Comparing nonpharmaceutical interventions for containing emerging epidemics

Strategies for containing an emerging infectious disease outbreak must be nonpharmaceutical when drugs or vaccines for the pathogen do not yet exist or are unavailable. The success of these nonpharmaceutical strategies will depend on not only the effectiveness of isolation measures but also the epidemiological characteristics of the infection. However, there is currently no systematic framework to assess the relationship between different containment strategies and the natural history and epidemiological dynamics of the pathogen. Here, we compare the effectiveness of quarantine and symptom monitoring, implemented via contact tracing, in controlling epidemics using an agent-based branching model. We examine the relationship between epidemic containment and the disease dynamics of symptoms and infectiousness for seven case-study diseases with diverse natural histories, including Ebola, influenza A, and severe acute respiratory syndrome (SARS). We show that the comparative effectiveness of symptom monitoring and quarantine depends critically on the natural history of the infectious disease, its inherent transmissibility, and the intervention feasibility in the particular healthcare setting. The benefit of quarantine over symptom monitoring is generally maximized for fast-course diseases, but we show the conditions under which symptom monitoring alone can control certain outbreaks. This quantitative framework can guide policymakers on how best to use nonpharmaceutical interventions and prioritize research during an outbreak of an emerging pathogen.

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Containing Emerging Epidemics: a Quantitative Comparison of Quarantine and Symptom Monitoring

10.1101/072652 ◽

2016 ◽

Author(s):

Corey M Peak ◽

Lauren M Childs ◽

Yonatan H Grad ◽

Caroline O Buckee

Keyword(s):

Infectious Disease ◽

Natural History ◽

Influenza A ◽

Healthcare Setting ◽

Contact Tracing ◽

Symptom Monitoring ◽

History Of ◽

Epidemiological Characteristics ◽

The Relationship

ABSTRACTStrategies for containing an emerging infectious disease outbreak must be non-pharmaceutical when drugs or vaccines for the pathogen do not yet exist or are unavailable. The success of these non-pharmaceutical strategies will depend not only on the effectiveness of quarantine or other isolation measures but also on the epidemiological characteristics of the infection. However, there is currently no systematic framework to assess the relationship between different containment strategies and the natural history and epidemiological dynamics of the pathogen. Here, we compare the effectiveness of quarantine and symptom monitoring, implemented via contact tracing, in controlling epidemics using an agent-based branching model. We examine the relationship between epidemic containment and the disease dynamics of symptoms and infectiousness for seven case study diseases with diverse natural histories including Ebola, Influenza A, and Severe Acute Respiratory Syndrome (SARS). We show that the comparative effectiveness of symptom monitoring and quarantine depends critically on the natural history of the infectious disease, its inherent transmissibility, and the intervention feasibility in the particular healthcare setting. The benefit of quarantine over symptom monitoring is generally maximized for fast-course diseases, but we show the conditions under which symptom monitoring alone can control certain outbreaks. This quantitative framework can guide policy-makers on how best to use non-pharmaceutical interventions to contain emerging outbreaks and prioritize research during an outbreak of a novel pathogen.SIGNIFICANCEQuarantine and symptom monitoring of contacts with suspected exposure to an infectious disease are key interventions for the control of emerging epidemics; however, there does not yet exist a quantitative framework for comparing the control performance of each. Here, we use a mathematical model of seven case study diseases to show how the choice of intervention is influenced by the natural history of the infectious disease, its inherent transmissibility, and the intervention feasibility in the particular healthcare setting. We use this information to identify the most important characteristics of the disease and setting that need to be characterized for an emerging pathogen in order to make an informed decision between quarantine and symptom monitoring.

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The Relationship Between Coronary Calcification and the Natural History of Coronary Artery Disease

JACC Cardiovascular Imaging ◽

10.1016/j.jcmg.2020.08.036 ◽

2020 ◽

Cited By ~ 1

Author(s):

Han-Young Jin ◽

Jonathan R. Weir-McCall ◽

Jonathon A. Leipsic ◽

Jang-Won Son ◽

Stephanie L. Sellers ◽

...

