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health around the world. To contain outbreaks of SARS, or other pathogens for which vaccines or treatment are not available, requires aggressive case management measures complemented by contact precautions to reduce transmission in healthcare settings. 67
Table 1. Summary of transmission and case management parameters, including baseline values used throughout the study and the three control strategies depicted in Figure 3. Parameter Symbol Range examined Baseline transmission rate (day -1 ) β 0.08-0.26 Factors modifying transmission rate, due to: Pre-symptomatic transmission Hospital-wide contact precautions Reduced HCW- community mixing (R0=1.5-5) Fig 3 (1) 0.15 (R0=3) Fig 3 (2) 0.15 (R0=3) Fig 3 (3) 0.15 (R0=3) ε 0-0.1 0.1 0.1 0.1 η 0-1 0.5 0.9 0.5 ρ 0-1 0.5 1 0.5 Case isolation κ 0-1 1 0.5 0.5 Quarantine γ 0-1 0.5 0.5 0.5 Daily probability of: Quarantining of Ec individual q 0-1 0 0.5 0.5 Isolation of Ic individual hc 0-1 0.3 0.9 0.9 Isolation of Ih individual hh 0.9 0.9 0.9 0.9 68
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Disease transmission in heterogeneo
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Abstract Disease transmission in he
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variation is quantified from outbre
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ACKNOWLEDGEMENTS I’ve been fortun
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Engineering Research Council of Can
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Epidemic modelers face an essential
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casual contact (DCC), common usage
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HCW, and patient pools) and dynamic
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Hoffmann 2004; Shen et al. 2004)—
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Chapter Two Frequency-dependent inc
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principles and reach robust conclus
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partnership, disease and demographi
Page 25 and 26: transmission to incorporate this ph
Page 27 and 28: This result can be understood intui
Page 29 and 30: Garnett 2002). We simulated epidemi
Page 31 and 32: 4. Infection-induced changes in pai
Page 33 and 34: susceptible population (Diekmann an
Page 35 and 36: epidemics, since they bring R0 clos
Page 37 and 38: equired.) For slower-moving, chroni
Page 39 and 40: addressed here. Our treatment consi
Page 41 and 42: Table 1. Results for epidemics with
Page 43 and 44: (Equations 3 and A4); the lighter l
Page 45 and 46: Figure 2 A) B) Total proportion inf
Page 47 and 48: Appendix Derivation of SI pair dens
Page 49 and 50: As described in Section 2, our goal
Page 51 and 52: can be calculated as the product of
Page 53 and 54: Chapter Three Curtailing transmissi
Page 55 and 56: egions with on-going epidemics has
Page 57 and 58: transmission to the general communi
Page 59 and 60: and Ih), as well as from off-duty t
Page 61 and 62: ours—see Diekmann & Heesterbeek (
Page 63 and 64: In all cases (Figure 2C, 2D), we id
Page 65 and 66: Sensitivity to quarantining rate (s
Page 67 and 68: precautions in the hospital (η→1
Page 69 and 70: Preventing generalized community tr
Page 71 and 72: everywhere. These robust conclusion
Page 73 and 74: increasingly significant contributi
Page 75: hospitals or wards. Future work on
Page 79 and 80: formulation of our model allows for
Page 81 and 82: Figure 3 (A) Increase in cumulative
Page 83 and 84: Figure 1 74
Page 85 and 86: Figure 3 (A) (B) (C) Cumulative num
Page 87 and 88: Appendix Sensitivity to population
Page 89 and 90: symptomatic HCWs is low. Indeed, th
Page 91 and 92: E I I I I m, i m, 1 m, 2 m , 3 m ,
Page 93 and 94: for a stochastic epidemic: the prob
Page 95 and 96: progress through the age sub-compar
Page 97 and 98: We therefore wish to characterize t
Page 99 and 100: Figure S4 Distribution of (A) incub
Page 101 and 102: Figure S2 (A) (C) 92 (B) (D)
Page 103 and 104: Figure S4 (A) (B) Proportion of cas
Page 105 and 106: 1. Introduction During the global e
Page 107 and 108: quantity p0, the proportion of case
Page 109 and 110: model selection techniques, lending
Page 111 and 112: elatively mild variation in ν, sho
Page 113 and 114: cannot make inferences based on the
Page 115 and 116: low k extinction happens within the
Page 117 and 118: measured by the variance-to-mean ra
Page 119 and 120: succeed (Figure 3B). For a given re
Page 121 and 122: to lower infectiousness. Other rele
Page 123 and 124: observations for the diseases exami
Page 125 and 126: Pneumonic plague 6 outbreaks N=74 A
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s surveillance data. 90% CI: Bootst
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Figure captions Figure 1 Evidence f
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Figure 4 Impact of control measures
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Figure 2 Other Measles Influenza Ru
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Figure 4 C Reproductive number, R 1
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epresenting transmission yields a g
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We rescaled the AICc by subtracting
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for which the median of bootstrap e
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transmission due to the most infect
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an integer Z (99) such that FPoisso
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fv(u). Demographic stochasticity in
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original process is eliminated with
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For RA control, with a random propo
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∞ ( , ) ∫ ( ) ( ). k−1 −t w
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* and for ν < ν : ∞ ∫ ν C 1
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Contrib(control policy) = Pr(contai
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ange of the first disease generatio
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Figure S1 MLE estimates of k 10 1 0
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Figure S2 (cont) D E F k=inf k=4 k=
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Figure S4 Relative frequency 0.4 0.
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SARS (March 12) and the imposition
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Transmission was predominantly by i
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Monkeypox, Zaire 1980-1984 (Jezek e
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Rubella, Hawaii 1970 (Hattis et al.
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tracing, with the stated goal of de
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Table S1. Superspreading events in
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Measles 250 Dance party ?M First ar
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SARS 187+ Apartment block 26M Amoy
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SARS 33 Hospital 62W Undiagnosed: S
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SARS 24/2* Home, emergency room, IC
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Streptococcus group A (type 1) 100+
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References Abbot, P. and L. M. Dill
Page 191 and 192:
Caswell, H. (2001) Matrix Populatio
Page 193 and 194:
Evatt, B. L., W. R. Dowdle, M. John
Page 195 and 196:
Health Canada (2003) Summary of Sev
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Kretzschmar, M. (2000). Sexual netw
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McCallum, H., N. Barlow and J. Hone
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Taylor, H. M. and S. Karlin (1998).
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