ehsan mostafavi

Born in 1940 in Rasht, Iran, Dr. Farrokh Modabber earned his B.A. in Bacteriology and Ph.D. in Microbiology from University of California, Los Angeles (UCLA). He joined the Harvard Medical School as a fellow before transitioning to a faculty role at Harvard School of Public Health (HSPH) and played a pivotal role in advancing Cellular Immunology. In the early 1970s, he returned to Iran as an Associate Professor at Pahlavi University in Shiraz. Subsequently, he rejoined HSPH before embarking on a tenure at Tehran University. As the head of the Pathobiology Department at Tehran University School of Public Health, he initiated the Tehran/Harvard joint M.Sc. program in Immunology, which played a crucial role in shaping the careers of numerous Iranian immunologists over the following decades. Dr. Modabber went on to hold esteemed positions such as Director General of the Pasteur Institute of Iran, visiting immunology lecturer at various universities, Coordinator of Research Capability Strengthening of WHO’s Special Program for Research and Training in Tropical Diseases (TDR), Director of the Infectious Disease Research Institute (IDRI), and Senior Advisor of Drugs for Neglected Diseases initiative (DNDi), to name a few. This article highlights Dr. Modabber’s impactful career, focusing on his efforts to combat global leishmaniasis.

 Pasteur Institute of Iran, as one of the oldest research and treatment centers in the country, plays an important role in controlling infectious diseases in Iran and the world. Dr. Sakineh Dora al-Sadat Tabatabaie Shahab (1914-2001), physician and specialist in laboratory science, was a prominent researcher at the institute who mainly focused on tuberculosis and other Infectious diseases. This article aims to highlight the services of this great Iranian scientist.

 Information about Dr.Tabatabaei Shahab and her activities in Pasteur Institute of Iran were collected from various sources including documents, articles and interviews with knowledgeable people.

Ethical Considerations:

 In all stages of the research, the principles of honesty and trustworthiness have been fully observed.

 This article reviews the life and valuable activities of Dr.Tabatabai Shahab in the field of tuberculosis by studying the available documents. Her continuous and unrelenting efforts and valuable services in Iran and the world are clearly evident during his life.

 Dr.Tabatabai Shahab achieved significant scientific honors not only in Iran but also in the international scene. Her precious services in Pasteur Institute of Iran will be a light for researchers, especially women, in serving the human society.

This paper presents a historical review of the founding of the Pasteur Institute of Iran, the development of the institution for animal pest control and serum production, and the subsequent establishment of the Razi Vaccine and Serum Research Institute after its separation from the Pasteur Institute of Iran.

Due to its faster evolution rate compared to nuclear genes, haploid mitochondrial DNA (mtDNA) is a promising species identification tool. This has led to its significant use in taxonomic and phylogenetic studies. While mtDNA is subject to selective constraints that prevent the accumulation of deleterious mutations, the prevalence of nuclear-mitochondrial fragments (known as NUMTs or pseudogenes) in mammals has complicated the use of mtDNA for taxonomy. In the present study, a pseudogene of the mitochondrial cytochrome b (Cytb) was detected in Meriones persicus. This pseudogene differed from its mitochondrial counterpart at 235 out of 1140 sites, and is characterized by frame-shift mutations, indels, and accumulation of non-synonymous substitutions. It is the first report of the Cytb pseudogene in a jird, highlighting the risk of misidentifying NUMTs as authentic mtDNA and the importance of addressing this potential pitfall in taxonomic studies.

It is important to honor the contributions of scientific leaders who have dedicated their lives to advancing knowledge and serving their country. One way is to document their experiences and personalities in a documentary format, which can serve as a historical record and an inspiration for future generations. Dr. Mostafa Pourtaghva Shahrestani, a renowned physician and specialist in infectious diseases and tropical medicine, has made significant contributions to public health in Iran. He has played a crucial role in controlling infectious diseases such as smallpox, tuberculosis, rabies, plague, and cholera. Throughout his career, he has held various executive positions, including the head of Pasteur Hospital and the director of the Pasteur Institute of Iran. Dr. Pourtaghva’s life is a testament to his unwavering dedication to public health services, as evidenced by his continuous effort, love, and interest in honest work. His inspiring story can serve as a model for those who seek to follow in his footsteps.

