Thursday, November 17, 2005

Interesting alterantive to mass quarantine -- focus on the high-risk super spreaders ...

Scientific American has a brief note on a fascinating topic. I did some simulation work during my last degree (10 years past now!) and I suspect the simulation community has been exploring this for awhile. Public health, of course, has been thinking about this since 'Typhoid Mary'; more recently one sociable male flight attendant was once considered to have been a sort of "super spreader" early in the HIV epidemic.

It turns out computer modeling of epidemics suggests an alternative strategy to mass quarantine:
Science & Technology at Scientific Study Assesses Impact of "Superspreaders" of Disease

... There are two ways for a population to protect itself: either everyone can act to reduce their chance of transmission--for example, by staying at home, which can throttle a country’s economy--or authorities can identify those most likely to be superspreaders, and focus their vaccination and isolation efforts on them. --Kaspar Mossman
In Minnesota we have recent experience with a young Amish child who is, due to an immune defect, a "super spreader" of polio [1]. The concept of "super spreader" has thus been in the news here. I suspect the simulation study is looking at more subtle super spreaders however.

If we do find reasonable tests to identify super spreaders, we would be well advised to think about compensating them for the inconveniences (or worse) a selective quarantine would create. As a way to manage the coming wave of epidemics [2], however, this is well worth researching.

[1] The combination of "super spreader", Polio, and unvaccinated community is potentially explosive, but fortunately our republican governor has not quite finished dismantling Minnesota's still excellent public health infrastructure.

[2] As humanity simultaneously travels more, congregates more, expands into Africa, and reproduces more, we become an ever richer petri dish for novel infections.

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