Blower S M, McLean A R, Porco T C, Small P M, Hopewell P C, Sanchez M A, Moss A R
Department of Epidemiology & Biostatistics, University of California San Francisco, San Francisco General Hospital 94143-1347, USA.
Nat Med. 1995 Aug;1(8):815-21. doi: 10.1038/nm0895-815.
In developed countries the major tuberculosis epidemics declined long before the disease became curable in the 1940s. We present a theoretical framework for assessing the intrinsic transmission dynamics of tuberculosis. We demonstrate that it takes one to several hundred years for a tuberculosis epidemic to rise, fall and reach a stable endemic level. Our results suggest that some of the decline of tuberculosis is simply due to the natural behaviour of an epidemic. Although other factors must also have contributed to the decline, these causal factors were constrained to operate within the slow response time dictated by the intrinsic dynamics.
在发达国家，早在20世纪40年代结核病可治愈之前，主要的结核病流行就已下降。我们提出了一个评估结核病内在传播动态的理论框架。我们证明，结核病流行的上升、下降并达到稳定的地方流行水平需要1到几百年的时间。我们的结果表明，结核病的一些下降仅仅是由于流行的自然行为。尽管其他因素也必定对下降起到了作用，但这些因果因素受到内在动态所决定的缓慢反应时间的限制。
