Multiscale modeling to explore Ebola vaccination strategies

The power to assess potential outcomes and intervention strategies is critical for epidemic preparedness. But emerging and mutated pathogens always challenge our current knowledge, pleading for fresh approaches to explore their epidemic potentials up front. This paper coupled a within-host viral dynamics model and a between-host network model of Ebola virus (EBOV) infection showing that its transmission characteristics can be faithfully recapitulated. Based on this multiscale model, EBOV’s incubation period is predicted in the range from 2.6 to 12.4 days, while infected subjects can remain infectious until day 17. The predicted basic reproductive number (R0) differs by age-groups: the overall is 1.4 and the highest is 4.7 for the 10-14 years old. Random vaccination strategies can reduce R0 and case-fatality rate, eliminate the possibility of large outbreaks, but the effect depends on timing and coverage. A random vaccination program can reduce R0 below one if 85% coverage is achieved, and if it was conducted during the period from five months before to one week after the start of an epidemic. A vaccination coverage of 33% can reduce the epidemic size by ten to hundred times compared to a non-intervention scenario. Altogether, infection characteristics and epidemic mitigation approaches could be assessed using experimental data. An early, age-group specific, and high coverage vaccination program is the most beneficial.