Basic reproduction rate - (R0)
The basic reproduction rate (R0) is used to measure the transmission potential of a disease. It is thought of as the number of secondary infections produced by a typical case of an infection in a population that is totally susceptible.1 It can therefore be measured by counting the number of secondary cases following the introduction of an infection into a totally susceptible population.
For example, if the R0 for measles in a population is 15, then we would expect it to spread rapidly because each new case of measles would produce 15 new secondary cases.
R0 excludes new cases produced by the secondary cases etc.
The basic reproductive rate is affected by several factors:
The rate of contacts in the host population
The probability of infection being transmitted during contact
The duration of infectiousness
In general, for an epidemic to occur in a susceptible population R0 must be >1, so the number of cases is increasing.1 If R
In many circumstances not all contacts will be susceptible to infection. That is, some contacts will be immune, for example due to prior infection which has conferred life-long immunity, or as a result of previous immunisation. Therefore, not all contacts will become infected and the average number of secondary cases per infectious case will decrease.
This is measured by the effective reproductive rate (R)
Effective reproductive rate (R)
A population will rarely be totally susceptible to an infection in the real world. The effective reproductive rate (R) estimates the average number of secondary cases per infectious case in a population made up of both susceptible and non-susceptible hosts. It can be thought of as the number of secondary infections produced by a typical infective.
R = R0x
It is the basic reproductive rate discounted by the fraction of the host population that is susceptible (x).
For example, if R0 for influenza is 12 in a population where half of the population is immune, the effective reproductive rate for influenza is 12 x 0.5 = 6. Therefore under these circumstances a single case of influenza would produce an average of 6 new secondary cases.1
To successfully eliminate a disease from a population, R needs to be maintained