Artikel
Impact of public health interventions in controlling the spread of SARS - Modelling intervention scenarios
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Veröffentlicht: | 6. September 2007 |
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Gliederung
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Background: A variety of intervention measures exist to prevent and control pandemic disease spread. Measures like quarantine and isolation can efficiently interrupt disease transmission. Population based measures like closing of schools and businesses can prevent casual disease transmission by reducing contact rates in a susceptible population. However, these measures differ in their approaches and their effectiveness in reducing secondary cases [Ref. 1].
Method: Mathematical modelling was applied to estimate the effect of interventions by calculating different SARS outbreak scenarios. The current study uses a decision model to estimate the impact of intervention measures on the effective reproductive number (Re) and the final outbreak size.
Results: The analysis showed that early case detection followed by strict isolation could exclusively control a SARS outbreak. Tracing of contacts of health care workers and of close contacts of cases had an additional effect to reduce Re. Tracing of casual contacts and measures to decrease social interaction was predicted to be less effective in reducing the number of secondary SARS cases.
Conclusion: The current study highlights that early identification of SARS cases, by measures like contact tracing, quarantine and monitoring of vulnerable groups, is vital to limit the number of secondary cases. However, doing so transfers cases to health care facilities which makes hospital hygiene measures, like isolation and infection control important to avoid nosocomial spread. Measures to decrease social interaction, like closing schools and cancelling public gatherings have a minor impact to reduce Re of SARS. In addition, such measures are costly and curtail social liberty. The current study points to measures suitable to prevent and control a SARS outbreak and shows how they are interconnected.
References
- 1.
- Bell DM, World Health Organization Working Group on International and Community Transmission of SARS. Public health interventions and SARS spread, 2003. Emerg Infect Dis 2004;10(11):1900-6.