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Public health vaccination policies for containing an anthrax outbreak

Author

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  • Ron Brookmeyer

    (Johns Hopkins Bloomberg School of Public Health)

  • Elizabeth Johnson

    (Johns Hopkins Bloomberg School of Public Health)

  • Robert Bollinger

    (Johns Hopkins University School of Medicine)

Abstract

Concern about biological weapons has raised questions about the most effective public health policies to contain an anthrax outbreak1,2,3. We developed a probability model to predict the impact of different anthrax antibiotic and vaccination policies. An anthrax outbreak can be significantly contained by minimizing the delay until initiation of antibiotic prophylaxis. However, even if mass distribution of antibiotics is completed within six days of the initial exposure, then at most about 70% of cases can be prevented. Post-exposure vaccination will not significantly increase that prevention rate if adherence to antibiotic regimens is similar or higher than that attained in the 2001 US outbreak4. However, post-exposure vaccination can be useful either in shortening the duration of a prolonged antibiotic regimen, in the event of an antibiotic-resistant strain, or if antibiotic adherence rates are very low. Here we show that a mass pre-exposure vaccination programme for the general population would require very high population coverage rates to significantly increase prevention rates from that achieved with targeted and rapid post-exposure prophylaxis programmes.

Suggested Citation

  • Ron Brookmeyer & Elizabeth Johnson & Robert Bollinger, 2004. "Public health vaccination policies for containing an anthrax outbreak," Nature, Nature, vol. 432(7019), pages 901-904, December.
    • Handle: RePEc:nat:nature:v:432:y:2004:i:7019:d:10.1038_nature03087
    DOI: 10.1038/nature03087
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    Cited by:

    1. R. Scott Braithwaite & Douglas Fridsma & Mark S. Roberts, 2006. "The Cost-Effectiveness of Strategies to Reduce Mortality from an Intentional Release of Aerosolized Anthrax Spores," Medical Decision Making, , vol. 26(2), pages 182-193, March.
    2. Ibrahim Musa & Hyun Woo Park & Lkhagvadorj Munkhdalai & Keun Ho Ryu, 2018. "Global Research on Syndromic Surveillance from 1993 to 2017: Bibliometric Analysis and Visualization," Sustainability, MDPI, vol. 10(10), pages 1-20, September.
    3. Margaret L. Brandeau, 2019. "OR Forum—Public Health Preparedness: Answering (Largely Unanswerable) Questions with Operations Research—The 2016–2017 Philip McCord Morse Lecture," Operations Research, INFORMS, vol. 67(3), pages 700-710, May.
    4. Judith Legrand & Joseph R Egan & Ian M Hall & Simon Cauchemez & Steve Leach & Neil M Ferguson, 2009. "Estimating the Location and Spatial Extent of a Covert Anthrax Release," PLOS Computational Biology, Public Library of Science, vol. 5(1), pages 1-9, April.
    5. Ron Brookmeyer, 2005. "Biosecurity and the role of statisticians," Journal of the Royal Statistical Society Series A, Royal Statistical Society, vol. 168(2), pages 263-266, March.
    6. Michael A. Hamilton & Tao Hong & Elizabeth Casman & Patrick L. Gurian, 2015. "Risk‐Based Decision Making for Reoccupation of Contaminated Areas Following a Wide‐Area Anthrax Release," Risk Analysis, John Wiley & Sons, vol. 35(7), pages 1348-1363, July.

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