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2016 ; 10
(11
): e0005093
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Containing Ebola at the Source with Ring Vaccination
#MMPMID27806049
Merler S
; Ajelli M
; Fumanelli L
; Parlamento S
; Pastore Y Piontti A
; Dean NE
; Putoto G
; Carraro D
; Longini IM Jr
; Halloran ME
; Vespignani A
PLoS Negl Trop Dis
2016[Nov]; 10
(11
): e0005093
PMID27806049
show ga
Interim results from the Guinea Ebola ring vaccination trial suggest high
efficacy of the rVSV-ZEBOV vaccine. These findings open the door to the use of
ring vaccination strategies in which the contacts and contacts of contacts of
each index case are promptly vaccinated to contain future Ebola virus disease
outbreaks. To provide a numerical estimate of the effectiveness of ring
vaccination strategies we introduce a spatially explicit agent-based model to
simulate Ebola outbreaks in the Pujehun district, Sierra Leone, structurally
similar to previous modelling approaches. We find that ring vaccination can
successfully contain an outbreak for values of the effective reproduction number
up to 1.6. Through an extensive sensitivity analysis of parameters characterising
the readiness and capacity of the health care system, we identify interventions
that, alongside ring vaccination, could increase the likelihood of containment.
In particular, shortening the time from symptoms onset to hospitalisation to 2-3
days on average through improved contact tracing procedures, adding a 2km spatial
component to the vaccination ring, and decreasing human mobility by quarantining
affected areas might contribute increase our ability to contain outbreaks with
effective reproduction number up to 2.6. These results have implications for
future control of Ebola and other emerging infectious disease threats.
|Ebola Vaccines/*administration & dosage
[MESH]
|Ebolavirus/*physiology
[MESH]
|Guinea/epidemiology
[MESH]
|Hemorrhagic Fever, Ebola/epidemiology/*prevention & control
[MESH]