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Basic reproduction number

In epidemiology, the basic reproduction number, or basic reproductive number, denoted , of an infection is the expected number of cases directly generated by one case in a population where all individuals are susceptible to infection. The definition assumes that no other individuals are infected or immunized. Some definitions, such as that of the Australian Department of Health, add the absence of "any deliberate intervention in disease transmission". The basic reproduction number is not necessarily the same as the effective reproduction number , which is the number of cases generated in the current state of a population, which does not have to be the uninfected state. is a dimensionless number and not a time rate, which would have units of time−1, or units of time like doubling time.

History
The roots of the basic reproduction concept can be traced through the work of Ronald Ross, Alfred Lotka and others, but its first modern application in epidemiology was by George Macdonald in 1952, who constructed population models of the spread of malaria. In his work he called the quantity basic reproduction rate and denoted it by Z_0. == Overview of R0 estimation methods ==
Overview of R0 estimation methods
Compartmental models Compartmental models are a general modeling technique often applied to the mathematical modeling of infectious diseases. In these models, population members are assigned to 'compartments' with labels – for example, S, I, or R, (Susceptible, Infectious, or Recovered). These models can be used to estimate R_0 . Epidemic models on networks Epidemics can be modeled as diseases spreading over networks of contact and disease transmission between people. Nodes in these networks represent individuals and links (edges) between nodes represent the contact or disease transmission between them. If such a network is a locally tree-like network, then the basic reproduction can be written in terms of the average excess degree of the transmission network such that: R_0 = \frac{\beta}{\beta+\gamma} \frac{{\langle k^2 \rangle} -{\langle k \rangle}}, where {\beta} is the per-edge transmission rate, {\gamma} is the recovery rate, {\langle k \rangle} is the mean-degree (average degree) of the network and {\langle k^2 \rangle} is the second moment of the transmission network degree distribution. Heterogeneous populations In populations that are not homogeneous, the definition of R_0 is more subtle. The definition must account for the fact that a typical infected individual may not be an average individual. As an extreme example, consider a population in which a small portion of the individuals mix fully with one another while the remaining individuals are all isolated. A disease may be able to spread in the fully mixed portion even though a randomly selected individual would lead to fewer than one secondary case. This is because the typical infected individual is in the fully mixed portion and thus is able to successfully cause infections. In general, if the individuals infected early in an epidemic are on average either more likely or less likely to transmit the infection than individuals infected late in the epidemic, then the computation of R_0 must account for this difference. An appropriate definition for R_0 in this case is "the expected number of secondary cases produced, in a completely susceptible population, produced by a typical infected individual". The basic reproduction number can be computed as a ratio of known rates over time: if a contagious individual contacts \beta other people per unit time, if all of those people are assumed to contract the disease, and if the disease has a mean infectious period of \dfrac{1}{\gamma}, then the basic reproduction number is just R_0 = \dfrac{\beta}{\gamma}. Some diseases have multiple possible latency periods, in which case the reproduction number for the disease overall is the sum of the reproduction number for each transition time into the disease. ==Effective reproduction number==
Effective reproduction number
. In reality, varying proportions of the population are immune to any given disease at any given time. To account for this, the effective reproduction number R_e or R is used. R_t is the average number of new infections caused by a single infected individual at time t in the partially susceptible population. It can be found by multiplying R_0 by the fraction S of the population that is susceptible. When the fraction of the population that is immune increases (i. e. the susceptible population S decreases) so much that R_e drops below 1, herd immunity has been achieved and the number of cases occurring in the population will gradually decrease to zero. ==Limitations of R0==
Limitations of R0
Use of R_0 in the popular press has led to misunderstandings and distortions of its meaning. R_0 can be calculated from many different mathematical models and can be calculated from a single model multiple ways. Each of these can give a different estimate of R_0, which needs to be interpreted in the context of that model. Therefore, the contagiousness of different infectious agents cannot be compared without recalculating R_0 with invariant assumptions. R_0 values for past outbreaks might not be valid for current outbreaks of the same disease. Generally speaking, R_0 can be used as a threshold, even if calculated with different methods: if R_0 , the outbreak will die out, and if R_0 > 1, the outbreak will expand. In some cases, for some models, values of R_0 can still lead to self-perpetuating outbreaks. This is particularly problematic if there are intermediate vectors between hosts (as is the case for zoonoses), such as malaria. Therefore, comparisons between values from the "Values of R_0 of well-known contagious diseases" table should be conducted with caution. Although R_0 cannot be modified through vaccination or other changes in population susceptibility, it can vary based on a number of biological, sociobehavioral, and environmental factors. Methods used to calculate R_0 include the survival function, rearranging the largest eigenvalue of the Jacobian matrix, the next-generation method, calculations from the intrinsic growth rate, existence of the endemic equilibrium, the number of susceptibles at the endemic equilibrium, the average age of infection and the final size equation. Few of these methods agree with one another, even when starting with the same system of differential equations. == Sample values for various contagious diseases ==
Sample values for various contagious diseases
Despite the difficulties in estimating R_0mentioned in the previous section, estimates have been made for a number of genera, and are shown in this table. Each genus may be composed of many species, strains, or variants. Estimations of R_0 for species, strains, and variants are typically less accurate than for genera, and so are provided in separate tables below for diseases of particular interest (influenza and COVID-19). Estimates for strains of influenza. Estimates for variants of SARS-CoV-2. ==In popular culture==
In popular culture
In the 2011 film Contagion, a fictional medical disaster thriller, an epidemiologist explains the concept of R_0. == See also ==
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