title: Comparison of smallpox outbreak control strategies using a spatial metapopulation model.
abstract: To determine the potential benefits of regionally targeted mass vaccination as an adjunct to other smallpox control strategies we employed a spatial metapopulation patch model based on the administrative districts of Great Britain. We counted deaths due to smallpox and to vaccination to identify strategies that minimized total deaths. Results confirm that case isolation, and the tracing, vaccination and observation of case contacts can be optimal for control but only for optimistic assumptions concerning, for example, the basic reproduction number for smallpox (R0=3) and smaller numbers of index cases ( approximately 10). For a wider range of scenarios, including larger numbers of index cases and higher reproduction numbers, the addition of mass vaccination targeted only to infected districts provided an appreciable benefit (5-80% fewer deaths depending on where the outbreak started with a trigger value of 1-10 isolated symptomatic individuals within a district).
authors.affiliation: Microbial Risk Assessment, Health Protection Agency, Centre for Emergency Preparedness and Response, Porton Down, Wiltshire, UK.
authors.forename: I M
authors.initials: IM
authors.lastname: Hall
authors.forename: J R
authors.initials: JR
authors.lastname: Egan
authors.forename: I
authors.initials: I
authors.lastname: Barrass
authors.forename: R
authors.initials: R
authors.lastname: Gani
authors.forename: S
authors.initials: S
authors.lastname: Leach
mesh_terms: D004196:Disease Outbreaks; D006801:Humans; D017053:Infection Control; D032541:Mass Vaccination; D008954:Models, Biological; D012899:Smallpox / Q000453:epidemiology / Q000401:mortality*; D012900:Smallpox Vaccine / Q000009:adverse effects*; D006113:United Kingdom / Q000453:epidemiology
chemical_list: D012900:Smallpox Vaccine