International Society for Disease Surveillance Conference 2011: Building the Future of Public Health Surveillance: Building the Future of Public Health Surveillance

Daniel Reidpath - ORCID: 0000-0002-8796-0420 https://orcid.org/0000-0002-8796-04204pubpub1117

Genomic Tools in Biological Invasions: Current State and Future Frontiers

Human activities are accelerating rates of biological invasions and climate-driven range expansions globally, yet we understand little of how genomic processes facilitate the invasion process. Although most of the literature has focused on underlying phenotypic correlates of invasiveness, advances in genomic technologies are showing a strong link between genomic variation and invasion success. Here, we consider the ability of genomic tools and technologies to (i) inform mechanistic understanding of biological invasions and (ii) solve real-world issues in predicting and managing biological invasions. For both, we examine the current state of the field and discuss how genomics can be leveraged in the future. In addition, we make recommendations pertinent to broader research issues, such as data sovereignty, metadata standards, collaboration, and science communication best practices that will require concerted efforts from the global invasion genomics community

A DECISION SUPPORT SYSTEM FRAMEWORK FOR SEASONAL ZOONOSIS PREDICTION

The arising number of zoonosis epidemics and the potential threat to human highlight the need to apply stringent system to contend zoonosis outbreak. Zoonosis is any infectious disease that is able to be transmitted from other animals, both wild and domestic, to humans. The increasing number of zoonotic diseases coupled with the frequency of occurrences, especially lately, has made the need to study and develop a framework to predict future number of zoonosis incidence. Unfortunately, study of literatures showed most prediction models are case-specific and often based on a single forecasting technique. This research analyses and presents the application of a decision support system (DSS) that applied multi forecasting methods to support and provide prediction on the number of zoonosis human incidence. The focus of this research is to identify and to design a DSS framework on zoonosis that is able to handle two seasonal time series type, namely additive seasonal model and multiplicative seasonal model. The first dataset describes the seasonal data pattern that exhibited the constant variation, while the second dataset showed the upward/downward trend. Two case studies were selected to evaluate the proposed framework: Salmonellosis and Tuberculosis for additive time series and Tuberculosis for multiplicative time series. Data was collected from the number of human Salmonellosis and Tuberculosis incidence in the United States published by Centers for Disease Control and Prevention (CDC). These data were selected based on availability and completeness. The proposed framework consists of three components: database management subsystem, model management subsystem, and dialog generation and management subsystem. A set of 168 monthly data (1993–2006) of Salmonellosis and Tuberculosis was used for developing the database management subsystem. Six forecasting methods, including five statistical methods and one soft computing method, were applied in the model management subsystem. They were regression analysis, moving average, decomposition, Holt-Winter’s, ARIMA, and neural network. The results of each method were compared using ANOVA, while Duncan Multiple Range Test was employed to identify the compatibility of each method to the time series. Coefficient of Variation (CV) was used to determine the most appropriate method among them. In the user interface subsystem, “What If” (sensitivity) analysis was chosen to construct this component. This analysis provided the fluctuation of forecasting results which was influenced by the changes in data. The sensitivity analysis was able to determine method with the highest fluctuation based on data update. Observation of the result showed that regression analysis was the fittest method for Salmonellosis and neural network was the fittest method of Tuberculosis. Thus, it could be concluded that results difference of both cases was affected by the available data series. Finally, the design of Graphical User Interface (GUI) was presented to show the connectivity flow between all DSS components. The research resulted in the development of a DSS theoretical framework for a zoonosis prediction system. The results are also expected to serve as a guide for further research and development of DSS for other zoonosis, not only for seasonal zoonosis but also for nonseasonal zoonosis

Development of a syndromic surveillance system to enhance early detection of emerging and re-emerging animal diseases