Rodents act as reservoirs, intermediate or definitive hosts for various zoonotic helminths. Parasitic diseases are among the critical factors affecting the survival and composition of wild rodent populations and wild rodents share their habitat with domestic free-grazing animals- mainly sheep, stray dogs, and cats, which allows the transmission of helminth infections to these animals: i.e., Toxocara and Trichinella. This study investigated the helminth parasite fauna of wild rodents in East Azerbaijan Province, North-Western Iran, and discussed the possibility of parasite transmission among wild rodents. A total of 204 rodents of seventeen different species have been collected in northwest Iran. Information about the genus, developmental stage and rodent species was recorded for each animal. The gastrointestinal tract, liver and diaphragm were examined for the presence of helminths. The recovered specimens were identified based on reference should be included.. The prevalence rate of helminths infection among the captured rodents was 67.16%. Meriones persicus showed the highest infection and diversity rates. This species harbored the zoonotic helminths Capillaria hepatica and species belonging to genera Toxocara, Syphacia, and Hymenolepis. M. persicus specimens from the mountainous area showed the highest infection rate. This study aimed at evaluating the potential role of wild rodent species as reservoirs of helminth infection in East Azerbaijan province, Iran. M. persicus is the more common species in our study and represents a higher proportion of the infected rodents in terms of helminths diversity and frequency. Harboring zoonotic helminths, M. persicus represents a health risk. - Further studies are recommended to evaluate the prevalence of these parasites in the human community and to inform the people concerned about the risk of disease transmission to humans through rodents.

The COVID-19 pandemic has led to great efforts to achieve effective vaccines with different approaches around the world, and different vaccine platforms have been developed against SARSCoV-2. Meanwhile, these technologies are still being investigated to obtain more data on the efficacy of combined vaccine platforms. The purpose of this study is to investigate the power of neutralizing antibodies of vaccinated people against COVID-19 in different vaccination regimens in Iran. We investigated Sinopharm/Sinopharm, Sinopharm/PastoCovac or Plus, AstraZeneca/AstraZeneca and AstraZeneca/ PastoCovac Plus recipients. The sera samples were collected from vaccinated individuals 3 weeks after the booster shots. cVNT test was done on the samples after sera dilution. The results showed that all the vaccine regimens induced neutralizing antibodies. Nevertheless, the combinational vaccine regimens in Sinopharm primed individuals showed greater neutralizing potency comparing to the homologous group. Moreover, PastoCovac Plus showed similar ability to AstraZeneca vaccine regarding neutralizing Wuhan and BA.5 variants.

The present study aims to provide an insight to the comprehensive efforts of Pasteur Institute of Iran (PII) regarding COVID-19 management, research, achievements, and vaccine production, though there are many challenges. The relevant literature review was investigated through national and international database and also reports from the related research departments. Six strategies were taken by PII to manage the pandemic of COVID-19. While this pandemic has been hopefully controlled, SARS-CoV-2 could still be a potential threat. Therefore, COVID-19 data management and updated studies, as well as long-term safety and efficacy of the SARS-CoV-2 vaccines are still on the agenda.

To reduce the clinical burden of COVID-19, healthcare providers, and policymakers need a clear understanding of the illness severity during epidemic waves. This study aimed to identify the clinical severity of patients with COVID-19 during different stages of an epidemic wave (pre-peak, peak, post-peak) in four provinces in Iran.

We conducted a secondary analysis of the data on COVID-19 patients admitted to hospitals (25,382 cases), which were recorded in the Medical Care Monitoring Center. Data included adult patients (≥18 years) who were hospitalized due to COVID-19 infection, confirmed by a positive SARS-CoV-2 RT-PCR test. No exclusion criteria were applied. A pairwise comparison method was used to evaluate clinical severity. Then, based on univariable and multivariable linear regression models, the severity scores of patients were compared during various stages of an epidemic wave.

The findings showed that the level of severity of the disease was higher during and after the peak in the total population. The means (SD) of severity scores were 0.16 (0.25), 0.18 (0.26), and 0.19 (0.26) before, during and after the peak, respectively. Besides, age and the underlying disease had a positive and significant relationship with disease severity.

During the middle and late phases of the COVID-19 epidemic wave, hospitals are seeing patients with more severe illnesses than in the early stages. Enhancing hospital preparedness is essential to avert excess deaths and critical cases. Moreover, it is important to maintain ongoing monitoring of clinical symptoms during the recovery phase to support individual patients, guide public health policy, and enhance scientific understanding of epidemic recovery processes.

