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实时使用动态模型来衡量公共卫生干预措施对麻疹疫情规模和持续时间的影响——伊利诺伊州芝加哥,2024 年。

Real-Time Use of a Dynamic Model To Measure the Impact of Public Health Interventions on Measles Outbreak Size and Duration - Chicago, Illinois, 2024.

出版信息

MMWR Morb Mortal Wkly Rep. 2024 May 16;73(19):430-434. doi: 10.15585/mmwr.mm7319a2.

Abstract

Measles is a highly infectious, vaccine-preventable disease that can cause severe illness, hospitalization, and death. A measles outbreak associated with a migrant shelter in Chicago occurred during February-April 2024, in which a total of 57 confirmed cases were identified, including 52 among shelter residents, three among staff members, and two among community members with a known link to the shelter. CDC simulated a measles outbreak among shelter residents using a dynamic disease model, updated in real time as additional cases were identified, to produce outbreak forecasts and assess the impact of public health interventions. As of April 8, the model forecasted a median final outbreak size of 58 cases (IQR = 56-60 cases); model fit and prediction range improved as more case data became available. Counterfactual analysis of different intervention scenarios demonstrated the importance of early deployment of public health interventions in Chicago, with a 69% chance of an outbreak of 100 or more cases had there been no mass vaccination or active case-finding compared with only a 1% chance when those interventions were deployed. This analysis highlights the value of using real-time, dynamic models to aid public health response, set expectations about outbreak size and duration, and quantify the impact of interventions. The model shows that prompt mass vaccination and active case-finding likely substantially reduced the chance of a large (100 or more cases) outbreak in Chicago.

摘要

麻疹是一种高度传染性的、可通过疫苗预防的疾病,可导致严重疾病、住院和死亡。2024 年 2 月至 4 月,在芝加哥的一个移民收容所发生了一起麻疹暴发疫情,共发现 57 例确诊病例,包括收容所居民 52 例、工作人员 3 例、与收容所有已知联系的社区成员 2 例。CDC 使用动态疾病模型模拟了收容所居民中的麻疹暴发情况,该模型实时更新,以识别出更多病例,从而生成暴发预测并评估公共卫生干预措施的影响。截至 4 月 8 日,该模型预测的中位最终暴发规模为 58 例(IQR=56-60 例);随着更多病例数据的出现,模型拟合度和预测范围得到了改善。对不同干预场景的反事实分析表明,在芝加哥早期部署公共卫生干预措施的重要性,与没有大规模接种疫苗或主动病例发现相比,干预措施的部署使暴发 100 例或更多病例的可能性从 69%降低到只有 1%。该分析强调了使用实时、动态模型来辅助公共卫生应对、设定暴发规模和持续时间的预期以及量化干预措施影响的价值。该模型表明,及时大规模接种疫苗和主动病例发现可能大大降低了芝加哥发生大规模(100 例或更多病例)暴发的可能性。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/1fb9/11115428/d6603e3f9bc1/mm7319a2-F.jpg

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