Keyword(s):

Coronary Artery Disease ◽

Coronary Artery ◽

Natural History ◽

Coronary Calcification ◽

History Of ◽

Artery Disease ◽

The Relationship

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Natural History of Infectious Disease. SirMacfarlane Burnet and David O. White. Pp. x + 278. (Cambridge University Press, Cambridge, 1972.) Price £4·00.

Journal of Biosocial Science ◽

10.1017/s0021932000009731 ◽

1974 ◽

Vol 6 (3) ◽

pp. 387-387

Author(s):

G. Melvyn Howe

Keyword(s):

Infectious Disease ◽

Natural History ◽

Cambridge University ◽

History Of

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The natural history of infectious disease. 2nd ed. By Sir Macfarlane Burnet. Cambridge University Press, New York, 1953. 356 pp. 14.5 × 22.5 cm. $4.50

Journal of the American Pharmaceutical Association (Scientific ed ) ◽

10.1002/jps.3030421122 ◽

1953 ◽

Vol 42 (11) ◽

pp. 704

Keyword(s):

Infectious Disease ◽

New York ◽

Natural History ◽

Cambridge University ◽

History Of

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Natural History of Infectious Disease

The Medical Journal of Australia ◽

10.5694/j.1326-5377.1973.tb128831.x ◽

1973 ◽

Vol 2 (6) ◽

pp. 290-290

Keyword(s):

Infectious Disease ◽

Natural History ◽

History Of

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Ethics, Secular and Religious

10.1093/oxfordhb/9780199988457.013.40 ◽

2017 ◽

Author(s):

John Teehan

Keyword(s):

Natural History ◽

Moral Psychology ◽

Social Cohesion ◽

Code Of Conduct ◽

Religious Violence ◽

Religious Ethics ◽

Evolutionary Perspective ◽

History Of ◽

Religious Morality ◽

The Relationship

Morality from an evolutionary perspective is a code of conduct that regulates behavior within a group in order to promote social cohesion and stability. Both religion and secularism are grounded in the same moral psychology. How should the distinction between secular and religious ethics be assessed? Religious morality is a late-comer to the natural history of morality, reinforcing much of morality with a worldview about unnatural powers that humans’ brains are prone to projecting onto reality. However, the natural history of morality reveals that religious moral traditions do not originate moral rules but instead reinforce ancient moral intuitions. Secularism as a worldview works within an immanent frame, compared to the transcendent frame of religious worldviews. This distinction is helpful in understanding the relationship between religious violence and secular-ideological driven violence.

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Human Papillomavirus and Genital Disease in Men: What We Have Learned from the HIM Study

Acta Cytologica ◽

10.1159/000493737 ◽

2019 ◽

Vol 63 (2) ◽

pp. 109-117 ◽

Cited By ~ 3

Author(s):

Laura Sichero ◽

Anna R. Giuliano ◽

Luisa Lina Villa

Keyword(s):

Human Papillomavirus ◽

Natural History ◽

The United States ◽

Hpv Infection ◽

Clinical Consequences ◽

History Of ◽

Crucial Information ◽

Associated Risk Factors ◽

The Relationship ◽

Genital Disease

It is currently recognized that in addition to the major impact of human papillomavirus (HPV) infection in females, HPV causes considerable disease in men at the genitals, anal canal, and oropharynx. Specifically, genital HPV infections may progress to genital warts and penile carcinoma. Although studies concerning the natural history of HPV infections and associated neoplasias have mainly focused on women, during the last 2 decades considerable attention has been given in further understanding these infections in men. The HIM (HPV infection in men) Study, the only prospective multicenter study of male HPV natural history, consisted of a large prospective international cohort study in which men from Brazil, the United States, and Mexico were enrolled. The design and protocols of this study allowed unraveling crucial information regarding the relationship between HPV infection and clinical consequences in men, and associated risk factors at each of the anatomic sites where HPV is known to cause cancer in men.

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