Journal Article

Lifetime Risks, Incubation Period, and Serial Interval of Tuberculosis

Emilia Vynnycky and Paul E. M. Fine

in American Journal of Epidemiology

Published on behalf of Johns Hopkins Bloomberg School of Public Health

Volume 152, issue 3, pages 247-263
Published in print August 2000 | ISSN: 0002-9262
Published online August 2000 | e-ISSN: 1476-6256 | DOI: https://dx.doi.org/10.1093/aje/152.3.247
Lifetime Risks, Incubation Period, and Serial Interval of Tuberculosis

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The lifetime risk of developing disease, the incubation period, and the time period between infection and transmission (the serial interval) are three important measures for interpreting trends in tuberculous infection and disease but are complicated by strong age dependencies regarding disease risk and by the potential for reinfection to occur. By using a model of the epidemiology of tuberculosis in England and Wales, the authors demonstrated that all three measures changed dramatically during the 20th century largely as a result of declines in the risk of infection. The estimated lifetime risk was highest following infection in early adulthood and declined with year of infection; the age-weighted average was approximately 12% during the last 50 years. Incubation period distributions depend on whether they are viewed prospectively (from infection to disease onset) or retrospectively (since infection for cases with disease onset at a particular time). As children rarely develop infectious forms of tuberculosis, infections acquired in childhood are associated with considerably longer serial intervals than those acquired in adulthood. These unusual properties are probably shared by other infections with long intervals between infection and disease. The results are important for interpreting data on transmission patterns, as are now being derived from molecular epidemiologic studies. Am J Epidemiol 2000;152:247–63.

Keywords: age factors; infection; models; biological; time factors; tuberculosis; AIDS, acquired immunodeficiency syndrome; HIV, human immunodeficiency virus.

Journal Article.  8631 words.  Illustrated.

Subjects: Public Health and Epidemiology

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