长沙市H1N1流感大流行防控措施的动力学模型研究

发布时间：2018-08-07 18:26

【摘要】：目的：采用动力学模型模拟长沙市甲型H1N1流感大流行,并评估隔离、治疗患者、疫苗接种等防控策略的效果。方法：根据甲型H1N1流感疾病特征和长沙市人口学特点,建立易感者-潜伏期-显性/隐性感染者-移出者(susceptible-exposed-infectious/asymptomatic-removed, SEIAR)模型,对长沙市甲型H1N1流感大流行疫情进行模拟,采用长沙市实际疫情数计算模型中的关键参数。在SEIAR模型基础上,引入隔离、治疗患者、疫苗接种等措施,构建易感者-潜伏期-显性/隐性感染者-移出者-隔离者(susceptible-exposed-infectious/asymptomatic-removed-quarantine, SEIARQ)模型、带治疗患者措施的模型、易感者-潜伏期-显性/隐性感染者-移出者-隔离者(susceptible-exposed-infectious/asymptomatic-removed-vaccination, SEIARV)模型、以及综合干预措施的模型。采用软件Matlab7.1和Berkeley Madonna8.3.18模拟有、无干预措施下的流感大流行疫情,并利用累计罹患率、累计感染率等指标评估干预的效果。结果：甲型H1N1流感的平均潜伏期为2.1天,平均病程为5.3天,隐性感染比例为41.54%,重症病例比例为3.11%,病死率为0.33%。长沙市甲型H1N1流感大流行的基本再生数为1.81,无干预情况下大流行导致的长沙市全人口的累计感染率为73.98%、累计罹患率为43.25%。隔离、治疗患者、疫苗接种措施均具有较好的疫情控制效果,而且隔离力度和疫苗接种力度越大、防控效果越好。综合干预措施效果的优劣顺序分别为：“隔离+治疗患者+疫苗接种”、“疫苗接种+治疗患者”、“隔离+治疗患者”、“隔离+疫苗接种”。通过实际干预后,人群实际累计感染率27.81%,实际干预措施能够将累计感染率降低73.60%。结论：SEIAR模型可以较好地模拟流感大流行的特点。综合干预措施的效果优于单项措施。药物干预措施的组合效果优于非药物干预措施。流感大流行时可以采取“隔离+治疗患者+疫苗接种”的综合干预措施。
[Abstract]:Objective: to simulate the influenza A (H1N1) pandemic in Changsha by using a dynamic model and to evaluate the effectiveness of isolation, treatment of patients, vaccination and other prevention and control strategies. Methods: according to the disease characteristics of influenza A (H1N1) and the demographic characteristics of Changsha, a model of susceptible-exposed-infective tomatic-removed-removed( SEIAR) was established to simulate the influenza A (H1N1) pandemic in Changsha. The key parameters in the calculation model of the actual epidemic situation in Changsha City were adopted. On the basis of SEIAR model, isolation, treatment, vaccination and so on were introduced to construct susceptible-exposed-infection-removed-quarantine (SEIARQ) model with treatment measures. Susceptible-exposed-infection-removed-accineration (SEIARV) model and comprehensive intervention model. Matlab7.1 and Berkeley Madonna8.3.18 were used to simulate the influenza pandemic without intervention, and the cumulative attack rate and cumulative infection rate were used to evaluate the effectiveness of the intervention. Results: the average incubation period and duration of influenza A (H1N1) were 2.1 days, 5.3 days, 41.54%, 3.11% and 0.33% respectively. The basic regenerative number of influenza A H1N1 pandemic in Changsha is 1.81. The cumulative infection rate of the whole population in Changsha is 73.98 and the cumulative attack rate is 43.25 under the condition of no intervention. Isolation, treatment of patients, vaccination measures have a better effect of epidemic control, and the greater the isolation and vaccination, the better the effect of prevention and control. The results of comprehensive intervention were as follows: vaccinations for patients treated with isolation, vaccinations for patients treated with vaccines, and vaccinations for patients with isolation. After actual intervention, the actual cumulative infection rate of the population was 27.81%, and the actual intervention measures could reduce the cumulative infection rate by 73.60%. ConclusionSeiar model can well simulate the characteristics of influenza pandemic. The effect of comprehensive intervention is better than that of single measure. The combination effect of drug intervention is superior to that of non-drug intervention. A comprehensive intervention can be taken in the event of an influenza pandemic, such as vaccination of isolated treatment patients.
【学位授予单位】：中南大学
【学位级别】：硕士
【学位授予年份】：2013
【分类号】：R181.3

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