中东呼吸综合征(MERS)的传播动力学和控制的新数学模型,由MERS-CoV冠状病毒引起的呼吸道病毒(主要通过单峰骆驼传播给人类)于2012年首次出现在沙特阿拉伯王国(KSA),设计并用于研究该疾病在人类中的传播动态。KSA内的骆驼种群。对模型进行了严格的分析,使用观察到的KSA的MERS-CoV数据进行拟合和交叉验证,表明,每当其繁殖数(用${\\mathbbR}_{0M}$表示)小于1时,其无病平衡都是局部渐近稳定的。利用模型的固定参数和估计参数,KSA的${\\mathbbR}_{0M}$的价值估计为0.84,这表明消除MERS-CoV的前景非常有希望。该模型进行了扩展,以便评估公共卫生干预策略,特别是对人类和骆驼的疫苗的潜在使用,以及人类在公共场合或靠近骆驼时使用口罩。扩展模型的模拟表明,靠近骆驼的人使用面罩,作为唯一的公共卫生干预策略,显着减少了该疾病的人向骆驼和骆驼向人的传播,这种减少取决于社区使用的口罩类型的功效和覆盖范围。例如,如果外科口罩被优先考虑,如果至少45%与骆驼密切接触的个体持续佩戴骆驼,这种疾病可以在人类和骆驼群体中消除。模拟进一步表明,虽然接种疫苗作为唯一的干预策略,对降低人群的疾病负担仅有边际影响。基于给骆驼接种疫苗的干预策略仅导致骆驼疾病负担的显着减少(并且,因此,在人类中也是如此)。因此,这项研究表明,应该把注意力集中在有效防治骆驼种群的疾病上,而不是在人口中。此外,扩展模型用于模拟混合策略,它结合了人类和骆驼的疫苗接种以及人类使用口罩。这个模拟显示人类和骆驼的疾病负担显著减少,随着这种干预措施有效性的提高,与基线方案或上述任何单独的疫苗接种方案相比。总之,这项研究表明,在沙特阿拉伯王国消除MERS-CoV-2的前景有望使用药物(疫苗接种)和非药物(面罩)干预策略,单独实施或(优选地)组合实施,专注于减少骆驼种群的疾病负担。
A new mathematical model for the transmission dynamics and control of the Middle Eastern respiratory syndrome (MERS), a respiratory virus caused by MERS-CoV coronavirus (and primarily spread to humans by dromedary camels) that first emerged out of the Kingdom of Saudi Arabia (KSA) in 2012, was designed and used to study the transmission dynamics of the disease in a human-camel population within the KSA. Rigorous analysis of the model, which was fitted and cross-validated using the observed MERS-CoV data for the KSA, showed that its disease-free equilibrium was locally asymptotically stable whenever its reproduction number (denoted by $ {\\mathbb R}_{0M} $) was less than unity. Using the fixed and estimated parameters of the model, the value of $ {\\mathbb R}_{0M} $ for the KSA was estimated to be 0.84, suggesting that the prospects for MERS-CoV elimination are highly promising. The model was extended to allow for the assessment of public health intervention strategies, notably the potential use of vaccines for both humans and camels and the use of face masks by humans in public or when in close proximity with camels. Simulations of the extended model showed that the use of the face mask by humans who come in close proximity with camels, as a sole public health intervention strategy, significantly reduced human-to-camel and camel-to-human transmission of the disease, and this reduction depends on the efficacy and coverage of the mask type used in the community. For instance, if surgical masks are prioritized, the disease can be eliminated in both the human and camel population if at least 45% of individuals who have close contact with camels wear them consistently. The simulations further showed that while vaccinating humans as a sole intervention strategy only had marginal impact in reducing the disease burden in the human population, an intervention strategy based on vaccinating camels only resulted in a significant reduction in the disease burden in camels (and, consequently, in humans as well). Thus, this study suggests that attention should be focused on effectively combating the disease in the camel population, rather than in the human population. Furthermore, the extended model was used to simulate a hybrid strategy, which combined vaccination of both humans and camels as well as the use of face masks by humans. This simulation showed a marked reduction of the disease burden in both humans and camels, with an increasing effectiveness level of this intervention, in comparison to the baseline scenario or any of the aforementioned sole vaccination scenarios. In summary, this study showed that the prospect of the elimination of MERS-CoV-2 in the Kingdom of Saudi Arabia is promising using pharmaceutical (vaccination) and nonpharmaceutical (mask) intervention strategies, implemented in isolation or (preferably) in combination, that are focused on reducing the disease burden in the camel population.