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Genotype-Specific Measles Transmissibility: A Branching Process Analysis.
Ackley, Sarah F; Hacker, Jill K; Enanoria, Wayne T A; Worden, Lee; Blumberg, Seth; Porco, Travis C; Zipprich, Jennifer.
Afiliación
  • Ackley SF; Francis I. Proctor Foundation, University of California, San Francisco.
  • Hacker JK; Department of Epidemiology and Biostatistics, University of California, San Francisco.
  • Enanoria WTA; California Department of Public Health, Richmond.
  • Worden L; Department of Epidemiology and Biostatistics, University of California, San Francisco.
  • Blumberg S; Francis I. Proctor Foundation, University of California, San Francisco.
  • Porco TC; Francis I. Proctor Foundation, University of California, San Francisco.
  • Zipprich J; St Mary's Medical Center, University of California, San Francisco.
Clin Infect Dis ; 66(8): 1270-1275, 2018 04 03.
Article en En | MEDLINE | ID: mdl-29228134
Background: Substantial heterogeneity in measles outbreak sizes may be due to genotype-specific transmissibility. Using a branching process analysis, we characterize differences in measles transmission by estimating the association between genotype and the reproduction number R among postelimination California measles cases during 2000-2015 (400 cases, 165 outbreaks). Methods: Assuming a negative binomial secondary case distribution, we fit a branching process model to the distribution of outbreak sizes using maximum likelihood and estimated the reproduction number R for a multigenotype model. Results: Genotype B3 is found to be significantly more transmissible than other genotypes (P = .01) with an R of 0.64 (95% confidence interval [CI], .48-.71), while the R for all other genotypes combined is 0.43 (95% CI, .28-.54). This result is robust to excluding the 2014-2015 outbreak linked to Disneyland theme parks (referred to as "outbreak A" for conciseness and clarity) (P = .04) and modeling genotype as a random effect (P = .004 including outbreak A and P = .02 excluding outbreak A). This result was not accounted for by season of introduction, age of index case, or vaccination of the index case. The R for outbreaks with a school-aged index case is 0.69 (95% CI, .52-.78), while the R for outbreaks with a non-school-aged index case is 0.28 (95% CI, .19-.35), but this cannot account for differences between genotypes. Conclusions: Variability in measles transmissibility may have important implications for measles control; the vaccination threshold required for elimination may not be the same for all genotypes or age groups.
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Vacuna Antisarampión / Brotes de Enfermedades / Vacunación / Sarampión / Virus del Sarampión / Modelos Teóricos Límite: Adolescent / Child / Humans País/Región como asunto: America do norte Idioma: En Revista: Clin Infect Dis Asunto de la revista: DOENCAS TRANSMISSIVEIS Año: 2018 Tipo del documento: Article Pais de publicación: Estados Unidos
Texto completo
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Vacuna Antisarampión / Brotes de Enfermedades / Vacunación / Sarampión / Virus del Sarampión / Modelos Teóricos Límite: Adolescent / Child / Humans País/Región como asunto: America do norte Idioma: En Revista: Clin Infect Dis Asunto de la revista: DOENCAS TRANSMISSIVEIS Año: 2018 Tipo del documento: Article Pais de publicación: Estados Unidos