Using GIS to create synthetic disease outbreaks

BACKGROUND: The ability to detect disease outbreaks in their early stages is a key component of efficient disease control and prevention. With the increased availability of electronic health-care data and spatio-temporal analysis techniques, there is great potential to develop algorithms to enable more effective disease surveillance. However, to ensure that the algorithms are effective they need to be evaluated. The objective of this research was to develop a transparent user-friendly method to simulate spatial-temporal disease outbreak data for outbreak detection algorithm evaluation. A state-transition model which simulates disease outbreaks in daily time steps using specified disease-specific parameters was developed to model the spread of infectious diseases transmitted by person-to-person contact. The software was developed using the MapBasic programming language for the MapInfo Professional geographic information system environment. RESULTS: The simulation model developed is a generalised and flexible model which utilises the underlying distribution of the population and incorporates patterns of disease spread that can be customised to represent a range of infectious diseases and geographic locations. This model provides a means to explore the ability of outbreak detection algorithms to detect a variety of events across a large number of stochastic replications where the influence of uncertainty can be controlled. The software also allows historical data which is free from known outbreaks to be combined with simulated outbreak data to produce files for algorithm performance assessment. CONCLUSION: This simulation model provides a flexible method to generate data which may be useful for the evaluation and comparison of outbreak detection algorithm performance

A tutorial introduction to Bayesian inference for stochastic epidemic models using Approximate Bayesian Computation

Likelihood-based inference for disease outbreak data can be very challenging due to the inherent dependence of the data and the fact that they are usually incomplete. In this paper we review recent Approximate Bayesian Computation (ABC) methods for the analysis of such data by fitting to them stochastic epidemic models without having to calculate the likelihood of the observed data. We consider both non-temporal and temporal-data and illustrate the methods with a number of examples featuring different models and datasets. In addition, we present extensions to existing algorithms which are easy to implement and provide an improvement to the existing methodology. Finally, R code to implement the algorithms presented in the paper is available on https://github.com/kypraios/epiABC

Evaluation of the performance of a dengue outbreak detection tool for China

An outbreak detection and response system, using time series moving percentile method based on historical data, in China has been used for identifying dengue fever outbreaks since 2008. For dengue fever outbreaks reported from 2009 to 2012, this system achieved a sensitivity of 100%, a specificity of 99.8% and a median time to detection of 3 days, which indicated that the system was a useful decision tool for dengue fever control and risk-management programs in China.This work was supported by the grants from Research and Promotion of Key Technology on Health Emergency Preparation and Dispositions (201202006), the National Key Science and Technology Project on Infectious Disease Surveillance Technique Platform of China (2012ZX10004-201) and Development of Early Warning Systems for Dengue Fever Based on Socio-ecological Factors (NHMRC APP1002608)

Improving surveillance and prediction of emerging and re-emerging infectious diseases

Infectious diseases are emerging at an unprecedent rate in recent years, such as the flu pandemic initialized from Mexico in 2009, the 2014 Ebola epidemic in West Africa, and the 2016-2017 expansion of Zika across Americas. They rarely happened previously and thus lack resources and data to detect and predict their spread. This highlights the challenges in emerging an re-emerging infectious disease surveillance. In the dissertation, I mainly put efforts in developing methods for early detection of such diseases, and assessing predictive power of various models in early phase of an epidemic. In Chapter 2, I developed a two-layer early detection framework which provides early warning of emerging epidemics based on the idea of anomaly detection. The framework could evaluate and identify data sources to achieve the best performance automatically from available data, such as data from the Internet and public health surveillance systems. I demonstrated the framework using historical influenza data in the US, and found that the optimal combination of predictors includes data sources from Google search query and Wikipedia page view. The optimized system is able to detect the onset of seasonal influenza outbreaks an average of 16.4 weeks in advance, and the second wave of the 2009 flu pandemic 5 weeks ahead. In Chapter 3, I extended the framework in Chapter 2 to identify large dengue outbreaks from small ones. The results show that the framework could personalize optimal combinations of predictors for different locations, and an optimal combination for one location might not perform well for other locations. In Chapter 4, I investigated the contribution of different population structures to total epidemic incidence, peak intensity and timing, and also explored the ability of various models with different population structures in predicting epidemic dynamics. The results suggest that heterogeneous contact pattern and direct contacts dominate the evolution of epidemics, and a homogeneous model is not able to provide reliable prediction for an epidemic. In summary, my dissertation not only provides method frameworks for building early detection systems for emerging and re-emerging infectious diseases, but also gives insight to the effects of various models in predicting epidemics.Cellular and Molecular Biolog

