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    Mar 02, 2021
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    The dynamics of measles in sub-Saharan Africa.

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    Authors
    Ferrari, M J
    Grais, RF
    Bharti, N
    Conlan, A J K
    Bjørnstad, O N
    Wolfson, L J
    Guerin, P J
    Djibo, A
    Grenfell, B T
    Affiliation
    Center for Infectious Disease Dynamics, The Pennsylvania State University, University Park, Pennsylvania 16802, USA. mferrari@psu.edu
    Issue Date
    2008-02-07
    
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    Journal
    Nature
    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.
    Publisher
    Macmillan
    URI
    http://hdl.handle.net/10144/40160
    DOI
    10.1038/nature06509
    PubMed ID
    18256664
    Language
    en
    ISSN
    1476-4687
    ae974a485f413a2113503eed53cd6c53
    10.1038/nature06509
    Scopus Count
    Collections
    Paediatrics
    Other Diseases

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