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      Model-consistent estimation of the basic reproduction number from the incidence of an emerging infection

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          Abstract

          We investigate the merit of deriving an estimate of the basic reproduction number \documentclass[12pt]{minimal} \usepackage{amsmath} \usepackage{wasysym} \usepackage{amsfonts} \usepackage{amssymb} \usepackage{amsbsy} \usepackage{mathrsfs} \usepackage{upgreek} \setlength{\oddsidemargin}{-69pt} \begin{document} $$ \mathcal{R}_0 $$ \end{document} early in an outbreak of an (emerging) infection from estimates of the incidence and generation interval only. We compare such estimates of \documentclass[12pt]{minimal} \usepackage{amsmath} \usepackage{wasysym} \usepackage{amsfonts} \usepackage{amssymb} \usepackage{amsbsy} \usepackage{mathrsfs} \usepackage{upgreek} \setlength{\oddsidemargin}{-69pt} \begin{document} $$ \mathcal{R}_0 $$ \end{document} with estimates incorporating additional model assumptions, and determine the circumstances under which the different estimates are consistent. We show that one has to be careful when using observed exponential growth rates to derive an estimate of \documentclass[12pt]{minimal} \usepackage{amsmath} \usepackage{wasysym} \usepackage{amsfonts} \usepackage{amssymb} \usepackage{amsbsy} \usepackage{mathrsfs} \usepackage{upgreek} \setlength{\oddsidemargin}{-69pt} \begin{document} $$ \mathcal{R}_0 $$ \end{document} , and we quantify the discrepancies that arise.

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          Most cited references25

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          Transmissibility of 1918 pandemic influenza

          The 1918 influenza pandemic killed 20–40 million people worldwide 1 , and is seen as a worst-case scenario for pandemic planning. Like other pandemic influenza strains, the 1918 A/H1N1 strain spread extremely rapidly. A measure of transmissibility and of the stringency of control measures required to stop an epidemic is the reproductive number, which is the number of secondary cases produced by each primary case 2 . Here we obtained an estimate of the reproductive number for 1918 influenza by fitting a deterministic SEIR (susceptible-exposed-infectious-recovered) model to pneumonia and influenza death epidemic curves from 45 US cities: the median value is less than three. The estimated proportion of the population with A/H1N1 immunity before September 1918 implies a median basic reproductive number of less than four. These results strongly suggest that the reproductive number for 1918 pandemic influenza is not large relative to many other infectious diseases 2 . In theory, a similar novel influenza subtype could be controlled. But because influenza is frequently transmitted before a specific diagnosis is possible and there is a dearth of global antiviral and vaccine stores, aggressive transmission reducing measures will probably be required. Supplementary information The online version of this article (doi:10.1038/nature03063) contains supplementary material, which is available to authorized users.
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            Different epidemic curves for severe acute respiratory syndrome reveal similar impacts of control measures.

            Severe acute respiratory syndrome (SARS) has been the first severe contagious disease to emerge in the 21st century. The available epidemic curves for SARS show marked differences between the affected regions with respect to the total number of cases and epidemic duration, even for those regions in which outbreaks started almost simultaneously and similar control measures were implemented at the same time. The authors developed a likelihood-based estimation procedure that infers the temporal pattern of effective reproduction numbers from an observed epidemic curve. Precise estimates for the effective reproduction numbers were obtained by applying this estimation procedure to available data for SARS outbreaks that occurred in Hong Kong, Vietnam, Singapore, and Canada in 2003. The effective reproduction numbers revealed that epidemics in the various affected regions were characterized by markedly similar disease transmission potentials and similar levels of effectiveness of control measures. In controlling SARS outbreaks, timely alerts have been essential: Delaying the institution of control measures by 1 week would have nearly tripled the epidemic size and would have increased the expected epidemic duration by 4 weeks.
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              A note on generation times in epidemic models.

              The time between the infection of a primary case and one of its secondary cases is called a generation time. The distribution (and mean) of the generation times is derived for a rather general class of epidemic models. The relation to assumptions on distributions of latency times and infectious times or more generally on random time varying infectiousness, is investigated. Serial times, defined as the times between occurrence of observable events in the progress of an infectious disease (e.g., the onset of clinical symptoms), are also considered.
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                Author and article information

                Contributors
                m.g.roberts@massey.ac.nz
                j.a.p.heesterbeek@vet.uu.nl
                Journal
                J Math Biol
                Journal of Mathematical Biology
                Springer-Verlag (Berlin/Heidelberg )
                0303-6812
                1432-1416
                8 August 2007
                November 2007
                : 55
                : 5-6
                : 803-816
                Affiliations
                [1 ]Centre for Mathematical Biology, Institute of Information and Mathematical Sciences, Massey University, Private Bag 102 904, North Shore Mail Centre, Auckland, New Zealand
                [2 ]Faculty of Veterinary Medicine, University of Utrecht, Yalelaan 7, 3584 CL Utrecht, The Netherlands
                Article
                112
                10.1007/s00285-007-0112-8
                2782110
                17684743
                a28f6fab-c290-44e2-9411-4260ded5ef73
                © Springer-Verlag 2007
                History
                : 17 August 2006
                : 23 May 2007
                Categories
                Article
                Custom metadata
                © Springer-Verlag 2007

                Quantitative & Systems biology
                epidemics,basic reproduction number,92b05,emerging infectious disease

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