Household structure and infectious disease transmission

被引:70
作者
House, T. [1 ]
Keeling, M. J. [1 ]
机构
[1] Univ Warwick, Dept Biol Sci, Coventry CV4 7AL, W Midlands, England
基金
英国惠康基金;
关键词
Household; influenza; modelling; transmission; EPIDEMIC MODELS; INFLUENZA; VACCINATION; IMPACT; POPULATION; STRATEGIES; PARAMETERS;
D O I
10.1017/S0950268808001416
中图分类号
R1 [预防医学、卫生学];
学科分类号
1004 ; 120402 ;
摘要
One of the central tenets of modern infectious disease epidemiology is that an understanding of heterogeneities, both in host demography and transmission, allows control to be efficiently optimized. Due to the strong interactions present, households are one of the most important heterogeneities to consider, both in terms of predicting epidemic severity and as a target for intervention. We consider these effects in the context of pandemic influenza in Great Britain, and find that there is significant local (ward-level) variation in the basic reproductive ratio, with some regions predicted to suffer 50% faster growth rate of infection than the mean. Childhood vaccination was shown to be highly effective at controlling an epidemic, generally outperforming random vaccination and substantially reducing the variation between regions; only nine out of over 10 000 wards did not obey this rule and these can be identified as demographically atypical regions. Since these benefits of childhood vaccination are a product of correlations between household size and number of dependent children in the household, our results are qualitatively robust for a variety of disease scenarios.
引用
收藏
页码:654 / 661
页数:8
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