alan Turing Institute, London, NW1 2DB, UK.
出版信息
Wellcome Open Res. 2021 Mar 31;5:239. doi: 10.12688/wellcomeopenres.16344.3. eCollection 2020.
Contact tracing has the potential to control outbreaks without the need for stringent physical distancing policies, e.g. civil lockdowns. Unlike forward contact tracing, backward contact tracing identifies the source of newly detected cases. This approach is particularly valuable when there is high individual-level variation in the number of secondary transmissions (overdispersion). By using a simple branching process model, we explored the potential of combining backward contact tracing with more conventional forward contact tracing for control of COVID-19. We estimated the typical size of clusters that can be reached by backward tracing and simulated the incremental effectiveness of combining backward tracing with conventional forward tracing. Across ranges of parameter values consistent with dynamics of SARS-CoV-2, backward tracing is expected to identify a primary case generating 3-10 times more infections than a randomly chosen case, typically increasing the proportion of subsequent cases averted by a factor of 2-3. The estimated number of cases averted by backward tracing became greater with a higher degree of overdispersion. Backward contact tracing can be an effective tool for outbreak control, especially in the presence of overdispersion as is observed with SARS-CoV-2.
接触者追踪有潜力在无需严格的物理距离政策(如全民封锁)的情况下控制疫情爆发。与正向接触者追踪不同,反向接触者追踪可识别新检测到病例的源头。当二代传播数量存在高度个体层面差异(过度离散)时,这种方法特别有价值。通过使用一个简单的分支过程模型,我们探讨了将反向接触者追踪与更传统的正向接触者追踪相结合以控制新冠疫情的潜力。我们估计了通过反向追踪能够追踪到的聚集性病例的典型规模,并模拟了将反向追踪与传统正向追踪相结合的增量效果。在与新冠病毒动态一致的参数值范围内,预计反向追踪能识别出比随机选择的病例产生多3至10倍感染的原发病例,通常会使后续避免的病例比例增加2至3倍。随着过度离散程度的提高,通过反向追踪避免的病例估计数量会增加。反向接触者追踪可以成为控制疫情爆发的有效工具,特别是在存在如新冠病毒所呈现的过度离散情况时。
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