Modelling the transmission dynamics of acute haemorrhagic conjuctivitis: Application to the 2003 outbreak in Mexico

G. Chowell, E. Shim, Fred Brauer, P. Diaz-Dueñas, J. M. Hyman, Carlos Castillo-Chavez

Research output: Contribution to journalArticlepeer-review

18 Scopus citations


We model an outbreak of acute haemorrhagic conjunctivitis (AHC) using a simple epidemic model that includes susceptible, infectious, reported, and recovered classes. The model's framework considers the impact of underreporting and behaviour changes on the transmission rate and is applied to a recent epidemic of AHC in Mexico, using a fit to the cumulative number of cases to estimate model parameters, which agree with those derived from clinical studies. The model predicts a 'mean time from symptomatic onset to diagnosis' of 1.43 days (95 per cent CI: 1-2.5) and that the final size of the Mexican epidemic was underreported by 39 per cent. We estimate that a primary infectious case generates approximately 3 secondary cases (R0* = 2.64, SD 0.65). We explore the impact of interventions on the final epidemic size, and estimate a 36 per cent reduction in the transmission rate due to behaviour changes. The effectiveness of the behaviour changes in slowing the epidemic is evident at 21.90 (SD 0.19) days after the first reported case. Results therefore support current public health policy including expeditious announcement of the outbreak and public health information press releases that instruct individuals on avoiding contagion and encourage them to seek diagnosis in hospital clinics.

Original languageEnglish (US)
Pages (from-to)1840-1857
Number of pages18
JournalStatistics in Medicine
Issue number11
StatePublished - Jun 15 2006


  • Acute haemorrhagic conjuctivitis
  • Epidemic model
  • Parameter estimation
  • Parameter identifiability
  • Reproductive number
  • Underreporting

ASJC Scopus subject areas

  • Epidemiology
  • Statistics and Probability


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