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Informing optimal environmental influenza interventions: how the host, agent, and environment alter dominant routes of transmission.

ABSTRACT: Influenza can be transmitted through respirable (small airborne particles), inspirable (intermediate size), direct-droplet-spray, and contact modes. How these modes are affected by features of the virus strain (infectivity, survivability, transferability, or shedding profiles), host population (behavior, susceptibility, or shedding profiles), and environment (host density, surface area to volume ratios, or host movement patterns) have only recently come under investigation. A discrete-event, continuous-time, stochastic transmission model was constructed to analyze the environmental processes through which a virus passes from one person to another via different transmission modes, and explore which factors increase or decrease different modes of transmission. With the exception of the inspiratory route, each route on its own can cause high transmission in isolation of other modes. Mode-specific transmission was highly sensitive to parameter values. For example, droplet and respirable transmission usually required high host density, while the contact route had no such requirement. Depending on the specific context, one or more modes may be sufficient to cause high transmission, while in other contexts no transmission may result. Because of this, when making intervention decisions that involve blocking environmental pathways, generic recommendations applied indiscriminately may be ineffective; instead intervention choice should be contextualized, depending on the specific features of people, virus strain, or venue in question.

SUBMITTER: Spicknall IH

PROVIDER: S-EPMC2965740 | biostudies-literature | 2010 Oct

REPOSITORIES: biostudies-literature

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Informing optimal environmental influenza interventions: how the host, agent, and environment alter dominant routes of transmission.

Spicknall Ian H IH Koopman James S JS Nicas Mark M Pujol Josep M JM Li Sheng S Eisenberg Joseph N S JN

PLoS computational biology 20101028 10

Influenza can be transmitted through respirable (small airborne particles), inspirable (intermediate size), direct-droplet-spray, and contact modes. How these modes are affected by features of the virus strain (infectivity, survivability, transferability, or shedding profiles), host population (behavior, susceptibility, or shedding profiles), and environment (host density, surface area to volume ratios, or host movement patterns) have only recently come under investigation. A discrete-event, con ...[more]

PMID: 21060854

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Project description:BackgroundA measles outbreak occurred in a western county of China in 2013, the year after China's historic nadir of measles. We conducted a field investigation to identify gaps in measles vaccination coverage and immunization program weaknesses, and to provide recommendations for measles outbreak response and immunization program improvement.MethodsWe analyzed surveillance data from 2008 to 2013 to describe the measles epidemiology of the county. Measles-containing vaccine coverage was estimated using two methods: previously-reported administrative coverage and an estimation of coverage by clinic-kept vaccination records (n = 542). We conducted a rapid field coverage assessment in a migrant population village to evaluate coverage after emergency vaccination. We conducted a review of hospital records of measles cases to address the role hospital transmission played during the early stage of this outbreak.ResultsThere were 153 cases in the outbreak, primarily among children too young to vaccinate, unvaccinated children less than 3 years old, and adults. Measles-containing vaccine coverage by the field assessment showed that 20% of children aged 8-17 months had zero doses, and 9% of ?2 years old children had fewer than two doses. The vaccination statuses of all adult cases were either zero doses or unknown. At least 61% of cases had been hospitalized. The proportion of cases who had been hospital-exposed 7 to 21 days prior to rash onset decreased from 52% to 22% after hospitals strengthen their isolation measures.ConclusionsThis outbreak was a result of measles vaccination coverage gaps among young children and adults, and insufficient hospital isolation of cases. The lower coverage seen in the field estimation compared with reported coverage showed that reported coverage could have been overestimated. Hospitals were sites of transmission in the early stage of the outbreak. A strict hospital isolation policy could decrease spread of measles. Emergency vaccination was associated with stopping measles transmission in low coverage areas.

Dataset Information

Informing optimal environmental influenza interventions: how the host, agent, and environment alter dominant routes of transmission.

Publications

Informing optimal environmental influenza interventions: how the host, agent, and environment alter dominant routes of transmission.

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