In honor of the esteemed professors and pioneers in the field of science who have made significant contributions to knowledge and the country, it is important to document their biographies and personalities in a documentary format. This will ensure that they are remembered in the history of the country and serve as role models for future generations.
This paper focuses on the life of Dr. Vardges Nahapetian, a physician and biostatistics specialist who is credited with founding the field of biostatistics in Iran. His impact on public health in the country, including the establishment of the Department of Biostatistics and Epidemiology at the University of Tehran, is discussed. Information about Dr. Vardges Nahapetian's valuable contributions to the field of biostatistics can provide valuable insights for the scientific community in Iran

In line with the commemoration of the scientists who played a significant role in advancing knowledge and providing services to the country, it is imperative to publish their biographies so that their lives and achievements are recorded in the history of the country and serve as an example for future generations. Dr. Bijan Sadrizadeh, a physician and a public health specialist, undertook many valuable activities, particularly in the field of public health in Iran and the world during more than 60 years of great services, including the promotion of public health in the Islamic Republic of Iran, the development of I.R. Iran’s international collaborations in the field of public health, and the development of research programs in the field of neglected tropical diseases and the eradication of polio in the world. He served the country in many high-level executive capacities, including three periods as deputy Minister of Health. In addition to several years of full-time employment in the World Health Organization (WHO), Dr. Sadrizadeh also served on the WHO Executive Board and was a member of numerous scientific and advisory committees. In reviewing his life, great determination, devotion, believing in primary health care and universal health coverage and a deep sense of responsibility are visible and can be an inspiration and a model for all.

Despite the fact that over three years have passed since the onset of the Covid-19 pandemic, it still remains a significant public health concern in Iran and around the world. It is important to acknowledge that the current situation does not signify an end to the epidemic, and measures must be taken across various levels of prevention, treatment, and policy to effectively manage this crisis. This paper analyzes Iran's response to the epidemic, evaluating the country's performance in areas such as surveillance and healthcare systems, diagnostic testing, long-term Covid-19 complications, vaccinations, treatment, and monitoring of variants. Recommendations are also provided for decision-makers in the field of health and Covid-19.

The publication of outbreak investigation reports is critical for disseminating lessons learned from outbreaks. While there are existing reporting guidelines for outbreak investigations, there is a gap in specific guidelines for reporting food-borne and water-borne outbreaks. This study aims to introduce a specific framework and reporting guideline for food and waterborne outbreak investigations in Iran.

The initial draft of the framework for reporting food and waterborne outbreaks was derived from existing general reporting guidelines for outbreak investigations. Additionally, a systematic review of studies reporting outbreaks of waterborne and foodborne diseases from 2010 to 2022 was conducted without language restrictions to extract relevant information. Expert opinions were then sought to finalize and adapt the reporting guideline.

The reporting guideline framework for outbreaks of waterborne and foodborne diseases consists of eight parts: title, abstract (background, methods, results, conclusion), introduction, methods (study characteristics, study type, variables under investigation), results (participant information, statistical results, laboratory results, environmental investigation results), discussion, conclusion, and conflict of interest.

This specific reporting guideline for food and waterborne outbreak investigations can be utilized by outbreak investigation teams, rapid response teams, and researchers to effectively report the results of outbreak investigations in this domain.

Vaccines are the most successful and cost-effective public health tools that have helped control, eliminate, or eradicate many infectious diseases, and are the key intervention to end the COVID-19 pandemic. Therefore, the World Health Organization recommends that to increase the acceptance of vaccination, each country should identify and provide appropriate strategies to increase the motivation and desire of people and also to solve the challenges created to receive the vaccine. The purpose of this qualitative study was to identify the motivations and challenges of the participants in the COVID-19 vaccination program, particularly with PastoCovac which was jointly developed by the Finlay Institute of Vaccines in Cuba (IFV) and Pasteur Institute of Iran (PII), and to achieve a better understanding of the challenges of vaccination in the Iranian society, and to find ways to increase and strengthen the motivations.

A purposeful sample of people who visited a major urban health center in Semnan were approached for this qualitative study to reach data saturation (30 people) with open questions in a 30-minute interview. Relatively, after conducting the interview, the audio file was listened to carefully and if necessary intermittently by the interviewer and transcribed. The overt and hidden content of data obtained from the statements were checked and then the traditional content analysis was used to develop meaningful clusters of themes.

