Using Modelling to Disentangle the Relative Contributions of Zoonotic and Anthroponotic Transmission: The Case of Lassa Fever

作者：Giovanni Lo Iacono, Andrew A. Cunningham, Élisabeth Fichet-Calvet, Robert F. Garry, Donald S. Grant, Sheik Humarr Khan, Melissa Leach, Lina Moses, John S. Schieffelin, Jeffrey G. Shaffer, Colleen T. Webb, James L. N. Wood · 发表于：PLoS neglected tropical diseases · 年份：2015 · DOI：10.1371/journal.pntd.0003398 · 被引用次数：128 · 研究领域：Viral Infections and Outbreaks Research、Zoonotic diseases and public health、Infection Control and Ventilation

BACKGROUND: Zoonotic infections, which transmit from animals to humans, form the majority of new human pathogens. Following zoonotic transmission, the pathogen may already have, or may acquire, the ability to transmit from human to human. With infections such as Lassa fever (LF), an often fatal, rodent-borne, hemorrhagic fever common in areas of West Africa, rodent-to-rodent, rodent-to-human, human-to-human and even human-to-rodent transmission patterns are possible. Indeed, large hospital-related outbreaks have been reported. Estimating the proportion of transmission due to human-to-human routes and related patterns (e.g. existence of super-spreaders), in these scenarios is challenging, but essential for planned interventions. METHODOLOGY/PRINCIPAL FINDINGS: Here, we make use of an innovative modeling approach to analyze data from published outbreaks and the number of LF hospitalized patients to Kenema Government Hospital in Sierra Leone to estimate the likely contribution of human-to-human transmission. The analyses show that almost [Formula: see text] of the cases at KGH are secondary cases arising from human-to-human transmission. However, we found much of this transmission is associated with a disproportionally large impact of a few individuals ('super-spreaders'), as we found only [Formula: see text] of human cases result in an effective reproduction number (i.e. the average number of secondary cases per infectious case) [Formula: see text], with a maximum value up to [...