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Clustering of susceptible individuals within households can drive measles outbreaks: an individual-based model exploration
Lander Willem
Elise Kuylen
Niel Hens
Philippe Beutels
Jan Broeckhove
Novel Coronavirus
Acceso Abierto
Atribución-NoComercial-SinDerivadas
10.1101/2019.12.10.19014282
When estimating important measures such as the herd immunity threshold, and the corresponding efforts required to eliminate measles, it is often assumed that susceptible individuals are uniformly distributed throughout populations. However, unvaccinated individuals may be clustered in a variety of ways, including by geographic location, by age, in schools, or in households. Here, we investigate to which extent different levels of within-household clustering of susceptible individuals may impact the risk and persistence of measles outbreaks. To this end, we apply an individual-based model, Stride, to a population of 600,000 individuals, using data from Flanders, Belgium. We compare realistic scenarios regarding the distribution of susceptible individuals within households in terms of their impact on epidemiological measures for outbreak risk and persistence. We find that higher levels of within-household clustering of susceptible individuals increase the risk, size and persistence of measles outbreaks. Ignoring within-household clustering thus leads to underestimations of measles elimination and outbreak mitigation efforts. ### Competing Interest Statement The authors have declared no competing interest. ### Funding Statement EK, LW and PB acknowledge support of the Antwerp Study Centre for Infectious Diseases (ASCID) at the University of Antwerp, and the Research Foundation Flanders (FWO) (research project G043815N and a postdoctoral fellowship 1234620N (LW)). NH acknowledges funding received from the European Research Council (ERC) under the European Union’s Horizon 2020 research and innovation programme (grant agreement 682540 — TransMID). ### Author Declarations All relevant ethical guidelines have been followed; any necessary IRB and/or ethics committee approvals have been obtained and details of the IRB/oversight body are included in the manuscript. Yes All necessary patient/participant consent has been obtained and the appropriate institutional forms have been archived. Yes I understand that all clinical trials and any other prospective interventional studies must be registered with an ICMJE-approved registry, such as ClinicalTrials.gov. I confirm that any such study reported in the manuscript has been registered and the trial registration ID is provided (note: if posting a prospective study registered retrospectively, please provide a statement in the trial ID field explaining why the study was not registered in advance). Yes I have followed all appropriate research reporting guidelines and uploaded the relevant EQUATOR Network research reporting checklist(s) and other pertinent material as supplementary files, if applicable. Yes The datasets generated and analysed during the current study are available from the corresponding author on reasonable request.
Cold Spring Harbor Laboratory Press
2019
Preimpreso
https://www.medrxiv.org/content/10.1101/2019.12.10.19014282v2
Inglés
VIRUS RESPIRATORIOS
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