The main themes of people's motivations identified in the current research include controlling disease and reducing mortality, protecting health and establishing collective safety, improving social and economic conditions, advancing medical knowledge, trust and credibility of the Pasteur Institute of Iran (PII), acceptable possible side effects and The high effectiveness, local production of the vaccine are the unique characteristics of the vaccine, while the obstacles identified are: false and ignorant beliefs, lack of trust in the vaccine, people's fear and worry of side effects, the unique characteristics of the vaccine, lack of universal acceptability, insufficient recognition of vaccine characteristics.

PastoCovac as one of the major vaccines against COVID-19 developed jointly by PII and IFV, was acceptable to the Iranian population in every aspect. PastoCovac, therefore, played an important role in achieving e acceptable levels of safety in the country during the pandemic.

With the aim of providing community health, the Pasteur Institute of Iran was established in 1920 as the oldest medical and health research institution in Iran. In addition to conducting research relevant to infectious diseases and manufacturing biological products, this institute has significantly contributed to the prevention and control of communicable diseases for more than a century. As an elder in the institute, Dr. Mahdokht Pourmansour, a physician and specialist in microbiology and laboratory science, was a prominent researcher at the Pasteur Institute of Iran. During four decades of her service to the institute, she has performed remarkable activities, particularly in the development of the Bacille Calmette-Guérin vaccine to prevent tuberculosis. In this biography paper, her scientific life and services are reviewed.

Early life:

Mahdokht Pourmansour was born on January 7th, 1935 in Tehran, the capital city of Iran. She attended Mehregan and Asadi elementary schools in Tehran from 1940 to 1946. During the time periods 1946-1952, she continued her high school education at Nizam Vafa in Ahvaz and obtained her high school diploma at Azarm high school in Tehran. From 1952 to 1958, she received her doctorate in medicine from the University of Tehran. During the years 1967-1968, she attended the Pasteur Institute of Paris on a scholarship from the Pasteur Institute of Iran. After returning to the country in 1974, she presented the courses she took in France and obtained Ph.D. degree in clinical laboratory science at the University of Tehran. Her Ph.D. dissertation was written on the development of a cholera vaccine in laboratory animals.

Ticks are vectors of many pathogens that involve various important diseases in humans and animals, they have several diverse hosts consequently can retain a diverse group of indigenous microbes, from bacteria to fungi. Little is known about the prevalence and diversity of tick microflora colonizing the midgut and their effects on ticks and their interaction. This information is important for development of vector control strategies.

This study was carried out in northern Iran during autumn 2019. Ticks, Ixodes ricinus caught alive on the bodies of domestic animals in the fall. The tick homogenate was prepared. The identification of fungal isolates was carried out according to a combination of macro and microscopic morphology and molecular sequencing. Pathogenic bacteria of the family Borreliaceae, Francisella tularensis, Borrelia burgdorferi and Coxiella burnetii were tested by real-time PCR.

A total of 133 mature I. ricinus ticks were collected from domestic animals, including 71.5% cattle and 28.5% sheep. The tick frequency rates were 87.21% for Mazandaran, 8.28% for Golestan and 4.51% for Gilan Provinces. Total prevalence of fungal tick contamination was 53.4% (75/133) of which Trichoderma harzianum (57%) was the most prevalent species followed by Aspergillus spp. (42%), Mortierella alpine (19%) and Penicillium polonicum (14%). All tick samples were negative for three pathogenic bacteria including Francisella tularensis, Coxiella burnetii, and Borrelia burgdorferi by real-time PCR analysis.

These results show a first picture of the microbial diversity of ticks and highlight the importance of microbiota and their role in host-pathogen interaction.

What has happened in the world since the pandemic began? More than two years after the COVID-19 pandemic outbreak, the status of the disease is still unclear to us. Up to August 1, 2022, the disease has killed about 6.4 million people worldwide, although the actual death toll is estimated to be three times more than the official death toll [1]. During this time, safe vaccines with high efficacy against the virus have been developed, methods of viral transmission and pathogenicity are better understood, and more effective treatments have been proposed that have helped better control the disease over time. A significant percentage of the world's population has acquired the infection at least once, more than 65% of the world's population has received at least one dose of a COVID-19 vaccine, and about 25% have received at least one booster dose of the COVID-19 vaccine. More than 12 billion doses have been administered globally, with 5.5 million added daily. However, the vaccine distribution is inequitable, and in low-income countries, only about 20% of people have received at least one dose of the vaccine [2].