Animal health surveillance plays an important role in protecting animal health, production and welfare, public health and trade from the negative impacts of disease. To address the challenges posed by new, exotic or re-emerging diseases as well as the limitations of traditional surveillance, new approaches, including syndromic surveillance (SyS) and modern communication technologies have been developed to improve early disease detection. SyS is based on the continuous monitoring of unspecific pre-diagnostic health data in order to detect an unusual increase in counts which may indicate a health hazard in a timely manner. An increasing number of studies has been investigating different types of animal health data for a possible use in SyS. Although the potential of cattle mortality data routinely collected in national cattle registers for use in a SyS system was highlighted, the performance of aberration-detection algorithms applied to such data has not yet been investigated. Furthermore, knowledge about the impact of delayed reporting of these data on outbreak detection performance is limited. Clinical observations made by veterinary practitioners reported in real-time using web- and mobile-based communication tools may improve the timeliness of outbreak detection. The willingness of practitioners to report their observations is essential for the successful implementation of such systems. A lack of knowledge about factors that motivate or hinder practitioners to participate in surveillance was found. The aim of this work was to contribute to the development of a national surveillance system for the early detection of emerging and re-emerging animal diseases in Switzerland, focusing on two Swiss data sources: cattle mortality data routinely reported by farmers to the Swiss system for individual identification and registration of cattle (Tierverkehrsdatenbank TVD); clinical data voluntarily reported by veterinary practitioners to Equinella, an electronic reporting and information system for the early detection of infectious equine diseases in Switzerland. Time series of on-farm and perinatal cattle deaths, extracted from the TVD, were analysed with regard to data quality and explainable temporal patterns, e.g. day-of-week effect or seasonality. A set of three temporal aberration detection algorithms (Shewhart, CuSum, EWMA) was retrospectively applied to these data to assess their performance in detecting varying simulated disease outbreak scenarios. The effect of reporting delay on outbreak detection was investigated in a Bayesian framework. Participation of veterinary practitioners during the first 12 months of the new internet-based reporting platform of Equinella was assessed. Telephone interviews were conducted to gain insights into factors that motivate or hinder practitioners to participate in a voluntary surveillance system offering non-monetary incentives. Furthermore, the suitability of mobile devices such as smartphones for collecting health data was investigated. The TVD provided timely cattle mortality data with comprehensive geographical information, making it a valuable data source for Sys. Mortality time series exhibited temporal patterns, associated with non-health related factors, that had to be considered before applying aberration detection algorithms. The three evaluated control chart algorithms adequately performed under specific outbreak conditions, but none of them was superior in detecting outbreak signals across multiple evaluation metrics. Combining algorithms outputs according to different rules did not satisfactorily increase the system’s overall performance, further illustrating the difficulty in finding a balance between a high sensitivity and a manageable number of false alarms. The Bayesian approach performed similarly well in the scenario where delayed reporting was accounted for to the (ideal) scenario where it was absent. Non-monetary incentives were attractive to sentinel practitioners and overall participation was experienced positive. Insufficient understanding of the reporting system and of its relevance, as well as concerns over the electronic dissemination of health data were identified as potential challenges to sustainable reporting. Mobile devices were sporadically used during the first year and an awareness of the advantages of mobile-based surveillance was yet lacking among practitioners, indicating that they may require some time to become accustomed to novel reporting methods. This work highlighted the value of routinely collected cattle mortality data for use in SyS, but also the need to carefully optimise aberration detection algorithms for a particular data stream. Alternative methods to the binary alarm system may be chosen for a prospective use of cattle mortality data in a SyS system. The value of evidence framework may be suitable for surveillance systems with multiple syndromes and delayed reporting of data. Before integrating these data into a national surveillance system for the early detection of new, exotic or re-emerging diseases, health authorities need to define response protocols enabling investigation of the data that triggered a statistical alarm and to identify the underlying cause. Possibilities for improving sensitivity and specificity were identified that may be addressed when implementing a future SyS system. In addition, the potential of voluntary reporting surveillance system based on non-monetary incentives was shown. Many of the identified barriers to reporting can be addressed in the future, making the outcome of the pilot project favourable. Continued information feedback loops within voluntary sentinel networks will be important to ensure sustainable participation. Combining reporting of syndromic data and mobile devices in a One Health context has the potential to benefit animal and public health as well as to enhance interdisciplinary collaboration

