应用系统动力学模型对SARS疫情传播及主要防控措施效果的计算机模拟仿真研究

曾哲淳; 赵冬; 李岩; 郭强; 石鹏; 李哲; 印惠俊; 李洋

Abstract

曾哲淳,赵冬,李岩,郭强,石鹏,李哲,印惠俊,李洋.应用系统动力学模型对SARS疫情传播及主要防控措施效果的计算机模拟仿真研究[J].Chinese journal of Epidemiology,2005,26(3):159-163

应用系统动力学模型对SARS疫情传播及主要防控措施效果的计算机模拟仿真研究

The application of a systematic??dynamic model to study the computer simulation of severe acute respiratory syndrome transmission and the impact of control measures

Received:November 04, 2004

DOI：

KeyWord: 严重急性呼吸综合征系统动力学模型计算机模拟

English Key Word: Severe acute r espiratory syndrome System dy namic mo del Simulat ion

FundProject:国家“863”科技攻关课题资助项目(2003AA208412D)

Author Name	Affiliation
ZENG Zhe-chun	Department of Epidemiology Beijing Institute of Heart Lung and Blood Vessel Disease,Beijing 100029, China
ZHAO Dong	Department of Epidemiology Beijing Institute of Heart Lung and Blood Vessel Disease,Beijing 100029, China
LI Yan	Department of Epidemiology Beijing Institute of Heart Lung and Blood Vessel Disease,Beijing 100029, China
GUO Qiang	北京市卫生局信息中心
SHI Peng	北京市朝阳区疾病预防控制中心/卫生监督所
LI Zhe	北京市朝阳区疾病预防控制中心/卫生监督所
YIN Hui-jun	民航总局卫生处
LI Yang	北京铁路局卫生防疫站

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Abstract:

目的　(1)应用系统动力学方法建立数学模型,宏观地模拟严重急性呼吸综合征(SARS)疫情在自然人群和医院内传播的过程,以及患者通过就诊和社区隔离措施移出传播链的过程。(2)通过计算机对该模型的仿真模拟,分析在突发 SARS疫情的情况下,代表主要防控措施的变量对疫情曲线的影响模式和相对强度。(3)重点分析发热监测措施对疫情的影响,根据分析结果对今后SARS防控工作提出政策建议。方法　采用面访、问卷调查、文献检索、个案分析等方式,获取SARS传播的重要参数。应用系统动力学理论及计算机仿真系统建立数学模型,并进行 What-if仿真分析。结果　建立了能够反映SARS自然传播、患者就诊及医院内传播、社区隔离措施、发热监测过程的计算机仿真模型,通过宏观模拟SARS患者从发病到被移出传播链的过程得出下列结果:(1)患者从发病到就诊的时间、患者每日平均接触人数、就诊时医院内接触人数等是对 SARS的院内、院外传播过程影响最大的几个变量(2)隔离强度、接诊医生对 SARS的警惕性、医院通风消毒、医院优化患者流动路线、医生防护强度是影响疫情控制的主要变量(3)医院入口的体温筛查措施对疫情控制的作用不大。结论　按照目前制定的SARS防治预案,卫生系统能够快速控制突发的SARS疫情。

English Abstract:

Objective ??(1) Building a macroscopical systematic??dy namic mo del of sev ere acute respiratory syndrome( SARS) transmission and disease control pro cess.(2) To determine key variables on the control of SARS epidemic thr ough computer simulation methodolog y, especially to analyze the effect of?? screening for fever?? practice during the epidemics.(3) To prov ide evidence for related decision??making.Methods ?? Parameters in the model w ere collected from local hospitals and municapal CDC t hrough interview,questionnaire surv ey,literature review and case analysis. A systemat ic??dynamic model was built under similar studies. ??What??if?? analysis was used during the simulation pro cess. Results ??(1) The mean duration between disease onset and hospital admission, rate of contacts of each infectious indiv idual as well as the rate of contacts in hospital of each infectious individual appeared to be t he key variables in the process of SARS transmission.(2) Physician?? s alertness/ sense and pr actice of self??protection on SARS, measures on quarantine and isolation to the patients, v entilation and disinfectio n pr ocess in the wards appear ed to be the key variables for the co ntrol of epidemics.(3)?? Screening for fev er?? practice on each patient at the entrance of the hospital did not seem to act as an impo rtant factor to the control of the epidemics. Conclusion?? The health system in Beijing can control SARS epidemic rapidly based on current applied disease control measures and plan.

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