原发性肺鼠疫二次传播病龄比频率的反算
Backcalculation of the disease-age specific frequency of secondary transmission of primary pneumonic plague
摘要：
目的：评估原发性肺鼠疫继发传播相对于发热的频率。方法：采用一种简单的反算方法来估计相对于患病年龄的二次传播频率。使用观察到的连续间隔（n = 177）和孵育期（n = 126）的分布，采用基于似然性的程序。此外，一个扩展的模型来解释的情况下的生存概率。结果如下：简单的反算表明，31.0%（95%置信区间（CI）：11.6，50.4）和28.0%（95% CI：10.2，45.8）的二次传播总数分别发生在疾病的第二天和第三天，超过五分之四的二次传播发生在疾病的第三天结束之前。二次传播的生存率调整频率，表明在疾病的后期阶段的传染性并不是无关紧要的，并表明所获得的频率可能偏向于潜在的因素，包括隔离措施。结论：简单的练习表明需要在临床前阶段或发病后立即实施对策。需要进一步的信息来阐明疾病-年龄特异性传染性的更详细的细节。
英文摘要：
Aim: To assess the frequency of secondary transmissions of primary pneumonic plague relative to the onset of fever. Methods: A simple backcalculation method was employed to estimate the frequency of secondary transmissions relative to disease-age. A likelihood-based procedure was taken using observed distributions of the serial interval (n = 177) and incubation period (n = 126). Furthermore, an extended model was developed to account for the survival probability of cases. Results: The simple backcalculation suggested that 31.0% (95% confidence intervals (CI): 11.6, 50.4) and 28.0 % (95% CI: 10.2, 45.8) of the total number of secondary transmissions had occurred at second and third days of the disease, respectively, and more than four-fifths of the secondary transmission occurred before the end of third day of disease. The survivorship-adjusted frequency of secondary transmissions was obtained, demonstrating that the infectiousness in later stages of illness was not insignificant and indicates that the obtained frequencies were likely biased on underlying factors including isolation measures. Conclusion: The simple exercise suggests a need to implement countermeasures during pre-clinical stage or immediately after onset. Further information is needed to elucidate the finer details of the disease-age specific infectiousness.
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