Journal Article

Evaluating Public Health Responses to Reintroduced Smallpox via Dynamic, Socially Structured, and Spatially Distributed Metapopulation Models

John W. Glasser, Stanley O. Foster, J. Donald Millar and J. Michael Lane

in Clinical Infectious Diseases

Published on behalf of Infectious Diseases Society of America

Volume 46, issue Supplement_3, pages S182-S194
Published in print March 2008 | ISSN: 1058-4838
Published online March 2008 | e-ISSN: 1537-6591 | DOI: http://dx.doi.org/10.1086/524382
Evaluating Public Health Responses to Reintroduced Smallpox via Dynamic, Socially Structured, and Spatially Distributed Metapopulation Models

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The risk of smallpox reintroduction has motivated preparations in potential target countries. After reproducing the spatiotemporal pattern after the 1972 importation into Yugoslavia via coupled, biologically realistic systems of ordinary differential equations, we developed dynamic population models with current US age distributions and typical spatially distributed social structures. Surveillance and containment (SC) coupled with vaccination of 95% of hospital-based health care workers (HCWs) within 2 days after the first diagnosis (estimated to be 18 days after aerosol release) were modeled after simulated exposure of 10, 50, or 10,000 people in various settings. If 90% of patients were isolated within days after symptom onset and 75% of contacts were vaccinated and monitored, SC would reduce cases by 82%–99%. Preemptive immunization of HCWs, closing of schools, and even vaccination of as many as 80% within 1 week would have small marginal benefits. Preparations should emphasize stockpiling vaccine, training HCWs, improving laboratory capacity, and fostering an understanding of SC.

Journal Article.  5689 words.  Illustrated.

Subjects: Infectious Diseases ; Immunology ; Public Health and Epidemiology ; Microbiology

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