Spatial and Temporal Dynamics of Rubella in Peru, 1997–2006: Geographic Patterns, Age at Infection and Estimation of Transmissibility
Detailed studies on the spatial and temporal patterns of rubella transmission are scarce particularly in developing countries but could prove useful in improving epidemiological surveillance and intervention strategies such as vaccination. We use highly refined spatial, temporal and age-specific incidence data of Peru, a geographically diverse country, to quantify spatial-temporal patterns of incidence and transmissibility for rubella during the period 1997–2006. We estimate the basic reproduction number (R0) based on the mean age at infection and the per capita birth rate of the population as well as the reproduction number (accounting for the fraction of the population effectively protected to infection) using the initial intrinsic growth rate of individual outbreaks and estimates of epidemiological parameters for rubella. A wavelet time series analysis is conducted to explore the periodicity of the rubella weekly time series, and the results of our analyses are compared to those carried out for time series of other childhood infectious diseases. We also identify the presence of a critical community size and quantify spatial heterogeneity across geographic regions through the use of Lorenz curves and their corresponding Gini indices. The underlying distributions of rubella outbreak attack rates and epidemic durations across Peru are characterized.
KeywordsRubella Peru Epidemic Periodicity Reproduction number Age at infection
Unable to display preview. Download preview PDF.
- 1.Benenson AS (1985) Control of Communicable Diseases of Man. vol. 8. 14th ed. American Public Health Association;Google Scholar
- 2.World Health Organization. Rubella and Congenital Rubella Syndrome (CRS);. http://www.who.int/immunization_monitoring/diseases/rubella/en/ (accessed on September 21, 2008).
- 3.Pan American Health Organization (1998) Public Health Burden of Rubella and CRS; EPI Newsletter Volume XX, Number 4.Google Scholar
- 4.Atkinson W, Hamborsky J, McIntyre L, Wolfe S (2007) Centers for Disease Control and Prevention. Epidemiology and Prevention of Vaccine-Preventable Diseases. 10th ed. Washington DC: Public Health Foundation;Google Scholar
- 6.Robertson SE, Featherstone DA, Gacica-Dobo M, Hersh BS (2003) Rubella and congenital rubella syndrome: global update. Pan American Journal of Public Health.14(5):306–315.Google Scholar
- 8.Dietz K (1981) The evaluation of rubella vaccination strategies. In: Hiorns W. Cooke D, eds. The Mathematical Theory of the Dynamics of Biological Populations. vol. 2. New York: Academic Press p. 81–97.Google Scholar
- 10.Hethcote HW (1983) Measles and Rubella in the United States. American Journal of Epidemiology 117(1):2–13.Google Scholar
- 13.Glasser J, Pistol A, Rafila A, Marin M. (2008) Designing interventions to ease an under-ascertained burden via mathematical modeling: Rubella and congenital rubella syndrome in Romania. (Manuscript)Google Scholar
- 19.Peru Instituto Nacional de Estadistica e Informatica; http://www.inei.gob.pe/ (Accessed 1 February 2008).
- 20.Wikipedia. Provinces of Peru; http://en.wikipedia.org/wiki/Proveinces_of_Peru (Accessed 1 February 2008).
- 21.Daubechies I (1992) Ten lectures on wavelets. SIAMGoogle Scholar
- 23.Maraun D, Kurths J (2004) Cross wavelet analysis: Significance testing and pitfalls. Nonlinear Processes in Geophysics. 11:505–514.Google Scholar
- 25.Grinsted A, Moore JC, Jevrejeva S. Software for Cross Wavelet and Wavelet Coherence; http://www.pol.ac.uk/home/research/waveletcoherence/ (accessed on October 6, 2008).
- 26.Anderson RM, May RM (1991) Infectious Diseases of Humans: Dynamics and Control. Oxford: Oxford University PressGoogle Scholar
- 27.Diekmann O, Heesterbeek JAP (2000) Mathematical Epidemiology of Infectious Diseases: Model Building, Analysis and Interpretation. Wiley.Google Scholar
- 28.Broutin H, Mantilla-Beniers NB, Simondon F, Aaby P, Grenfell BT, Guegan JF, et al. (2005) Epidemiological impact of vaccination on the dynamics of two childhood diseases in rural Senegal. Microbes and Infection. 7(4):593–999.Google Scholar
- 30.Bjornstad ON, Finkenstadt BF, Grenfell BT (2002) Dynamics of measles epidemics: Estimating scaling of transmission rates using a time series SIR model. Ecological Monographs. 72(2):169–184.Google Scholar
- 32.Lipsitch M, Cohen T, Cooper B, Robins JM, Ma S, James L, et al. (2003) Transmission dynamics and control of severe acute respiratory syndrome. Science 300(5627).Google Scholar
- 47.Jong MCMD, Diekmann O, Heesterbeck H (1995) Epidemic Models: Their Structure and Relation to Data. How does transmission of infection depend on population size. Cambridge University PressGoogle Scholar
- 50.Panagiotopoulos T, Antoniadou I, Valassi-Adam E (1999) Increase in congential rubella occurence after immunisation in Greece: Retrospective survey and systematic review. BMJ. 319:1462–1467.Google Scholar