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Analysis of CDC social control measures using an agent-based simulation of an influenza epidemic in a city

机译:使用基于代理的城市流感疫情模拟分析CDC社会控制措施

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Abstract Background The transmission of infectious disease amongst the human population is a complex process which requires advanced, often individual-based, models to capture the space-time details observed in reality. Methods An Individual Space-Time Activity-based Model (ISTAM) was applied to simulate the effectiveness of non-pharmaceutical control measures including: (1) refraining from social activities, (2) school closure and (3) household quarantine, for a hypothetical influenza outbreak in an urban area. Results Amongst the set of control measures tested, refraining from social activities with various compliance levels was relatively ineffective. Household quarantine was very effective, especially for the peak number of cases and total number of cases, with large differences between compliance levels. Household quarantine resulted in a decrease in the peak number of cases from more than 300 to around 158 for a 100% compliance level, a decrease of about 48.7%. The delay in the outbreak peak was about 3 to 17 days. The total number of cases decreased to a range of 3635-5403, that is, 63.7%-94.7% of the baseline value. When coupling control measures, household quarantine together with school closure was the most effective strategy. The resulting space-time distribution of infection in different classes of activity bundles (AB) suggests that the epidemic outbreak is strengthened amongst children and then spread to adults. By sensitivity analysis, this study demonstrated that earlier implementation of control measures leads to greater efficacy. Also, for infectious diseases with larger basic reproduction number, the effectiveness of non-pharmaceutical measures was shown to be limited. Conclusions Simulated results showed that household quarantine was the most effective control measure, while school closure and household quarantine implemented together achieved the greatest benefit. Agent-based models should be applied in the future to evaluate the efficacy of control measures for a range of disease outbreaks in a range of settings given sufficient information about the given case and knowledge about the transmission processes at a fine scale.
机译:摘要背景传染病在人类中的传播是一个复杂的过程,需要先进的(通常是基于个体的)模型来捕获现实中观察到的时空细节。方法采用基于个人时空活动的模型(ISTAM)模拟非药物控制措施的有效性,包括:(1)避免社交活动;(2)学校停课;(3)家庭隔离;市区爆发流感。结果在所测试的一系列控制措施中,避免进行各种达标水平的社会活动相对无效。家庭隔离非常有效,特别是在高峰病例数和总病例数方面,达标水平之间的差异很大。对于100%的达标水平,家庭隔离导致峰值病例数从300多个减少到158个左右,减少了48.7%。爆发高峰的延迟时间约为3至17天。病例总数减少到3635-5403,即基线值的63.7%-94.7%。当结合控制措施时,家庭隔离和停课是最有效的策略。由此产生的感染在不同类别的活动捆绑中的时空分布(AB)表明该流行病在儿童中得到加强,然后传播到成人。通过敏感性分析,该研究表明,早期实施控制措施可提高疗效。同样,对于具有较大基本繁殖数量的传染病,非药物措施的有效性也受到限制。结论模拟结果表明,家庭隔离是最有效的控制措施,而关闭学校和实施家庭隔离共同获得了最大的收益。未来应使用基于代理的模型来评估针对一系列疾病暴发的控制措施在各种环境中的有效性,前提是要有足够的有关给定病例的足够信息,并且要有关于传播过程的详细知识。

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