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The dynamics of measles in sub-Saharan Africa.

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dc.contributor Center for Infectious Disease Dynamics, The Pennsylvania State University, University Park, Pennsylvania 16802, USA. mferrari@psu.edu
dc.creator Ferrari, M J
dc.creator Grais, R
dc.creator Bharti, N
dc.creator Conlan, A J K
dc.creator Bjørnstad, O N
dc.creator Wolfson, L J
dc.creator Guerin, P J
dc.creator Djibo, A
dc.creator Grenfell, B T
dc.date 2008-02-07
dc.date.accessioned 2017-01-31T07:12:42Z
dc.date.available 2017-01-31T07:12:42Z
dc.identifier The dynamics of measles in sub-Saharan Africa. 2008, 451 (7179):679-84 Nature
dc.identifier 1476-4687
dc.identifier 18256664
dc.identifier 10.1038/nature06509
dc.identifier http://hdl.handle.net/10144/40160
dc.identifier http://fieldresearch.msf.org/msf/handle/10144/40160
dc.identifier Nature
dc.identifier.uri http://dspace.mediu.edu.my:8181/xmlui/handle/10144/40160
dc.description Although vaccination has almost eliminated measles in parts of the world, the disease remains a major killer in some high birth rate countries of the Sahel. On the basis of measles dynamics for industrialized countries, high birth rate regions should experience regular annual epidemics. Here, however, we show that measles epidemics in Niger are highly episodic, particularly in the capital Niamey. Models demonstrate that this variability arises from powerful seasonality in transmission-generating high amplitude epidemics-within the chaotic domain of deterministic dynamics. In practice, this leads to frequent stochastic fadeouts, interspersed with irregular, large epidemics. A metapopulation model illustrates how increased vaccine coverage, but still below the local elimination threshold, could lead to increasingly variable major outbreaks in highly seasonally forced contexts. Such erratic dynamics emphasize the importance both of control strategies that address build-up of susceptible individuals and efforts to mitigate the impact of large outbreaks when they occur.
dc.language en
dc.publisher Macmillan
dc.rights Archived on this site with permission from Macmillan Publishers Ltd. Copyright 2008
dc.title The dynamics of measles in sub-Saharan Africa.


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