Age-related changes in the rate of disease transmission: implications for the design of vaccination programmes

Cambridge University Press (CUP) - Tập 94 Số 3 - Trang 365-436 - 1985
Roy M. Anderson1, Robert M. May2
1Department of Pure and Applied Biology, Imperial College, London University, London SW7 2BB
2Biology Department, University of Princeton, Princeton, New Jersey 08540, U.S.A

Tóm tắt

SUMMARYMathematical models are developed to aid in the investigation of the implications of heterogeneity in contact with infection within a community, on the design of mass vaccination programmes for the control of childhood viral and bacterial infections in developed countries. Analyses are focused on age-dependency in the rate at which individuals acquire infection, the question of ‘who acquires infection from whom’, and the implications of genetic variability in susceptibility to infection. Throughout, theoretical predictions are based on parameter estimates obtained from epidemiological studies and are compared with observed temporal trends in disease incidence and age-stratified serological profiles.Analysis of case notification records and serological data suggest that the rate at which individuals acquire many common infections changes from medium to high and then to low levels in the infant, child and teenage plus adult age groups respectively. Such apparent age-dependency in attack rate acts to reduce slightly the predicted levels of herd immunity required for the eradication of infections such as measles, when compared with the predictions of models based on age-independent transmission. The action of maternally derived immunity in prohibiting vaccination in infants, and the broad span of age classes over which vaccination currently takes place in the U.K., however, argue that levels of herd immunity of between 90 and 94 % would be required to eliminate measles.Problems surrounding the interpretation of apparent age-related trends in the acquisition of infection and their relevance to the design of vaccination programmes, are discussed in relation to the possible role of genetically based variation in susceptibility to infection and observations on epidemics in “virgin” populations. Heterogeneous mixing models provide predictions of changes in serology and disease incidence under the impact of mass vaccination which well mirror observed trends in England and Wales.

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Tài liệu tham khảo

Bliss, 1959, The analysis of seasonal variation in measles, American Journal of Hygiene, 70, 328

10.1017/S002217240002893X

1974, Statistics of Infectious Diseases

Wilson G. N. (1904). Measles: its prevalence and mortality in Aberdeen. Report of the Medical Office of Health, Aberdeen, 41–50.

Marks, 1978, Measles vaccine efficacy in children previously vaccinated at 12 months of age, Pediatrics, 62, 955

10.1093/ije/11.1.15

Anderson, 1985, Spatial, temporal and genetic heterogeneity in host populations and the design of immunization programmes, Journal of Mathematics Applied in Biology and Medicine

1948, Annual Review of the Registrar General of England and Wales

10.1093/ije/9.1.13

10.1038/280361a0

10.1136/bmj.1.5751.698

Black, 1959, Measles antibodies in the population of New Haven, Connecticut, Journal of Immunology, 83, 74, 10.4049/jimmunol.83.1.74

1963, Baltimore Public Health Reports 1963

Dietz, 1984, A Celebration of Statistics

10.1093/oxfordjournals.aje.a112666

10.1093/oxfordjournals.aje.a121576

Fales, 1928, The age distribution of whooping cough, measles, chicken pox, scarlet fever and diphtheria in various areas in he United States, American Journal of Hygiene, 8, 759

10.1073/pnas.27.1.7

10.1136/bmj.2.5401.75

10.1007/978-3-642-93287-8_24

10.1001/jama.1976.03270100028021

Dietz, 1975, Epidemiology, 104

10.1093/oxfordjournals.aje.a112016

10.2307/2342553

Christensen, 1953, Measles in virgin soil, Greenland, 1951, Danish Medical Bulletin, 1, 2

Bartlett, 1956, Proceedings of the Third Berkely Symposium on Mathematics, Statistics and Probability, 81

10.1007/978-3-642-93048-5_1

10.1093/ije/11.1.5

Enderle J. D. (1980). A stochastic communicable disease model with age-specific states and applications to measles. (Ph.D. dissertation, Rensselaer Polytechnic Institute, Troy, U.S.A.)

10.2307/4579202

10.1017/S0022172400065177

10.1017/S0022172400063993

Shelton, 1978, Measles vaccine efficacy: Influence of age at vaccination vs. duration of time since vaccination, Pediatrics, 62, 961, 10.1542/peds.62.6.961

10.1093/oxfordjournals.epirev.a036220

10.1001/jama.1965.03080080009002

May R. M. (1985). Population biology of microparasitic infections. Lecture Notes in Biomathematics (In the Press).

Roden, 1977, Effects of vaccination against measles in the incidence of the disease and on the immunity of the child population in England and Wales, Health Trends, 9, 69

10.1126/science.7063839

Butler, 1913, Measles, Proceedings of the Royal Society of Medicine, 6, 120, 10.1177/003591571300601406

10.2105/AJPH.6.9.971

Hedrich, 1933, Monthly estimates of the child population ‘susceptible’ to measles, 1900–1931, Baltimore, M.D., American Journal of Hygiene, 17, 613

10.1136/bmj.282.6262.434

Chapin, 1925, Measles in Providence, R. I., 1858–1923, American Journal of Hygiene, 5, 635

10.1016/0016-0032(74)90037-4

10.1093/oxfordjournals.aje.a113511

10.2307/2347126

10.1016/0025-5564(84)90063-4

Knolle, 1983, The general age-dependent endemic with age-specific contract rates, Biometrical Journal, 25, 468, 10.1002/bimj.19830250507

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Cambridge University Press (CUP)

Tập 94 Số 3

365-436

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