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Dynamic Epidemic Model for Influenza with Clinical Complications

Published online by Cambridge University Press:  02 January 2015

Sen-Te Wang
Affiliation:
Department of Family Medicine, School of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan Department of Family Medicine, Taipei Medical University Hospital, Taipei, Taiwan
Li-Sheng Chen
Affiliation:
School of Oral Hygiene, College of Oral Medicine, Taipei Medical University, Taipei, Taiwan
Long-Teng Lee
Affiliation:
Department of Family Medicine, National Taiwan University Hospital, Taipei, Taiwan
Hsiu-Hsi Chen*
Affiliation:
Division of Biostatistics, Institute of Epidemiology/Center for Biostatistics, College of Public Health, National Taiwan University, Taipei, Taiwan
*
College of Public Health, National Taiwan University, Room 533, No. 17, Hsu-Chow Road, Taipei, Taiwan 100 (chenlin@ntu.edu.tw)

Abstract

Objective.

To incorporate clinical complications in the susceptible-infectious-recovered model to estimate parameters needed in dynamic changes of infectious diseases and to further evaluate the impact of disease-controlling methods.

Methods.

We developed a new extended epidemic model that incorporates of disease-related complications. This model was applied to empirical data on influenza during the epidemic season of 2001–2002 in Taipei County, Taiwan, to estimate the transmission parameters that were converted to the basic reproductive rate (R0). The proposed model, in conjunction with estimated parameters, was applied in quantifying the efficacy of different preventive strategies.

Results.

During the study period there were 5 outbreaks of influenza. The estimated transmission probability for outbreak 1 was 0.135, with corresponding estimate of R0, 2.7; for outbreak 2, 0.165, with estimated R0, 3.3; for outbreak 3, 0.15, with R0, 4.5; for outbreak 4, 0.165, with R0, 5; and for outbreak 5, 0.165, with R0 5. The efficacy of antiviral prophylaxis to reduce the total episodes was 18% (95% CI, 15%–21%) under the coverage rate of 30%, 31% (95% CI, 26%–36%) under the coverage rate of 50%, and 73% (95% CI, 59%–90%) under the coverage rate of 80%. The corresponding figures for the efficacy of vaccination were 17% (95% CI, 15%–20%), 41% (95% CI, 35%–48%), and 76% (95% CI, 61%–95%). Combination of both methods would yield efficacy of 32% (95% CI, 28%–38%), 59% (95% CI, 49%–71%), and 88% (95% CI, 66%–118%), respectively.

Conclusions.

We demonstrate how to apply a novel extended model to empirical surveillance data of an influenza study for estimating parameters pertaining to dynamic changes in the infection process. These parameters were further used to evaluate the impact of antiviral prophylaxis alone, vaccination alone, or the use of both methods.

Type
Original Articles
Copyright
Copyright © The Society for Healthcare Epidemiology of America 2011

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