Hand, foot and mouth disease in China: Evaluating an automated system for the detection of outbreaks

Objective To evaluate the performance of China's infectious disease automated alert and response system in the detection of outbreaks of hand, foot and mouth (HFM) disease. Methods We estimated size, duration and delay in reporting HFM disease outbreaks from cases notified between 1 May 2008 and 30 April 2010 and between 1 May 2010 and 30 April 2012, before and after automatic alert and response included HFM disease. Sensitivity, specificity and timeliness of detection of aberrations in the incidence of HFM disease outbreaks were estimated by comparing automated detections to observations of public health staff. Findings The alert and response system recorded 106 005 aberrations in the incidence of HFM disease between 1 May 2010 and 30 April 2012 - a mean of 5.6 aberrations per 100 days in each county that reported HFM disease. The response system had a sensitivity of 92.7% and a specificity of 95.0%. The mean delay between the reporting of the first case of an outbreak and detection of that outbreak by the response system was 2.1 days. Between the first and second study periods, the mean size of an HFM disease outbreak decreased from 19.4 to 15.8 cases and the mean interval between the onset and initial reporting of such an outbreak to the public health emergency reporting system decreased from 10.0 to 9.1 days. Conclusion The automated alert and response system shows good sensitivity in the detection of HFM disease outbreaks and appears to be relatively rapid. Continued use of this system should allow more effective prevention and limitation of such outbreaks in China

Multi-stage stochastic optimization and reinforcement learning for forestry epidemic and covid-19 control planning

This dissertation focuses on developing new modeling and solution approaches based on multi-stage stochastic programming and reinforcement learning for tackling biological invasions in forests and human populations. Emerald Ash Borer (EAB) is the nemesis of ash trees. This research introduces a multi-stage stochastic mixed-integer programming model to assist forest agencies in managing emerald ash borer insects throughout the U.S. and maximize the public benets of preserving healthy ash trees. This work is then extended to present the first risk-averse multi-stage stochastic mixed-integer program in the invasive species management literature to account for extreme events. Significant computational achievements are obtained using a scenario dominance decomposition and cutting plane algorithm.The results of this work provide crucial insights and decision strategies for optimal resource allocation among surveillance, treatment, and removal of ash trees, leading to a better and healthier environment for future generations. This dissertation also addresses the computational difficulty of solving one of the most difficult classes of combinatorial optimization problems, the Multi-Dimensional Knapsack Problem (MKP). A novel 2-Dimensional (2D) deep reinforcement learning (DRL) framework is developed to represent and solve combinatorial optimization problems focusing on MKP. The DRL framework trains different agents for making sequential decisions and finding the optimal solution while still satisfying the resource constraints of the problem. To our knowledge, this is the first DRL model of its kind where a 2D environment is formulated, and an element of the DRL solution matrix represents an item of the MKP. Our DRL framework shows that it can solve medium-sized and large-sized instances at least 45 and 10 times faster in CPU solution time, respectively, with a maximum solution gap of 0.28% compared to the solution performance of CPLEX. Applying this methodology, yet another recent epidemic problem is tackled, that of COVID-19. This research investigates a reinforcement learning approach tailored with an agent-based simulation model to simulate the disease growth and optimize decision-making during an epidemic. This framework is validated using the COVID-19 data from the Center for Disease Control and Prevention (CDC). Research results provide important insights into government response to COVID-19 and vaccination strategies