Hurdles and opportunities in implementing marine biosecurity systems in data-poor regions

Managing marine nonindigenous species (mNIS) is challenging, because marine environments are highly connected, allowing the dispersal of species across large spatial scales, including geopolitical borders. Cross-border inconsistencies in biosecurity management can promote the spread of mNIS across geopolitical borders, and incursions often go unnoticed or unreported. Collaborative surveillance programs can enhance the early detection of mNIS, when response may still be possible, and can foster capacity building around a common threat. Regional or international databases curated for mNIS can inform local monitoring programs and can foster real-time information exchange on mNIS of concern. When combined, local species reference libraries, publicly available mNIS databases, and predictive modeling can facilitate the development of biosecurity programs in regions lacking baseline data. Biosecurity programs should be practical, feasible, cost-effective, mainly focused on prevention and early detection, and be built on the collaboration and coordination of government, nongovernment organizations, stakeholders, and local citizens for a rapid response.This work resulted from a workshop organized at the King Abdul- lah University of Science and Technology and sponsored under the Support for Conferences and Workshops Program. We would like to thank the admin support of the Red Sea Research Cen- ter team, IT, and teachers and students from the KAUST schools who participated in some outreach activities. We thank Ana Bi- gio for the artwork presented in this article (figures 1–4). GS was supported by the European Social Fund, under project no 09.3.3- LMT-K-712, the “Development of Competences of Scientists, other Researchers and Students through Practical Research Activities” measure, grant agreement no. 09.3.3-LMT-K-712–19-0083

A DECISION SUPPORT SYSTEM FRAMEWORK FOR SEASONAL ZOONOSIS PREDICTION

The arising number of zoonosis epidemics and the potential threat to human highlight the need to apply stringent system to contend zoonosis outbreak. Zoonosis is any infectious disease that is able to be transmitted from other animals, both wild and domestic, to humans. The increasing number of zoonotic diseases coupled with the frequency of occurrences, especially lately, has made the need to study and develop a framework to predict future number of zoonosis incidence. Unfortunately, study of literatures showed most prediction models are case-specific and often based on a single forecasting technique. This research analyses and presents the application of a decision support system (DSS) that applied multi forecasting methods to support and provide prediction on the number of zoonosis human incidence. The focus of this research is to identify and to design a DSS framework on zoonosis that is able to handle two seasonal time series type, namely additive seasonal model and multiplicative seasonal model. The first dataset describes the seasonal data pattern that exhibited the constant variation, while the second dataset showed the upward/downward trend. Two case studies were selected to evaluate the proposed framework: Salmonellosis and Tuberculosis for additive time series and Tuberculosis for multiplicative time series. Data was collected from the number of human Salmonellosis and Tuberculosis incidence in the United States published by Centers for Disease Control and Prevention (CDC). These data were selected based on availability and completeness. The proposed framework consists of three components: database management subsystem, model management subsystem, and dialog generation and management subsystem. A set of 168 monthly data (1993–2006) of Salmonellosis and Tuberculosis was used for developing the database management subsystem. Six forecasting methods, including five statistical methods and one soft computing method, were applied in the model management subsystem. They were regression analysis, moving average, decomposition, Holt-Winter’s, ARIMA, and neural network. The results of each method were compared using ANOVA, while Duncan Multiple Range Test was employed to identify the compatibility of each method to the time series. Coefficient of Variation (CV) was used to determine the most appropriate method among them. In the user interface subsystem, “What If” (sensitivity) analysis was chosen to construct this component. This analysis provided the fluctuation of forecasting results which was influenced by the changes in data. The sensitivity analysis was able to determine method with the highest fluctuation based on data update. Observation of the result showed that regression analysis was the fittest method for Salmonellosis and neural network was the fittest method of Tuberculosis. Thus, it could be concluded that results difference of both cases was affected by the available data series. Finally, the design of Graphical User Interface (GUI) was presented to show the connectivity flow between all DSS components. The research resulted in the development of a DSS theoretical framework for a zoonosis prediction system. The results are also expected to serve as a guide for further research and development of DSS for other zoonosis, not only for seasonal zoonosis but also for nonseasonal zoonosis

