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Modeling measles transmission in adults and children: Implications to vaccination for eradication
Anjana Pokharel1,2, Khagendra Adhikari2,3, Ramesh Gautam2,4
1Padma Kanya Multiple Campus, Tribhuvan University, Kathmandu, Nepal.
Abstract:
Despite the availability of successful vaccines, measles outbreaks have occurred frequently in recent years, presumably due to the lack of proper vaccination implementation. Moreover, measles cases in adult groups, albeit small in number, indicate that the previously neglected adult group may need to be brought into vaccine coverage to achieve WHO's goal of measles eradication from the globe. In this study, we develop a novel transmission dynamics model to describe measles cases in adults and children to evaluate the role of adult infection in persistent measles cases and vaccination programs for eradication. Analysis of our model, validated by measles cases from outbreaks in Nepal, provides the vaccination reproduction number (conditions for measles eradication or persistence) and the role of contact network size. Our results highlight that while children are primary targets for measles outbreaks, a small number of infections in adults may act as a reservoir for measles, causing obstacles to eradication. Furthermore, our model analysis shows that while impactful controls can be achieved by children-focused vaccines, a combined adult-child vaccination program may help assert eradication of the disease.
Insights
Measles outbreaks persist due to poor vaccination. Adults can act as a reservoir, hindering eradication efforts. Combined adult and child vaccination programs are key to eliminating measles globally.
Area of Science:
- Epidemiology and Public Health
- Mathematical Modeling of Infectious Diseases
- Vaccinology
Background:
- Measles outbreaks continue despite available vaccines, linked to vaccination implementation gaps.
- Adult measles cases, though fewer, suggest a need for adult vaccination to achieve global eradication goals.
Purpose of the Study:
- To develop a novel transmission dynamics model for measles in adults and children.
- To evaluate the role of adult infections in measles persistence and eradication strategies.
- To assess the impact of vaccination programs on measles eradication.
Main Methods:
- Development of a novel mathematical model for measles transmission dynamics.
- Model validation using measles case data from outbreaks in Nepal.
- Analysis of the vaccination reproduction number and contact network size.
Main Results:
- Adult measles infections can act as a reservoir, impeding eradication efforts.
- Children are primary targets in outbreaks, but adult reservoirs pose significant obstacles.
- Model analysis identified conditions for measles eradication or persistence.
Conclusions:
- Children-focused vaccination is impactful but may be insufficient for complete eradication.
- A combined adult and child vaccination strategy is proposed to achieve global measles eradication.
- Understanding adult infection dynamics is crucial for effective public health interventions.
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