COS 104-8 - Optimizing reactive responses to outbreaks of immunizing infections: Case management vs vaccination

Thursday, August 6, 2009: 4:00 PM
Santa Ana, Albuquerque Convention Center
Petra Klepac, Ecology and Evolutionary Biology, Princeton University, Princeton, NJ, Ottar Bjornstad, Pennsylvania State University, University Park, PA, Rebecca F. Grais, Epicentre, Paris, France and Bryan Grenfell, Center for Infectious Disease Dynamics, Pennsylvania State University, University Park, PA
Background/Question/Methods

The two most common approaches to reduce the burden of mortality and morbidity from outbreaks of acute, vaccine preventable infectious diseases, are treatment of infected individuals (palliative care) and outbreak-response vaccine (ORVs) campaigns.  Costs of palliative care and vaccination and availability of vaccine doses vary by disease and by region.  In developing countries resources for controlling infectious diseases are often limited, so an important question from the point of view of optimizing interventions is how to best spend the limited resources.  Using measles as a case study, we formulate a SEIR model that includes –both palliative care and vaccination.  We investigate the range of feasible strategies that can implement in the face of an ongoing epidemic and develop rule-of-thumb principles for how to best allocate towards palliative care versus outbreak response vaccination to limit mortality and morbidity from outbreaks.

Results/Conclusions

We show that the strategy for best management depends critically on the time of implementation relative to the timing of the onset of the outbreak.  We then broaden our analysis over a range of epidemic parameter values, making our work relevant to other vaccine preventable diseases of concern such as meningitis.  We show that the time in the epidemic when one should switch from vaccination to care strategy depends on the relative costs of intervention and the basic reproductive number, R0, of the infection on question.

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