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The dynamics of measles in sub-Saharan Africa | Journal Article / Research | MSF Science Portal
Journal Article
|Research

The dynamics of measles in sub-Saharan Africa

Ferrari MJ, Grais RF, Bharti N, Conlan AJK, Bjørnstad ON, Wolfson LJ, Guerin PJ, Djibo A, Grenfell BT
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Abstract
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.

Subject Area

measles

Languages

English
DOI
10.1038/nature06509
Published Date
07 Feb 2008
PubMed ID
18256664
Journal
Nature
Volume | Issue | Pages
Volume 451, Issue 7179
Issue Date
2008-02-01
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