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Control policy optimization for SARS and other emerging infections (SARSTRANS)

Date: Thursday 1 November 13.30–15.00
Source: Forum 11
Authors: Sir Roy Anderson, Rector Elect, Imperial College London, United Kingdom
with CA Donnelly, BX Fan, AJ Hedley, H Heesterbeek, CA Hsiung, GM Leung, AJ Valleron and the SARSTRANS research teams

Abstract

The evolution, spread and persistence of infectious diseases are facilitated by aspects of contemporary society, for example through more frequent air travel, the growing world population and the increasing number of densely crowded urban areas. Under these conditions, epidemic outbreaks of novel infectious agents are likely to become ever more common. Policy-makers and health workers, therefore, need to be prepared, and the experience with severe acute respiratory syndrome (SARS) has provided important lessons for the future.

The European Union (EU)-funded SARSTRANS project brings together existing knowledge about the SARS virus and its mode of transmission to develop models and analytical methods to inform policy-makers on how to achieve more effective control of infectious diseases. The SARSTRANS consortium has outlined recommendations on the construction and real-time analysis of databases, integrating epidemiological, clinical and treatment information, for the monitoring and evaluation of epidemic outbreaks of infectious diseases. The recommendations cover guidelines for pre- outbreak data collection and analysis, followed by guidelines for outbreak analysis and epidemiological investigations once a new emerging epidemic has been recognized. The effectiveness of control measures is evaluated most effectively through real-time unbiased estimation of the effective reproductive number.

Key epidemiological parameters have been estimated in a comparative epidemiological analysis using the most comprehensive dataset to date, including SARS patients from Hong Kong, Taiwan and Beijing. Demographic and clinical variables were analysed to explain observed differences between the three regions. Although the research was motivated by the SARS epidemic, the mathematical and statistical frameworks developed will facilitate assessment of how best to control the spread of infectious agents depending on various factors, including: the time from infection until symptom onset (the incubation period); the timing on infectiousness relative to the onset of symptoms; the short- and long-distance travel patterns of the population; and any age- or gender-dependence on the susceptibility or severity of the disease.