236351 Protecting Households: Sensitivity of Household Transmission to Household Contact Structure and Size

Tuesday, November 1, 2011

Achla Marathe, MA, PhD , Network Dynamics and Simulation Science Laboratory, Virginia Bioinformatics Institute at Virginia Tech, Blacksburg, VA
Jiangzhuo Chen, MA, PhD , Network Dynamics and Simulation Science Laboratory, Virginia Bioinformatics Institute at Virginia Tech, Alexandria, VA
Bryan Lewis, MPH, PhD , Network Dynamics and Simulation Science Laboratory, Virginia Bioinformatics Institute at Virginia Tech, Blacksburg, VA
Stephen Eubank, PhD , Network Dynamics and Simulation Science Laboratory, Virginia Bioinformatics Institute at Virginia Tech, Blacksburg, VA
Objective: Study the influence of household contact structure on the spread of disease within households. Examine whether changes to in-home care giving arrangements can significantly affect the household secondary attack rate.

Method: Simulations of influenza epidemics are used to study the impact of two different in-home care giving strategies. A primary caregiver is assigned for each household, if a household member becomes symptomatic either that individual isolates themselves from the other household members besides the primary caregiver, or they remain in contact will the entire household. Under these two extremes of household exposure to illness, the household secondary attack rates are assessed.

Result: The partial isolation of symptomatic individuals reduces the number of household secondary infections, but the attack rate for the primary caregiver is higher. The secondary attack rate (SAR) varies almost linearly with the household size under both conditions, as does the benefit of the partial isolation of the symptomatic individual.

Conclusions: Details about human behavior and household structure can make a significant difference to the outcomes of epidemiological simulations. Partially isolating symptomatic individuals can reduce secondary infections within the house but increase risk to the primary care-giver, protecting the care-giver with prophylactic antiviral medication should be considered.

Learning Areas:
Assessment of individual and community needs for health education
Epidemiology
Implementation of health education strategies, interventions and programs
Protection of the public in relation to communicable diseases including prevention or control
Public health or related public policy

Learning Objectives:
Explain the role of contact structure and in-home interventions on infectious disease transmission

Keywords: Computer-Assisted, Evaluation

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I have conducted computational epidemiological research for over a decade, have worked as an epidemiologist for several years, and having just completed my PhD dissertation have a deep understanding of the use of simulation and its application to public health problems.
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.

See more of: Infectious disease surveillance and influenza poster session
See more of: Epidemiology