Countries in the World Health Organization (WHO) Eastern Mediterranean Region (EMR) are predisposed to highly contagious, severe and fatal, emerging infectious diseases (EIDs), and re-emerging infectious diseases (RIDs). This paper reviews the epidemiological situation of EIDs and RIDs of global concern in the EMR between 2001 and 2018.

To do a narrative review, a complete list of studies in the field was we prepared following a systematic search approach. Studies that were purposively reviewed were identified to summarize the epidemiological situation of each targeted disease. A comprehensive search of all published studies on EIDs and RIDs between 2001 and 2018 was carried out through search engines including Medline, Web of Science, Scopus, Google Scholar, and ScienceDirect.

Leishmaniasis, hepatitis A virus (HAV) and hepatitis E virus (HEV) are reported from all countries in the region. Chikungunya, Crimean Congo hemorrhagic fever (CCHF), dengue fever, and H5N1 have been increasing in number, frequency, and expanding in their geographic distribution. Middle East respiratory syndrome (MERS), which was reported in this region in 2012 is still a public health concern. There are challenges to control cholera, diphtheria, leishmaniasis, measles, and poliomyelitis in some of the countries. Moreover, Alkhurma hemorrhagic fever (AHF), and Rift Valley fever (RVF) are limited to some countries in the region. Also, there is little information about the real situation of the plague, Q fever, and tularemia.

EIDs and RIDs are prevalent in most countries in the region and could further spread within the region. It is crucial to improve regional capacities and capabilities in preventing and responding to disease outbreaks with adequate resources and expertise.

SummaryParasitic infections in rodents have zoonotic significance. This study aimed to determine the frequency of gastrointestinal parasites in rodents in Lorestan Province, west of Iran. We captured 118 rodents from eight species, including Meriones persicus, Mus macedonicus, Meriones tristrami, Microtus qazvinensis, Arvicola terrestris, Apodemus sp., Cricetulus migratorius, and Meriones libycus, in the fall of 2017. Trapped rodents were humanly sacrificed, and the gastrointestinal tracts were removed and examined to identify parasites. The rate of infection with gastrointestinal parasites was 50.8%. The highest diversity of parasites was found in Meriones persicus. The most common helminths were Hymenolepis nana (13.5%), Trichuris sp. (11%), and Syphacia obvelata (8.5%). Rodents were also infected with Heligmosomum sp. (0.8%), Trichostrongylus (1.7%), Physaloptera (0.8%), Hymenolepis diminuta (0.8%), and Catenotaenia sp. (0.8%). The rate of infection with protozoa was 9.3%. Five (4.2%) were infected with Giardia sp., and two (1.7%) with Entamoeba coli. In addition, Chilomastix sp. (0.8%), Iodamoeba butschlii (0.8%), and Eimeria sp. (0.8%) were seen. The trematode Notocotylus noyeri is reported in Arvicola terrestris for the first time in Iran. This study emphasizes the impact of rodents on the spread of infectious agents and the necessity of effective preventive programs.

We aimed to determine the generation time, the best model for estimating reproduction number (R), and to estimate the basic reproduction number (R0) and effective reproduction number (Rt) for COVID-19 in Iran.

We used the daily incidence cases of COVID-19, hospitalized due to a probable diagnosis of COVID-19 from 19 February 2020 to 17 November 2020 in Iran. Four models, including maximum likelihood (ML), exponential growth (EG), time-dependent (TD), sequential Bayesian (SB) were evaluated. The weekly reproduction number with a 95% confidence interval (CI) was calculated.

TD model shows the best fit compared to other models for estimating reproduction number in Iran. The R0 in Iran in the first week of the epidemic, leading up to 21 February 2020 was 7.19, 95% CI: 5.56, 9.00.  The lowest value for the Rt was equal to 0.77 between 3 to 10 March 2020 and 4 to 11 December 2020. From 11 June 2020 up to13 August 2020, the Rt was more than one but after then to 24 September 2021 was less than one.

TD model was the best fit for estimating the R in Iran. The worst situation of the epidemic in Iran was related to the weeks leading up to 26 February 2020 and 28 October 2020, and better status was related to the weeks leading up to 10 March 2020 and 11 December 2020.

Zoonotic diseases as health concerns worldwide account for more than half of the emerging infectious diseases. Arachnids are powerful vectors to transmit several diseases to humans. Additionally, these emerging zoonotic diseases have been a considerable health threat in the Eastern Mediterranean Region of the WHO (EMRO) due to the large population living close to farms and international trade with nearby countries.

