Efficacy of antibiotic medication strategy following a bioterrorist attack involving Francisella tularensis
通过连续时间马尔可夫链和离散事件模拟，研究了土拉弗朗西斯菌感染后不同抗生素用药策略的效果，发现暴露后5天内用药可减少59%的症状病例，为公共卫生决策提供依据。
Francisella tularensis is a virulent bacterium which hijacks the host’s immune response, turning cells usually tasked with killing foreign organisms as nutrient-rich receptacles for rapid multiplication. It is designated a Tier 1 Select Agent by the US CDC due to its potential to cause widespread mortality upon deliberate release. In this study, the key biological mechanisms of host infection are modelled as a continuous-time Markov chain (CTMC) and solved via discrete event simulation (DES). The efficacy of various medication strategies at the behest of public health authorities are investigated. Without treatment, the median lethal dose – not previously considered in humans – is estimated at approximately 1,000 organisms. Results suggest that fatality can be averted if antibiotics are administered for at least 7 days, no later than 10 days post exposure. In a mass casualty setting, this can reduce symptomatic cases by 18% from the baseline involving no medication. Reductions of 59% are possible if medication can be disseminated no later than 5 days post exposure, mitigating otherwise severe pressure on healthcare services. Novel use of CTMC and DES highlight the potential for OR in the field of immunology, where further opportunities may present in a post COVID-19 world.