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Containing a large bioterrorist smallpox attack: a computer simulation approach

Longini, IM and Elizabeth Halloran, M and Nizam, A and Yang, Y and Xu, S and Burke, DS and Cummings, DAT and Epstein, JM (2007) Containing a large bioterrorist smallpox attack: a computer simulation approach. International Journal of Infectious Diseases, 11 (2). 98 - 108. ISSN 1201-9712

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Background: A bioterrorist release of smallpox is a constant threat to the population of the USA and other countries. Design: A stochastic simulation model of the spread of smallpox due to a large bioterrorist attack in a structured population was constructed. Disease natural history parameter estimates, time lines of behavioral activities, and control scenarios were based on the literature and on the consensus opinion of a panel of smallpox experts. Results: The authors found that surveillance and containment, i.e., isolation of known cases and vaccination of their close contacts, would be sufficient to effectively contain a large intentional smallpox release. Given that surveillance and containment measures are in place, preemptive vaccination of hospital workers would further reduce the number of smallpox cases and deaths but would require large numbers of prevaccinations. High levels of reactive mass vaccination after the outbreak begins would further reduce smallpox cases and deaths to a minimum, but would require even larger numbers of vaccinations. Reactive closure of schools would have a minimal effect. Conclusion: A rapid and well-organized response to a bioterrorist attack would be necessary for effective surveillance and containment to control spread. Preemptive vaccination of hospital workers and reactive vaccination of the target population would further limit spread, but at a cost of many more vaccinated. This cost in resources and potential harm due to vaccination will have to be weighed against the potential benefits should an attack occur. Prevaccination of the general population is not necessary. © 2006 International Society for Infectious Diseases.


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Item Type: Article
Status: Published
CreatorsEmailPitt UsernameORCID
Longini, IM
Elizabeth Halloran, M
Nizam, A
Yang, Y
Xu, S
Burke, DSdonburke@pitt.eduDONBURKE
Cummings, DAT
Epstein, JM
Centers: Other Centers, Institutes, Offices, or Units > Center for Vaccine Research
Date: 1 March 2007
Date Type: Publication
Journal or Publication Title: International Journal of Infectious Diseases
Volume: 11
Number: 2
Page Range: 98 - 108
DOI or Unique Handle: 10.1016/j.ijid.2006.03.002
Schools and Programs: Graduate School of Public Health > Epidemiology
Refereed: Yes
ISSN: 1201-9712
Date Deposited: 07 May 2015 20:42
Last Modified: 06 Jan 2018 14:55


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