The Influence of Social Network Graph Structure on Disease Dynamics in a Simulated Environment Page: 17
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Ro is an established epidemiologic indicator used to estimate the probability that an infectious
disease will create an epidemic or pandemic . Ro > 1 indicates that an epidemic or pandemic
is likely to occur because, on average, every infectious person will transfer the disease to more
than one other person; therefore, the disease will continue to spread. A value of Ro0 < 1 suggests
that the disease spread cannot be maintained and should die quickly with relatively few individuals
It is unlikely that the primary infectious case and the secondary infections resulting from that
case can be identified, however, estimates of Ro0 are generally based on data collected near the
beginning of an outbreak since the majority of the population is susceptible at that time. Ro pro-
vides an indication of how quickly a disease will spread throughout a population and is related to
a trendline based on initial data from an outbreak. The graphs in Figure 2.6 were created by simu-
lated outbreaks with estimated Ro0 values of 2, 6, and 10. Each outbreak curve is accompanied by
a linear graph y = x. In this linear equation, d represents the infectious period and x represents
a single day of the outbreak. Because an infectious individual has the potential to create secondary
infections over d days, dividing by d normalizes the trendline to the outbreak curve which mea-
sures infected individuals per day. Note that as the R0-related slope increases, the outbreak curve
becomes taller and the duration of the outbreak decreases. As Ro0 increases, the disease spreads
more rapidly throughout the population which results in an increase in infectious individuals (a
taller peak) and a decrease in the time it takes the epidemic to run its course (a shorter duration).
2.3.1. The Importance of Understanding Ro0
From a public health point of view, a clear understanding of Ro0 is beneficial in determining a
course of action when a disease is introduced into a susceptible population. A valid estimate of
Ro provides an indication of the force of a specific disease. The Ro0 estimate can be used to guide
implementation of accepted intervention strategies to prevent the outbreak from progressing into
an epidemic or pandemic. Estimates of R0 have been calculated for past outbreaks of malaria,
tuberculosis, SARS, and Spanish influenza (see Table 2.1) [20, 19, 67, 71, 77].
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Johnson, Tina V. The Influence of Social Network Graph Structure on Disease Dynamics in a Simulated Environment, dissertation, December 2010; Denton, Texas. (https://digital.library.unt.edu/ark:/67531/metadc33173/m1/27/: accessed May 23, 2019), University of North Texas Libraries, Digital Library, https://digital.library.unt.edu; .