title: The Effect of Contact Investigations and Public Health Interventions in the Control and Prevention of Measles Transmission: A Simulation Study.
abstract: BACKGROUND
  Measles cases continue to occur despite its elimination status in the United States. To control transmission, public health officials confirm the measles diagnosis, identify close contacts of infectious cases, deliver public health interventions (i.e., post-exposure prophylaxis) among those who are eligible, and follow-up with the close contacts to determine overall health outcomes. A stochastic network simulation of measles contact tracing was conducted using existing agent-based modeling software and a synthetic population with high levels of immunity in order to estimate the impact of different interventions in controlling measles transmission.
  
  
  RESULTS
  The synthetic population was created to simulate California`s population in terms of population demographics, household, workplace, school, and neighborhood characteristics using California Department of Finance 2010 census data. Parameters for the model were obtained from a review of the literature, California measles case surveillance data, and expert opinion. Eight different scenarios defined by the use of three different public health interventions were evaluated: (a) post-exposure measles, mumps, and rubella (MMR) vaccine, (b) post-exposure immune globulin (IG), and (c) voluntary isolation and home quarantine in the presence or absence of public health response delays. Voluntary isolation and home quarantine coupled with one or two other interventions had the greatest reduction in the number of secondary cases infected by the index case and the probability of escape situations (i.e., the outbreak continues after 90 days).
  
  
  CONCLUSIONS
  Interrupting contact patterns via voluntary isolation and home quarantine are particularly important in reducing the number of secondary cases infected by the index case and the probability of uncontrolled outbreaks.
authors.affiliation: Department of Epidemiology & Biostatistics, University of California at San Francisco, San Francisco, California, United States of America.
authors.forename: Wayne T A
authors.initials: WT
authors.lastname: Enanoria
authors.affiliation: Francis I. Proctor Foundation for Research in Ophthalmology, University of California at San Francisco, San Francisco, California, United States of America.
authors.forename: Fengchen
authors.initials: F
authors.lastname: Liu
authors.affiliation: Immunization Branch, Division of Communicable Disease Control, California Department of Public Health, Richmond, California, United States of America.
authors.forename: Jennifer
authors.initials: J
authors.lastname: Zipprich
authors.affiliation: Immunization Branch, Division of Communicable Disease Control, California Department of Public Health, Richmond, California, United States of America.
authors.forename: Kathleen
authors.initials: K
authors.lastname: Harriman
authors.affiliation: Department of Epidemiology & Biostatistics, University of California at San Francisco, San Francisco, California, United States of America.|Francis I. Proctor Foundation for Research in Ophthalmology, University of California at San Francisco, San Francisco, California, United States of America.
authors.forename: Sarah
authors.initials: S
authors.lastname: Ackley
authors.affiliation: Francis I. Proctor Foundation for Research in Ophthalmology, University of California at San Francisco, San Francisco, California, United States of America.
authors.forename: Seth
authors.initials: S
authors.lastname: Blumberg
authors.affiliation: Francis I. Proctor Foundation for Research in Ophthalmology, University of California at San Francisco, San Francisco, California, United States of America.
authors.forename: Lee
authors.initials: L
authors.lastname: Worden
authors.affiliation: Department of Epidemiology & Biostatistics, University of California at San Francisco, San Francisco, California, United States of America.|Francis I. Proctor Foundation for Research in Ophthalmology, University of California at San Francisco, San Francisco, California, United States of America.|Department of Ophthalmology, University of California at San Francisco, San Francisco, California, United States of America.
authors.forename: Travis C
authors.initials: TC
authors.lastname: Porco
mesh_terms: D002140:California / Q000453:epidemiology; D003198:Computer Simulation; D016358:Contact Tracing; D004196:Disease Outbreaks; D061345:Early Medical Intervention; D006801:Humans; D008457:Measles / Q000453:epidemiology / Q000517:prevention & control* / Q000635:transmission*; D008458:Measles Vaccine / Q000276:immunology; D008962:Models, Theoretical; D017063:Outcome Assessment, Health Care; D056990:Post-Exposure Prophylaxis; D062486:Public Health Surveillance; D011790:Quarantine; D018571:Sentinel Surveillance
chemical_list: D008458:Measles Vaccine