学校流感暴发疫情防控措施动力学模型效果分析
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摘要
目的探讨学校流感暴发疫情的最佳控制方式,为制定停课标准提供参考。方法通过SEIAR模型对流感暴发疫情隔离和停课效果进行分析。结果本起流感暴发疫情基本再生数R_0为7.6180,无干预措施下疫情会持续20天,1 169名学生和教职工(99.74%)会感染流感。第5～10天开始隔离措施,疫情持续时间介于35～44天,第10天开始隔离感染人数是第5天开始隔离的6.9倍。与单独采取隔离措施相比,停课1天、3天、5天、7天可以减少4.51%～10.92%、13.41%～29.31%、19.46%～45.40%和24.82%～57.47%的感染人数,持续时间并没有太大变化;停课14天疫情持续时间都会明显下降,感染人数下降33.43%～65.52%。结论隔离措施越早实施对疫情控制效果越好,显性感染人数达到20%以上时可以停课,出现重症或死亡病例时要将停课时间延长。
Objective To study the best way to control the outbreak of influenza in schools,so as to provide residents reference for the formulation of the standards for closing classes.Methods The effect of isolation and suspension of the flu outbreak in the area was analyzed by SEIAR model.Results The basic reproduction of this influenza outbreak in a number of R0 was 7.6180,and the non-intervention measures epidemic lasted for 20 days,with 1169 students and faculties(99.74%)infected.When the isolation measures began on the 5 th-10 th day,the duration of the epidemic lasted for 35-44 days,and the number of isolated infections began on the tenth day was 6.9 times higher than that on the fifth day.Compared with the separate quarantine measures,the number of infections for 1 day,3 days,5 days,7 days could reduce 4.51-10.92%,12.41-29.31%,19.46-45.40% and 24.82-57.47%,respectively,but the duration change little.The epidemic duration closing for 14 days would be significantly decreased,and the number of infections decreased by 33.43-65.52%.Conclusion The earlier implementation of quarantine measures,the better the effect of epidemic control would be.If the number of symptomatic infected persons reached over 20%,the school or the class should be closed.It is necessary to extend the closing time when there are severe or fatal cases.
Objective To study the best way to control the outbreak of influenza in schools,so as to provide residents reference for the formulation of the standards for closing classes.Methods The effect of isolation and suspension of the flu outbreak in the area was analyzed by SEIAR model.Results The basic reproduction of this influenza outbreak in a number of R0 was 7.6180,and the non-intervention measures epidemic lasted for 20 days,with 1169 students and faculties(99.74%)infected.When the isolation measures began on the 5 th-10 th day,the duration of the epidemic lasted for 35-44 days,and the number of isolated infections began on the tenth day was 6.9 times higher than that on the fifth day.Compared with the separate quarantine measures,the number of infections for 1 day,3 days,5 days,7 days could reduce 4.51-10.92%,12.41-29.31%,19.46-45.40% and 24.82-57.47%,respectively,but the duration change little.The epidemic duration closing for 14 days would be significantly decreased,and the number of infections decreased by 33.43-65.52%.Conclusion The earlier implementation of quarantine measures,the better the effect of epidemic control would be.If the number of symptomatic infected persons reached over 20%,the school or the class should be closed.It is necessary to extend the closing time when there are severe or fatal cases.
引文
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[18] 陈田木,陈水连,谢知,等.不同隐性感染和传播能力条件下的流感暴发防控措施效果模拟[J].中国热带医学,2017,17(5):470-476.
[2] Chen T,Zhao B,Liu R,et al.Simulation of key interventions for seasonal influenza outbreak control at school in Changsha,China[J].The Journal of international medical research,2018,2018:300060518764268.
[3] 陈田木,刘如春,张锡兴,等.长沙市甲型H1N1流感流行干预措施效果的数学模拟[J].中国卫生统计,2015,32(2):205-210.
[4] Yang Y,Sugimoto JD,Halloran ME,et al.The transmissibility and control of pandemic influenza A(H1N1)virus[J].Science,2009,326(5953):729-733.
[5] Chen T,Chen T,Liu R,et al.Transmissibility of the influenza virus during influenza outbreaks and related asymptomatic infection in mainland China,2005-2013[J].PLOS One,2016,11(11):e0166180.
[6] 陈田木,刘如春,谭爱春,等.隔离患者对控制学校甲型H1N1流感暴发疫情效果的数学模拟[J].中国卫生统计,2014,31(3):390-394.
[7] Chen SL,Liu RC,Chen FM,et al.Dynamic modelling of strategies for the control of acute haemorrhagic conjunctivitis outbreaks in schools in Changsha,China(2004-2015)[J].Epidemiology and Infection,2017,145(2):368-378.
[8] 孟玲,李超,汪立杰,等.2017年12月全国突发公共卫生事件及需关注的传染病风险评估[J].疾病监测,2017,32(12):907-910.
[9] 温雯,黄立勇,王海滨,等.2014-2016年北京市朝阳区流感聚集性疫情流行特征及影响因素分析[J].现代预防医学,2017,44(14):2507-2511.
[10] Effler PV,Carcione D,Giele C,et al.Household responses to pandemic(H1N1)2009-related school closures,Perth,Western Australia[J].Emerging Infectious Diseases,2010,16(2):205-211.
[11] Cauchemez S,Maria DV,Brett NA.School closures during the 2009 influenza pandemic:national and local experiences[J].BMC Infectious Diseases,2014,14:207.
[12] 许晴,祖正虎,张文斗,等.实施学校停课措施对流感疫情及经济的影响[J].军事医学,2013,37(2):150-154.
[13] 马萍,王敬军,张义,等.陕西省2006-2013年流感暴发疫情流行特征影响因素[J].中国公共卫生,2015,31(1):17-21.
[14] 徐展凯.基于个体的传染病传播模型构建及应用[D].北京:中国人民解放军军事医学科学院,2016.
[15] 黄婷,程秀伟,周丽君,等.2004-2016年四川省流感暴发疫情流行病学分析[J].现代预防医学,2018,45(4):591-595,599.
[16] Halder N,Kelso JK,Milne GJ.Developing guidelines for school closure interventions to be used during a future influenza pandemic[J].BMC Infectious Diseases,2010,10:221.
[17] Sasaki A,Hoen AG,Ozonoff A,et al.Evidence-based tool for triggering school closures during influenza outbreaks,Japan[J].Emerging Infectious Diseases,2009,15(11):1841-1843.
[18] 陈田木,陈水连,谢知,等.不同隐性感染和传播能力条件下的流感暴发防控措施效果模拟[J].中国热带医学,2017,17(5):470-476.