1,869 research outputs found
A generalized-growth model to characterize the early ascending phase of infectious disease outbreaks
A better characterization of the early growth dynamics of an epidemic is
needed to dissect the important drivers of disease transmission. We introduce a
2-parameter generalized-growth model to characterize the ascending phase of an
outbreak and capture epidemic profiles ranging from sub-exponential to
exponential growth. We test the model against empirical outbreak data
representing a variety of viral pathogens and provide simulations highlighting
the importance of sub-exponential growth for forecasting purposes. We applied
the generalized-growth model to 20 infectious disease outbreaks representing a
range of transmission routes. We uncovered epidemic profiles ranging from very
slow growth (p=0.14 for the Ebola outbreak in Bomi, Liberia (2014)) to near
exponential (p>0.9 for the smallpox outbreak in Khulna (1972), and the 1918
pandemic influenza in San Francisco). The foot-and-mouth disease outbreak in
Uruguay displayed a profile of slower growth while the growth pattern of the
HIV/AIDS epidemic in Japan was approximately linear. The West African Ebola
epidemic provided a unique opportunity to explore how growth profiles vary by
geography; analysis of the largest district-level outbreaks revealed
substantial growth variations (mean p=0.59, range: 0.14-0.97). Our findings
reveal significant variation in epidemic growth patterns across different
infectious disease outbreaks and highlights that sub-exponential growth is a
common phenomenon. Sub-exponential growth profiles may result from
heterogeneity in contact structures or risk groups, reactive behavior changes,
or the early onset of interventions strategies, and consideration of
"deceleration parameters" may be useful to refine existing mathematical
transmission models and improve disease forecasts.Comment: 31 pages, 9 Figures, 1 Supp. Figure, 1 Table, final accepted version
(in press), Epidemics - The Journal on Infectious Disease Dynamics, 201
Predicting the extinction of Ebola spreading in Liberia due to mitigation strategies
The Ebola virus is spreading throughout West Africa and is causing thousands
of deaths. In order to quantify the effectiveness of different strategies for
controlling the spread, we develop a mathematical model in which the
propagation of the Ebola virus through Liberia is caused by travel between
counties. For the initial months in which the Ebola virus spreads, we find that
the arrival times of the disease into the counties predicted by our model are
compatible with World Health Organization data, but we also find that reducing
mobility is insufficient to contain the epidemic because it delays the arrival
of Ebola virus in each county by only a few weeks. We study the effect of a
strategy in which safe burials are increased and effective hospitalisation
instituted under two scenarios: (i) one implemented in mid-July 2014 and (ii)
one in mid-August---which was the actual time that strong interventions began
in Liberia. We find that if scenario (i) had been pursued the lifetime of the
epidemic would have been three months shorter and the total number of infected
individuals 80\% less than in scenario (ii). Our projection under scenario (ii)
is that the spreading will stop by mid-spring 2015
Predicting the extinction of Ebola spreading in Liberia due to mitigation strategies
The Ebola virus is spreading throughout West Africa and is causing thousands of deaths. In order to quantify the effectiveness of different strategies for controlling the spread, we develop a mathematical model in which the propagation of the Ebola virus through Liberia is caused by travel between counties. For the initial months in which the Ebola virus spreads, we find that the arrival times of the disease into the counties predicted by our model are compatible with World Health Organization data, but we also find that reducing mobility is insufficient to contain the epidemic because it delays the arrival of Ebola virus in each county by only a few weeks. We study the effect of a strategy in which safe burials are increased and effective hospitalisation instituted under two scenarios: (i) one implemented in mid-July 2014 and (ii) one in mid-August—which was the actual time that strong interventions began in Liberia. We find that if scenario (i) had been pursued the lifetime of the epidemic would have been three months shorter and the total number of infected individuals 80% less than in scenario (ii). Our projection under scenario (ii) is that the spreading will stop by mid-spring 2015.H.E.S. thanks the NSF (grants CMMI 1125290 and CHE-1213217) and the Keck Foundation for financial support. L.D.V. and L.A.B. wish to thank to UNMdP and FONCyT (Pict 0429/2013) for financial support. (CMMI 1125290 - NSF; CHE-1213217 - NSF; Keck Foundation; UNMdP; Pict 0429/2013 - FONCyT)Published versio
Testing Modeling Assumptions in the West Africa Ebola Outbreak
The Ebola virus in West Africa has infected almost 30,000 and killed over
11,000 people. Recent models of Ebola Virus Disease (EVD) have often made
assumptions about how the disease spreads, such as uniform transmissibility and
homogeneous mixing within a population. In this paper, we test whether these
assumptions are necessarily correct, and offer simple solutions that may
improve disease model accuracy. First, we use data and models of West African
migration to show that EVD does not homogeneously mix, but spreads in a
predictable manner. Next, we estimate the initial growth rate of EVD within
country administrative divisions and find that it significantly decreases with
population density. Finally, we test whether EVD strains have uniform
transmissibility through a novel statistical test, and find that certain
strains appear more often than expected by chance.Comment: 16 pages, 14 figure
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Adequacy of SEIR models when epidemics have spatial structure: Ebola in Sierra Leone.
Dynamic SEIR (Susceptible, Exposed, Infectious, Removed) compartmental models provide a tool for predicting the size and duration of both unfettered and managed outbreaks-the latter in the context of interventions such as case detection, patient isolation, vaccination and treatment. The reliability of this tool depends on the validity of key assumptions that include homogeneity of individuals and spatio-temporal homogeneity. Although the SEIR compartmental framework can easily be extended to include demographic (e.g. age) and additional disease (e.g. healthcare workers) classes, dependence of transmission rates on time, and metapopulation structure, fitting such extended models is hampered by both a proliferation of free parameters and insufficient or inappropriate data. This raises the question of how effective a tool the basic SEIR framework may actually be. We go some way here to answering this question in the context of the 2014-2015 outbreak of Ebola in West Africa by comparing fits of an SEIR time-dependent transmission model to both country- and district-level weekly incidence data. Our novel approach in estimating the effective-size-of-the-populations-at-risk ( Neff) and initial number of exposed individuals ( E0) at both district and country levels, as well as the transmission function parameters, including a time-to-halving-the-force-of-infection ( tf/2) parameter, provides new insights into this Ebola outbreak. It reveals that the estimate R0 ≈ 1.7 from country-level data appears to seriously underestimate R0 ≈ 3.3 - 4.3 obtained from more spatially homogeneous district-level data. Country-level data also overestimate tf/2 ≈ 22 weeks, compared with 8-10 weeks from district-level data. Additionally, estimates for the duration of individual infectiousness is around two weeks from spatially inhomogeneous country-level data compared with 2.4-4.5 weeks from spatially more homogeneous district-level data, which estimates are rather high compared with most values reported in the literature. This article is part of the theme issue 'Modelling infectious disease outbreaks in humans, animals and plants: approaches and important themes'. This issue is linked with the subsequent theme issue 'Modelling infectious disease outbreaks in humans, animals and plants: epidemic forecasting and control'
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