This review study is based on the reported three tick-borne diseases, Lyme disease, Tularemia, and Q fever, from Iran and other EMRO countries. To this end, we searched PubMed central, ISI web of Science, and Google with the related keywords in English at any time. The reported data are then sorted by countries for each disease.

According to the published data, 15 countries in the region have one/more emerging infectious diseases. Q fever has been the most frequent infection in EMRO countries, while Lyme was less recorded. Furthermore, Iran is among the countries with documented history of all three investigated diseases.

Tick-borne disease is popular among EMRO countries, indicating that they have natural conditions for infections in animals and humans. It appears necessary to develop a disease management strategy and control programs against tick-borne diseases (TBDs). Moreover, the disease-resistant animal could be bred instead of susceptible livestock. Therefore, research studies to control TBDs should be regarded as a top priority plan.

We aimed to evaluate the rate of infection by endoparasites amongst rodents in the western regions of Iran to enhance the level of knowledge amongst health authorities in this entity.

This study was conducted in the west and southwest of Kurdistan Province, including the cities of Sanandaj, Marivan, and Sarvabad. The field mission of this work was performed in three seasons’ spring, summer, and autumn. The rodents were captured alive and their gastrointestinal tracts were evaluated for the worm endoparasites.

Herein, 208 rodents from 15 types of seven species, including Apodemus, Meriones, Mus, Sciurus, Cricetulus, Microtus, and Dryomys, were captured. In addition, 67 (32.21%) rodents were infected with endoparasites and 10 types of worms endoparasites, including Syphacia muris, Streptophagus spp., Mastophorus muris, Skrjabinema spp., Trichostrongylus spp., Trichuris muris, Hymenolepis nana, Hymenolepis dimimuta, Heligmosomoide spp., and other oxiuros were isolated from their gastrointestinal tracts. Most of these parasites (60%) were isolated from their small intestine whereas they were least (10%) found in their stomach and cecum.

Having compared the results of this study with other studies in different regions of Iran, there is a higher variety of rodents and worm parasites in these regions of Iran.

Dr. Abolghasem Bahrami was among the generation of Iranian scientists in the early twentieth century who gained most of their knowledge through resources available inside the country. Educated at Dar-ul-Funun Medical School, he was a physician with a great talent in learning, especially self-teaching natural sciences and European languages. He joined the Pasteur Institute of Iran (IPI) at the early days of its foundation and became an integral contributor to this institution during the first twenty-five years of its mission. One of his first assignments at IPI was to help initiating an anti-rabies department by bringing back the rabies vaccine and its manufacturing equipment from Institut Pasteur of Paris. During his IPI years, aside from managerial tasks, he actively participated in upgrading the medical treatments and protocols used for controlling many infectious diseases. He functioned twice as the provisional director of IPI (1925-1926 and 1937-1946) and is considered as the first Iranian director of the Institute. Meanwhile, Dr. Bahrami was a significant contributor to the public health system and assumed several responsibilities such as Chief Quarantine Medical Officer, Chief of Public Health, and the Head of Public Health Administration, in order to improve public health planning throughout the country.

Iran is one of the first few countries that was hit hard with the coronavirus disease 2019 (COVID-19) pandemic. We aimed to estimate the total number of COVID-19 related infections, deaths, and hospitalizations in Iran under different physical distancing and isolation scenarios.

We developed a susceptible-exposed-infected/infectious-recovered/removed (SEIR) model, parameterized to the COVID-19 pandemic in Iran. We used the model to quantify the magnitude of the outbreak in Iran and assess the effectiveness of isolation and physical distancing under five different scenarios (A: 0% isolation, through E: 40% isolation of all infected cases). We used Monte-Carlo simulation to calculate the 95% uncertainty intervals (UIs).

Under scenario A, we estimated 5 196 000 (UI 1 753 000-10 220 000) infections to happen till mid-June with 966 000 (UI 467 800-1 702 000) hospitalizations and 111 000 (UI 53 400-200 000) deaths. Successful implantation of scenario E would reduce the number of infections by 90% (ie, 550 000) and change the epidemic peak from 66 000 on June 9, to 9400 on March 1, 2020. Scenario E also reduces the hospitalizations by 92% (ie, 74 500), and deaths by 93% (ie, 7800).

With no approved vaccination or therapy available, we found physical distancing and isolation that include public awareness and case-finding and isolation of 40% of infected people could reduce the burden of COVID-19 in Iran by 90% by mid-June.