Individual-Based Modeling of Potential Poliovirus Transmission in Connected Religious Communities in North America With Low Uptake of Vaccination

    Authors

    K. H. Kisjes; R. J. D. Tebbens; G. S. Wallace; M. A. Pallansch; S. L. Cochi; S. G. F. Wassilak;K. M. Thompson

    Comments

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    Abbreviated Journal Title

    J. Infect. Dis.

    Keywords

    polio; immunization; individual-based model; disease outbreaks; heterogeneity; UNITED-STATES; PANDEMIC INFLUENZA; POLICY OPTIONS; DISEASE; OUTBREAKS; ERADICATION; IMMUNITY; STOCKPILE; EPIDEMIC; NETWORKS; Immunology; Infectious Diseases; Microbiology

    Abstract

    Background. Pockets of undervaccinated individuals continue to raise concerns about their potential to sustain epidemic transmission of vaccine-preventable diseases. Prior importations of live polioviruses (LPVs) into Amish communities in North America led to their recognition as a potential and identifiable linked network of undervaccinated individuals. Methods.aEuro integral We developed an individual-based model to explore the potential transmission of a LPV throughout the North American Amish population. Results.aEuro integral Our model demonstrates the expected limited impact associated with the historical importations, which occurred in isolated communities during the low season for poliovirus transmission. We show that some conditions could potentially lead to wider circulation of LPVs and cases of paralytic polio in Amish communities if an importation occurred during or after 2013. The impact will depend on the uncertain historical immunity to poliovirus infection among members of the community. Conclusions.aEuro integral Heterogeneity in immunization coverage represents a risk factor for potential outbreaks of polio if introduction of a LPV occurs, although overall high population immunity in North America suggests that transmission would remain relatively limited. Efforts to prevent spread between Amish church districts with any feasible measures may offer the best opportunity to contain an outbreak and limit its size.

    Journal Title

    Journal of Infectious Diseases

    Volume

    210

    Publication Date

    1-1-2014

    Document Type

    Article

    Language

    English

    First Page

    S424

    Last Page

    S433

    WOS Identifier

    WOS:000344612400050

    ISSN

    0022-1899

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