Containing a large bioterrorist smallpox attack

a computer simulation approach

Ira M. Longini, M. Elizabeth Halloran, Azhar Nizam, Yang Yang, Shufu Xu, Donald S. Burke, Derek A T Cummings, Joshua Epstein

Research output: Contribution to journalArticle

Abstract

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.

Original languageEnglish (US)
Pages (from-to)98-108
Number of pages11
JournalInternational Journal of Infectious Diseases
Volume11
Issue number2
DOIs
StatePublished - Mar 2007

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Smallpox
Computer Simulation
Vaccination
Population
Mass Vaccination
Costs and Cost Analysis
Health Services Needs and Demand
Natural History
Disease Outbreaks

Keywords

  • Bioterrorism
  • Computer simulation
  • Patient isolation
  • Population surveillance
  • Smallpox
  • Vaccine

ASJC Scopus subject areas

  • Microbiology (medical)

Cite this

Containing a large bioterrorist smallpox attack : a computer simulation approach. / Longini, Ira M.; Elizabeth Halloran, M.; Nizam, Azhar; Yang, Yang; Xu, Shufu; Burke, Donald S.; Cummings, Derek A T; Epstein, Joshua.

In: International Journal of Infectious Diseases, Vol. 11, No. 2, 03.2007, p. 98-108.

Research output: Contribution to journalArticle

Longini, IM, Elizabeth Halloran, M, Nizam, A, Yang, Y, Xu, S, Burke, DS, Cummings, DAT & Epstein, J 2007, 'Containing a large bioterrorist smallpox attack: a computer simulation approach', International Journal of Infectious Diseases, vol. 11, no. 2, pp. 98-108. https://doi.org/10.1016/j.ijid.2006.03.002
Longini, Ira M. ; Elizabeth Halloran, M. ; Nizam, Azhar ; Yang, Yang ; Xu, Shufu ; Burke, Donald S. ; Cummings, Derek A T ; Epstein, Joshua. / Containing a large bioterrorist smallpox attack : a computer simulation approach. In: International Journal of Infectious Diseases. 2007 ; Vol. 11, No. 2. pp. 98-108.
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