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Transmission potential of smallpox in contemporary populations

Author

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  • Raymond Gani

    (Centre for Applied Microbiology and Research, Porton Down)

  • Steve Leach

    (Centre for Applied Microbiology and Research, Porton Down)

Abstract

Despite eradication1, smallpox still presents a risk to public health whilst laboratory stocks of virus remain2,3. One factor crucial to any assessment of this risk is R0, the average number of secondary cases infected by each primary case. However, recently applied estimates have varied too widely (R0 from 1.5 to >20) to be of practical use, and often appear to disregard contingent factors such as socio-economic conditions and herd immunity4,5,6,7,8. Here we use epidemic modelling9 to show a more consistent derivation of R0. In isolated pre-twentieth century populations10,11,12 with negligible herd immunity, the numbers of cases initially rose exponentially, with an R0 between 3.5 and 6. Before outbreak controls were applied, smallpox also demonstrated similar levels of transmission in 30 sporadic outbreaks in twentieth century Europe1, taking into account pre-existing vaccination levels13,14 (about 50%) and the role of hospitals in doubling early transmission. Should smallpox recur, such estimates of transmission potential (R0 from 3.5 to 6) predict a reasonably rapid epidemic rise before the implementation of public health interventions, because little residual herd immunity exists now that vaccination has ceased.

Suggested Citation

  • Raymond Gani & Steve Leach, 2001. "Transmission potential of smallpox in contemporary populations," Nature, Nature, vol. 414(6865), pages 748-751, December.
    • Handle: RePEc:nat:nature:v:414:y:2001:i:6865:d:10.1038_414748a
    DOI: 10.1038/414748a
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    Cited by:

    1. Chung‐Min Liao & Chao‐Fang Chang & Huang‐Min Liang, 2005. "A Probabilistic Transmission Dynamic Model to Assess Indoor Airborne Infection Risks," Risk Analysis, John Wiley & Sons, vol. 25(5), pages 1097-1107, October.
    2. Mishra, Bimal Kumar & Keshri, Ajit Kumar & Rao, Yerra Shankar & Mishra, Binay Kumar & Mahato, Buddhadeo & Ayesha, Syeda & Rukhaiyyar, Bansidhar Prasad & Saini, Dinesh Kumar & Singh, Aditya Kumar, 2020. "COVID-19 created chaos across the globe: Three novel quarantine epidemic models," Chaos, Solitons & Fractals, Elsevier, vol. 138(C).
    3. Fredrik Liljeros & Johan Giesecke & Petter Holme, 2007. "The Contact Network of Inpatients in a Regional Healthcare System. A Longitudinal Case Study," Mathematical Population Studies, Taylor & Francis Journals, vol. 14(4), pages 269-284, November.
    4. Eva K. Lee & Siddhartha Maheshwary & Jacquelyn Mason & William Glisson, 2006. "Large-Scale Dispensing for Emergency Response to Bioterrorism and Infectious-Disease Outbreak," Interfaces, INFORMS, vol. 36(6), pages 591-607, December.
    5. Wei Yang, 2021. "Modeling COVID-19 Pandemic with Hierarchical Quarantine and Time Delay," Dynamic Games and Applications, Springer, vol. 11(4), pages 892-914, December.
    6. Wen-Dou Zhang & Zheng-Hu Zu & Qing Xu & Zhi-Jing Xu & Jin-Jie Liu & Tao Zheng, 2014. "Optimized Strategy for the Control and Prevention of Newly Emerging Influenza Revealed by the Spread Dynamics Model," PLOS ONE, Public Library of Science, vol. 9(1), pages 1-11, January.
    7. Hazhir Rahmandad & John Sterman, 2008. "Heterogeneity and Network Structure in the Dynamics of Diffusion: Comparing Agent-Based and Differential Equation Models," Management Science, INFORMS, vol. 54(5), pages 998-1014, May.
    8. Yuval Arbel & Yifat Arbel & Amichai Kerner & Miryam Kerner, 2022. "Is COVID-19 Herd Immunity Influenced by Population Densities of Cities?," Sustainability, MDPI, vol. 14(16), pages 1-11, August.
    9. Victoria Chebotaeva & Paula A. Vasquez, 2023. "Erlang-Distributed SEIR Epidemic Models with Cross-Diffusion," Mathematics, MDPI, vol. 11(9), pages 1-18, May.
    10. Yonatan Dinku & Boyd Hunter & Francis Markham, 2020. "How might COVID-19 affect the Indigenous labour market?," Australian Journal of Labour Economics (AJLE), Bankwest Curtin Economics Centre (BCEC), Curtin Business School, vol. 23(2), pages 189-209.
    11. Marcin Budzynski & Aneta Luczkiewicz & Jacek Szmaglinski, 2021. "Assessing the Risk in Urban Public Transport for Epidemiologic Factors," Energies, MDPI, vol. 14(15), pages 1-34, July.
    12. Bibha Dhungel & Md. Shafiur Rahman & Md. Mahfuzur Rahman & Aliza K. C. Bhandari & Phuong Mai Le & Nushrat Alam Biva & Stuart Gilmour, 2022. "Reliability of Early Estimates of the Basic Reproduction Number of COVID-19: A Systematic Review and Meta-Analysis," IJERPH, MDPI, vol. 19(18), pages 1-14, September.
    13. Xiaolei Gao & Jianjian Wei & Hao Lei & Pengcheng Xu & Benjamin J Cowling & Yuguo Li, 2016. "Building Ventilation as an Effective Disease Intervention Strategy in a Dense Indoor Contact Network in an Ideal City," PLOS ONE, Public Library of Science, vol. 11(9), pages 1-20, September.
    14. Roberto Benedetti & Federica Piersimoni & Giacomo Pignataro & Francesco Vidoli, 2020. "Identification of spatially constrained homogeneous clusters of COVID‐19 transmission in Italy," Regional Science Policy & Practice, Wiley Blackwell, vol. 12(6), pages 1169-1187, December.
    15. Scott Barrett, 2007. "The Smallpox Eradication Game," Public Choice, Springer, vol. 130(1), pages 179-207, January.
    16. Davenport, Romola Jane & Satchell, Max & Shaw-Taylor, Leigh Matthew William, 2018. "The geography of smallpox in England before vaccination: A conundrum resolved," Social Science & Medicine, Elsevier, vol. 206(C), pages 75-85.

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