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Volume 23, Number 1—January 2017

Research

Modeling Tool for Decision Support during Early Days of an Anthrax Event

Gabriel RainischComments to Author , Martin I. Meltzer1, Sean Shadomy, William A. Bower, and Nathaniel Hupert1
Author affiliations: Centers for Disease Control and Prevention, Atlanta, Georgia, USA (G. Rainisch, M.I. Meltzer, S. Shadomy, W.A. Bower, N. Hupert); Weill Cornell Medical College and New York–Presbyterian Hospital, New York, New York, USA (N. Hupert)

Main Article

Table 5

PEP effects by number of days of surveillance data available and different scenarios of PEP distribution, uptake, and adherence*

Days of baseline case data, scenario Median projected caseload, no. Cases averted by PEP, no. (%) Peak treatment load, no. Median projected deaths, no. Deaths averted by PEP, no. (%)
2†
Scenario 1 (no PEP) 1,441 Not applicable 856 506 Not applicable
Scenario 2 (ideal) 324 1,117 (79) 188 124 382 (75)
Scenario 3 (practical) 760 681 (48) 447 279 227 (45)
Scenario 4 (constrained)
1,084
358 (25)
648
385
121 (24)
3‡
Scenario 1 (no PEP) 1,164 Not applicable 692 408 Not applicable
Scenario 2 (ideal) 323 841 (79) 191 123 283 (70)
Scenario 3 (practical) 614 550 (52) 363 225 183 (45)
Scenario 4 (constrained)
875
289 (27)
521
316
92 (23)
Scenario 1 (no PEP) 750 Not applicable 440 270 Not applicable
Scenario 2 (ideal) 269 481 (79) 161 103 165 (62)
Scenario 3 (practical) 481 332 (54) 244 163 107 (40)
Scenario 4 (constrained) 572 178 (29) 334 215 55 (20)

*Case data are from the 1979 Sverdlovsk (USSR) anthrax outbreak (12), inflated by a factor of 10. Estimates were calculated by using values shown in Table 2, except for the selected PEP Impact model parameters varied to create the PEP scenarios analyzed here: these are identified in Table 3. PEP, postexposure prophylaxis.
†Day 1, 20 cases; day 2, 10 cases.
‡Day 1, 20 cases; day 2, 10 cases; day 3, 70 cases.
§Day 1, 20 cases; day 2, 10 cases; day 3, 70 cases; day 4, 40 cases.

Main Article

1These senior authors contributed equally to this article.

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