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Title: The dynamics of measles in sub-Saharan Africa.
Authors: Ferrari, M J
Grais, Rebecca F
Bharti, Nita
Conlan, Andrew J K
Bjørnstad, O N
Wolfson, Lara J
Guerin, Philippe J
Djibo, A
Grenfell, Bryan T
Affiliation: Center for Infectious Disease Dynamics, The Pennsylvania State University, University Park, Pennsylvania 16802, USA.
Citation: The dynamics of measles in sub-Saharan Africa. 2008, 451 (7179):679-84 Nature
Publisher: Macmillan
Journal: Nature
Issue Date: 7-Feb-2008
DOI: 10.1038/nature06509
PubMed ID: 18256664
Abstract: Although vaccination has almost eliminated measles in parts of the world, the disease remains a major killer in some high birth rate countries of the Sahel. On the basis of measles dynamics for industrialized countries, high birth rate regions should experience regular annual epidemics. Here, however, we show that measles epidemics in Niger are highly episodic, particularly in the capital Niamey. Models demonstrate that this variability arises from powerful seasonality in transmission-generating high amplitude epidemics-within the chaotic domain of deterministic dynamics. In practice, this leads to frequent stochastic fadeouts, interspersed with irregular, large epidemics. A metapopulation model illustrates how increased vaccine coverage, but still below the local elimination threshold, could lead to increasingly variable major outbreaks in highly seasonally forced contexts. Such erratic dynamics emphasize the importance both of control strategies that address build-up of susceptible individuals and efforts to mitigate the impact of large outbreaks when they occur.
Language: en
MeSH: Disease Outbreaks
Measles Vaccine
Stochastic Processes
ISSN: 1476-4687
Rights: Archived on this site with permission from Macmillan Publishers Ltd. Copyright 2008
Appears in topics: Other Diseases

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