Another look at silent circulation of poliovirus in small populations

作     者：Dominika A.Kalkowska Radboud J.Duintjer Tebbens Kimberly M.Thompson 

作者机构：Kid RiskInc.605 N.High St.#253ColumbusOH 43215USA 

出 版 物：《Infectious Disease Modelling》 (传染病建模（英文）)

年 卷 期：2018年第3卷第1期

页      面：107-117页

学科分类：0403[教育学-体育学] 04[教育学] 

基　　金：We thank the Bill and Melinda Gates Foundation for support for this work under grant OPP1129391 

主　　题：Polio Small populations Silent circulation Stochastic modeling 

摘      要：Background:Silent circulation of polioviruses complicates the polio endgame and motivates analyses that explore the probability of undetected circulation for different scenarios.A recent analysis suggested a relatively high probability of unusually long silent circulation of polioviruses in small populations(defined as 10,000 people or smaller).Methods:We independently replicated the simple,hypothetical model by Vallejo et al.(2017)and repeated their analyses to explore the model behavior,interpretation of the results,and implications of simplifying ***:We found a similar trend of increasing times between detected cases with increasing basic reproduction number(R0)and population ***,we found substantially lower estimates of the probability of at least 3 years between successive polio cases than they reported,which appear more consistent with the prior *** small and isolated populations may sustain prolonged silent circulation,our reanalysis suggests that the existing rule of thumb of less than a 5%chance of 3 or more years of undetected circulation with perfect surveillance holds for most conditions of the model used by Vallejo et *** most realistic ***:Avoiding gaps in surveillance remains critical to declaring wild poliovirus elimination with high confidence as soon as possible after the last detected poliovirus,but concern about transmission in small populations with adequate surveillance should not significantly change the criteria for the certification of wild polioviruses.