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Epidemiology and Infection
Article . 2004 . Peer-reviewed
License: Cambridge Core User Agreement
Data sources: Crossref
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Modelling responses to a smallpox epidemic taking into account uncertainty

Authors: Legrand, Judith; Viboud, Cecile; Boelle, Pierre-Yves; Valleron, Alain-Jacques; Flahault, Antoine;

Modelling responses to a smallpox epidemic taking into account uncertainty

Abstract

Epidemiology and modelling are currently under pressure to build consistent scenarios of control in case of deliberate release of biological weapons. In order to assess the key parameters for the control of a smallpox outbreak in a large city (2 million inhabitants), we built a stochastic model to simulate the course of an epidemic controlled by ring vaccination and case isolation. Assuming a reference scenario with 100 index cases and implementation of intervention 25 days after the attack, the model forecasts an epidemic of 730 cases with an epidemic duration of 240 days. Setting intervention 20 days later would result in an almost fourfold increase in the epidemic size. A multivariate sensitivity analysis has selected three key parameters: the basic reproduction number (i.e. the number of secondary cases infected by one case in an entirely susceptible population, equal to 3 in the reference scenario), time to intervention, and proportion of traced and vaccinated contacts.

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Keywords

Time Factors, Quarantine/methods, Sensitivity and Specificity, Patient Isolation, Patient Isolation/methods, Humans, Vaccination/methods, Poisson Distribution, Contact Tracing/methods, Disease Susceptibility/epidemiology, Population Density, Stochastic Processes, Uncertainty, Urban Health, Bioterrorism/prevention & control, *Regression Analysis, *Uncertainty, Bioterrorism, Survival Analysis, Multivariate Analysis, Quarantine, Regression Analysis, Disease Susceptibility, Contact Tracing, Algorithms, Smallpox Vaccine, Smallpox/*epidemiology/*prevention & control/transmission, Forecasting, Smallpox

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    popularity
    This indicator reflects the "current" impact/attention (the "hype") of an article in the research community at large, based on the underlying citation network.
    Top 10%
    influence
    This indicator reflects the overall/total impact of an article in the research community at large, based on the underlying citation network (diachronically).
    Top 10%
    impulse
    This indicator reflects the initial momentum of an article directly after its publication, based on the underlying citation network.
    Top 10%
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selected citations
These citations are derived from selected sources.
This is an alternative to the "Influence" indicator, which also reflects the overall/total impact of an article in the research community at large, based on the underlying citation network (diachronically).
BIP!Citations provided by BIP!
popularity
This indicator reflects the "current" impact/attention (the "hype") of an article in the research community at large, based on the underlying citation network.
BIP!Popularity provided by BIP!
influence
This indicator reflects the overall/total impact of an article in the research community at large, based on the underlying citation network (diachronically).
BIP!Influence provided by BIP!
impulse
This indicator reflects the initial momentum of an article directly after its publication, based on the underlying citation network.
BIP!Impulse provided by BIP!
25
Top 10%
Top 10%
Top 10%
Green
gold