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dc.contributor.authorFerrari, M J
dc.contributor.authorGrais, R
dc.contributor.authorBharti, N
dc.contributor.authorConlan, A J K
dc.contributor.authorBjørnstad, O N
dc.contributor.authorWolfson, L J
dc.contributor.authorGuerin, P J
dc.contributor.authorDjibo, A
dc.contributor.authorGrenfell, B T
dc.date.accessioned2008-11-03T13:34:47Z
dc.date.available2008-11-03T13:34:47Z
dc.date.issued2008-02-07
dc.identifier.citationThe dynamics of measles in sub-Saharan Africa. 2008, 451 (7179):679-84 Natureen
dc.identifier.issn1476-4687
dc.identifier.pmid18256664
dc.identifier.doi10.1038/nature06509
dc.identifier.urihttp://hdl.handle.net/10144/40160
dc.description.abstractAlthough 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.
dc.language.isoenen
dc.publisherMacmillanen
dc.rightsArchived on this site with permission from Macmillan Publishers Ltd. Copyright 2008en
dc.subject.meshDisease Outbreaksen
dc.subject.meshHumansen
dc.subject.meshMeaslesen
dc.subject.meshMeasles Vaccineen
dc.subject.meshNigeren
dc.subject.meshRainen
dc.subject.meshSeasonsen
dc.subject.meshStochastic Processesen
dc.subject.meshVaccinationen
dc.titleThe dynamics of measles in sub-Saharan Africa.en
dc.contributor.departmentCenter for Infectious Disease Dynamics, The Pennsylvania State University, University Park, Pennsylvania 16802, USA. mferrari@psu.eduen
dc.identifier.journalNatureen
refterms.dateFOA2019-03-04T12:08:34Z
html.description.abstractAlthough 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.


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