Estimating the Location and Spatial Extent of a Covert Anthrax Release 英文参考文献.docVIP

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Estimating the Location and Spatial Extent of a Covert Anthrax Release 英文参考文献.doc

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Estimating the Location and Spatial Extent of a Covert Anthrax Release 英文参考文献

EstimatingtheLocationandSpatialExtentofaCovert AnthraxRelease JudithLegrand1*,JosephR.Egan2,IanM.Hall2,SimonCauchemez1,SteveLeach2,NeilM.Ferguson1 1MRCCentreforOutbreakAnalysisandModelling,DepartmentofInfectiousDiseasesEpidemiology,ImperialCollegeLondon,London,UnitedKingdom,2MicrobialRisk Assessment,EmergencyResponseDepartment,CentreforEmergencyPreparednessandResponse,HealthProtectionAgency,Wiltshire,UnitedKingdom Abstract Rapidlyidentifyingthefeaturesofacovertreleaseofanagentsuchasanthraxcouldhelptoinformtheplanningofpublic healthmitigationstrategies.Previousstudieshavesoughttoestimatethetimeandsizeofabioterrorattackbasedonthe symptomaticonsetdatesofearlycases.Weextendthescopeofthesemethodsbyproposingamethodforcharacterizing the time, strength, and also the location of an aerosolized pathogen release. A back-calculation method is developed allowingthecharacterizationofthereleasebasedonthedataonthefirstfewobservedcasesofthesubsequentoutbreak, meteorological data, population densities, and data on population travel patterns. We evaluate this method on small simulatedanthraxoutbreaks(about25–35cases)andshowthatitcoulddateandlocalizeareleaseafterafewcaseshave beenobserved,althoughmisspecificationsofthesporedispersionmodel,orthewithin-hostdynamicsmodel,onwhichthe methodreliescanbiastheestimates.Ourmethodcouldalsoprovideanestimateoftheoutbreak’sgeographicalextentand, asaconsequence,couldhelptoidentifypopulationsatriskand,therefore,requiringprophylactictreatment.Ouranalysis demonstratesthatwhileestimatesbasedonthefirsttenor15observedcasesweremoreaccurateandlesssensitiveto modelmisspecificationsthanthosebasedonfivecases,overallmortalityisminimizedbytargetingprophylactictreatment early on the basis of estimates made using data on the first five cases. The method we propose could provide early estimates of the time, strength, and location of an aerosolized anthrax release and the geographical extent of the subsequent outbreak. In addition, estimates of release features cou