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Contingency planning for a deliberate release of smallpox in Great Britain : the role of geographical scale and contact structure

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House, Thomas A., Hall, Ian, Danon, Leon and Keeling, Matthew James. (2010) Contingency planning for a deliberate release of smallpox in Great Britain : the role of geographical scale and contact structure. BMC Infectious Diseases, Vol.10 . Article no. 25. ISSN 1471-2334

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Official URL: http://dx.doi.org/10.1186/1471-2334-10-25

Abstract

Background: In the event of a release of a pathogen such as smallpox, which is human-to-human transmissible
and has high associated mortality, a key question is how best to deploy containment and control strategies. Given
the general uncertainty surrounding this issue, mathematical modelling has played an important role in informing
the likely optimal response, in particular defining the conditions under which mass-vaccination would be
appropriate. In this paper, we consider two key questions currently unanswered in the literature: firstly, what is the
optimal spatial scale for intervention; and secondly, how sensitive are results to the modelling assumptions made
about the pattern of human contacts?

Methods: Here we develop a novel mathematical model for smallpox that incorporates both information on
individual contact structure (which is important if the effects of contact tracing are to be captured accurately) and
large-scale patterns of movement across a range of spatial scales in Great Britain.

Results: Analysis of this model confirms previous work suggesting that a locally targeted ‘ring’ vaccination strategy
is optimal, and that this conclusion is actually quite robust for different socio-demographic and epidemiological
assumptions.

Conclusions: Our method allows for intuitive understanding of the reasons why national mass vaccination is
typically predicted to be suboptimal. As such, we present a general framework for fast calculation of expected
outcomes during the attempted control of diverse emerging infections; this is particularly important given that
parameters would need to be interactively estimated and modelled in any release scenario.

Item Type:	Journal Article
Subjects:	Q Science > QR Microbiology > QR180 Immunology
Divisions:	Faculty of Science > Life Sciences (2010- ) > Biological Sciences ( -2010) Faculty of Science > Mathematics
Library of Congress Subject Headings (LCSH):	Smallpox -- Mathematical models, Smallpox -- Vaccination, Smallpox -- Transmission, Bioterrorism
Journal or Publication Title:	BMC Infectious Diseases
Publisher:	BioMed Central Ltd.
ISSN:	1471-2334
Official Date:	February 2010
Volume:	Vol.10
Number of Pages:	12
Page Range:	Article no. 25
Identification Number:	10.1186/1471-2334-10-25
Status:	Peer Reviewed
Publication Status:	Published
Access rights to Published version:	Open Access
Funder:	Great Britain. Dept. of Health (DoH), Home Office Counter Terrorism and Intelligence Directorate, Medical Research Council (Great Britain) (MRC)
Grant number:	G0701256 (MRC)
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URI:	http://wrap.warwick.ac.uk/id/eprint/3021