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American Journal of Epidemiology Advance Access published online on July 13, 2005
American Journal of Epidemiology, doi:10.1093/aje/kwi206
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American Journal of Epidemiology Copyright © 2005 by the Johns Hopkins Bloomberg School of Public Health All rights reserved
Received June 1, 2004
Accepted March 25, 2005

Article

A Dynamic Model of Poliomyelitis Outbreaks: Learning from the Past to Help Inform the Future

Radboud J. Duintjer Tebbens 1, Mark A. Pallansch 2, Olen M. Kew 2, Victor M. Cáceres 3, Roland W. Sutter 4, and Kimberly M. Thompson 5*

1 KidsRisk Project, Harvard School of Public Health, Boston, MA; Department of Mathematics, Delft University of Technology, Delft, the Netherlands
2 Respiratory and Enteric Viruses Branch, Division of Viral and Rickettsial Diseases, National Center for Infectious Diseases, Centers for Disease Control and Prevention, Atlanta, GA
3 Polio Eradication Branch, Global Immunization Division, National Immunization Program, Centers for Disease Control and Prevention, Atlanta, GA
4 Department of Immunization, Vaccines and Biologicals, World Health Organization, Geneva, Switzerland
5 KidsRisk Project, Harvard School of Public Health, Boston, MA

* To whom correspondence should be addressed.
Kimberly M. Thompson, E-mail: kimt{at}hsph.harvard.edu


  Abstract

Policy-makers now face important questions regarding the tradeoffs among different strategies for managing poliomyelitis risks after they succeed with polio eradication. To estimate the potential consequences of reintroductions of polioviruses and the resulting outbreaks, the authors developed a dynamic disease transmission model that can simulate many aspects of outbreaks for different posteradication conditions. In this paper, the authors identify the issues related to prospective modeling of future outbreaks using such a model, including the reality that accurate prediction of conditions and associated model inputs prior to future outbreaks remains challenging. The authors explored the model's behavior in the context of three recent outbreaks resulting from importation of poliovirus into previously polio-free countries and found that the model reproduced reported data on the incidence of cases. The authors expect that this model can provide important insights into the dynamics of future potential poliomyelitis outbreaks and in this way serve as a useful tool for risk assessment.

Keywords: disease outbreaks; disease transmission; models, statistical; poliomyelitis; poliovirus; risk assessment; vaccination.
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