运用SIQR模型模拟学校急性出血性结膜炎暴发的隔离防控效果

Study on the efficacy of quarantine during outbreaks of acute hemorrhagic conjunctivitis outbreaks at schools through the susceptive-infective-quarantine-removal model

采用动力学模型评估急性出血性结膜炎（AUC）暴发疫情中隔离效果。结合AHC和动力学模型的特点，建立学校AHC暴发的易感-染病-移出（SIR）模型，由此再加入隔离措施，建立控制学校AHC暴发的易感-染病-隔离-移出（SIQR）模型，并以2011年长沙市某校AHC暴发疫情为例，评估AHC暴发学校隔离的防控作用。在无干预情况下，学校AHC暴发疫情的基本繁殖数（λo）为6．80，疫情传播速度非常快，若不采取干预措施，在23d内，几乎所有学生和教职员工均发病，累计发病738例，罹忠率高达99．73％，疫情将在9月11日达到发病高峰，当日的新发病例数将达到126例。不同时间采取不同力度的隔离措施，防控效果不同，越早采取隔离措施、隔离力度越大，发病高峰越低、累计罹患率（TAR）越小，暴发疫情控制效果越好。在第6天采取6=0．9措施时，累计患病数已经降至132例，此时TAR=17．84％。在AHC暴发疫情处置中，隔离可作为一项主要的防控措施。

To assess the efficacy of quarantine for acute hemorrhagic conjunctivitis （AHC） outbreaks control in schools, by using the Compartment Model. Through combining the characteristics of both AHC and compartment model, we built a susceptive-infectivc- removal （SIR） model suited for AHC outbreaks control in schools, and then quarantine was added into the model to develop a susceptive-infeetive-quarantine-removal （SIQR） model. An outbreak of AHC in Changsha in 2011 was employed as a sample to assess the effect of quarantine for the prevention and control of AHC. Basic reproduction number （ λ 0） of the AHC outbreak without intervention was 6.80, thus the transmission speed of the disease became quite fast. If no intervention had been adopted, almost all the students, faculties and staff members would have been infected within 23 days, and the accumulative cases would become 738, with the total attack rate （TAR） as 99.73%. The peak of the outbreak was at Sep. 11^th and the number of new cases was 126 on that day. The efficacy would have been different if quarantine forces had been taken at different time and differently. The bigger and earlier the quarantine force had been adopted, the lower morbidity peak and the smaller TAR would have been appeared, with better efficacy of outbreak control. If the quarantine rate had been taken at the level of 90% on the sixth day, the accumulative case would have been reduced to 132 and the TAR had become 17.84% consequently. Quarantine program could be used as a main intervention approach to be employed for ACH outbreak at schools.