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American Journal of Epidemiology Vol. 126, No. 6: 1082-1092
Copyright © 1987 by The Johns Hopkins University School of Hygiene and Public Health

research-article

STOCHASTIC MODEL FOR INTERHUMAN SPREAD OF MONREYPOX

Z. JEZEK1,, B. GRAB1 and H. DIXON2

1Smallpox Eradication Unit, World Health Organization Geneva, Switzerland
2Epidemiological and Statistical Methodology, World Health Organization Geneva, Switzerland

Reprint requesta to Dr. Z. Jezek, Smallpox Eradication Unit, World Health Organization, 1211 Geneva 27, Switzerland

With the eradication of smallpox; systematic routine vaccination with vaccinia has ceased and an Increasing proportion of the human population In tropical rain forest areas of central and western Africa lacks vaccinia-derived immunity to monkeypox virus. This raises the question of the ability of monkeypox virus to establish and maintain itself In an unvaccinated population through continuous man-to-man transmission. A computerized stochastic model of Monte Carlo type was constructed to assess this potential risk. Simulated series were repeated 100 times to obtain distributions of predicted outcomes for decreasing levels of vaccination coverage (70 per cent, 50 per cent, and 0 per cent). The results revealed a substantial increase in new secondary cases in the total absence of vaccinia-Induced immunity. Nevertheless, none of the simulated series did lead to an "explosive" epidemic. The model clearly indicated diminishing numbers of cases In successive generations and eventual cessation of transmission. There fore, it appears highly hnprobable that the virus could maintain Itself permanently in communities by interhuman transmission. After the eradication of smallpox, human monkeypox constitutes the most important orthopoxvirus Infection in man, but analysis of Information collected up to this time suggests that it does not represent currently a serious public health problem or a challenge to the achieved eradication of smallpox.

models; theoretical; monkeypox; poxvirus infections; zoonoses


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