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Investigation of Key Interventions for Shigellosis Outbreak Control in China

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  • Tianmu Chen
  • Ross Ka-kit Leung
  • Zi Zhou
  • Ruchun Liu
  • Xixing Zhang
  • Lijie Zhang

Abstract

Shigellosis is a major public health concern in China, where waterborne disease outbreaks are common. Shigellosis-containing strategies, mostly single or multiple interventions, are implemented by primary-level health departments. Systematic assessment of the effectiveness of these measures is scarce. To estimate the efficacy of commonly used intervention strategies, we developed a Susceptible–Exposed–Infectious/Asymptomatic–Recovered–Water model. No intervention was predicted to result in a total attack rate (TAR) of 90% of the affected population (95% confidence interval [CI]: 86.65–92.80) and duration of outbreak (DO) of 89 days, and the use of single-intervention strategies can be futile or even counter-productive. Prophylactics and water disinfection did not improve TAR or DO. School closure for up to 3 weeks did not help but only increased DO. Isolation alone significantly increased DO. Only antibiotics treatment could shorten the DO to 35 days with TAR unaffected. We observed that these intervention effects were additive when in combined usage under most circumstances. Combined intervention “Isolation+antibiotics+prophylactics+water disinfection” was predicted to result in the lowest TAR (41.9%, 95%CI: 36.97–47.04%) and shortest DO (28 days). Our actual Shigellosis control implementation that also included school closure for 1 week, attained comparable results and the modeling produced an epidemic curve of Shigellosis highly similar to our actual outbreak data. This lends a strong support to the reality of our model that provides a possible reference for public health professionals to evaluate their strategies towards Shigellosis control.

Suggested Citation

  • Tianmu Chen & Ross Ka-kit Leung & Zi Zhou & Ruchun Liu & Xixing Zhang & Lijie Zhang, 2014. "Investigation of Key Interventions for Shigellosis Outbreak Control in China," PLOS ONE, Public Library of Science, vol. 9(4), pages 1-9, April.
  • Handle: RePEc:plo:pone00:0095006
    DOI: 10.1371/journal.pone.0095006
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    Cited by:

    1. Wenti Xu & Tianmu Chen & Xiaochun Dong & Mei Kong & Xiuzhi Lv & Lin Li, 2017. "Outbreak detection and evaluation of a school-based influenza-like-illness syndromic surveillance in Tianjin, China," PLOS ONE, Public Library of Science, vol. 12(9), pages 1-10, September.
    2. Zeyu Zhao & Qi Chen & Yao Wang & Meijie Chu & Qingqing Hu & Mikah Ngwanguong Hannah & Jia Rui & Xingchun Liu & Yunhan Yu & Fuwei Zhao & Zhengyun Ren & Shanshan Yu & Ran An & Lili Pan & Yi-Chen Chiang , 2021. "Relative transmissibility of shigellosis among different age groups: A modeling study in Hubei Province, China," PLOS Neglected Tropical Diseases, Public Library of Science, vol. 15(6), pages 1-20, June.
    3. Haocheng Wu & Chen Wu & Qinbao Lu & Zheyuan Ding & Ming Xue & Junfen Lin, 2019. "Evaluating the effects of control interventions and estimating the inapparent infections for dengue outbreak in Hangzhou, China," PLOS ONE, Public Library of Science, vol. 14(8), pages 1-16, August.

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