Geographic and Temporal Epidemiology of Campylobacteriosis

Campylobacteriosis is a leading cause of gastroenteritis in the United States. The focus of this research was to (i) analyze and predict spatial and temporal patterns and associations for campylobacteriosis risk and (ii) compare the utility of advanced modeling methods. Laboratory-confirmed Campylobacter case data, obtained from the Foodborne Diseases Active Surveillance Network were used in all investigations. We compared the accuracy of forecasting techniques for campylobacteriosis risk in Minnesota, Oregon and Georgia and found that time series regression, decomposition, and Box-Jenkins Autoregressive Integrated Moving Averages reliably predict monthly risk of infection for campylobacteriosis. Decomposition provided the fastest, most accurate, user-friendly method. Secondly, forecasting models were used to predict monthly climatic effects on the risk of campylobacteriosis in Georgia. The objectives were to (i) assess temporal patterns of campylobacteriosis risk (ii) compare univariate forecasting models with those that incorporate precipitation and temperature and (iii) investigate alternatives to random walk series and non random occurrences that could be outliers. We found significant regional associations between campylobacteriosis risk and climatic factors and control charting identified high risk time periods. Our spatial study in Tennessee compared standardized risk estimates and investigated high risk spatial clustering of campylobacteriosis at three geographic scales. Spatial scan methods identified overlapping clusters (p Objectives of the second study were to (i) identify socioeconomic determinants of the geographic disparities of campylobacteriosis risk (ii) investigate if regression coefficients demonstrate spatial variability and (iii) compare the performance of four modeling approaches: negative binomial, spatial lag, global and local Poisson geographically weighted regression. Local models had the best fit and identified associations between socioeconomic factors and geographic disparities in campylobacteriosis risk. Significant variables included race, unemployment rate, education attainment, urbanicity, and divorce rate. Recent technological advancements have opened a virtually limitless ‘toolbox’ of analytical methods and offer novel means of identifying temporal spikes, spatial clusters and geographic disparities in campylobacteriosis risk that expand and hone our ability to create cost efficient, needs-based prevention and control measures

Modeling and Optimization of Dynamical Systems in Epidemiology using Sparse Grid Interpolation

Infectious diseases pose a perpetual threat across the globe, devastating communities, and straining public health resources to their limit. The ease and speed of modern communications and transportation networks means policy makers are often playing catch-up to nascent epidemics, formulating critical, yet hasty, responses with insufficient, possibly inaccurate, information. In light of these difficulties, it is crucial to first understand the causes of a disease, then to predict its course, and finally to develop ways of controlling it. Mathematical modeling provides a methodical, in silico solution to all of these challenges, as we explore in this work. We accomplish these tasks with the aid of a surrogate modeling technique known as sparse grid interpolation, which approximates dynamical systems using a compact polynomial representation. Our contributions to the disease modeling community are encapsulated in the following endeavors. We first explore transmission and recovery mechanisms for disease eradication, identifying a relationship between the reproductive potential of a disease and the maximum allowable disease burden. We then conduct a comparative computational study to improve simulation fits to existing case data by exploiting the approximation properties of sparse grid interpolants both on the global and local levels. Finally, we solve a joint optimization problem of periodically selecting field sensors and deploying public health interventions to progressively enhance the understanding of a metapopulation-based infectious disease system using a robust model predictive control scheme