Modeling Super-spreading Events for Infectious Diseases: Case Study SARS

Super-spreading events for infectious diseases occur when some infected individuals infect more than the average number of secondary cases. Several super-spreading individuals have been identified for the 2003 outbreak of severe acute respiratory syndrome (SARS). We develop a model for super-spreading events of infectious diseases, which is based on the outbreak of SARS. Using this model we describe two methods for estimating the parameters of the model, which we demonstrate with the small-scale SARS outbreak at the Amoy Gardens, Hong Kong, and the large-scale outbreak in the entire Hong Kong Special Administrative Region. One method is based on parameters calculated for the classical susceptible - infected - removed (SIR) disease model. The second is based on parameter estimates found in the literature. Using the parameters calculated for the SIR model, our model predicts an outcome similar to that for the SIR model. On the other hand, using parameter estimates from SARS literature our model predicts a much more serious epidemic.Comment: 8 pages, 1 figure, 7 table

Shadows of the SIS immortality transition in small networks

Much of the research on the behavior of the SIS model on networks has concerned the infinite size limit; in particular the phase transition between a state where outbreaks can reach a finite fraction of the population, and a state where only a finite number would be infected. For finite networks, there is also a dynamic transition---the immortality transition---when the per-contact transmission probability $\lambda$ reaches one. If $\lambda < 1$, the probability that an outbreak will survive by an observation time $t$ tends to zero as $t \rightarrow \infty$; if $\lambda = 1$, this probability is one. We show that treating $\lambda = 1$ as a critical point predicts the $\lambda$-dependence of the survival probability also for more moderate $\lambda$-values. The exponent, however, depends on the underlying network. This fact could, by measuring how a vertex' deletion changes the exponent, be used to evaluate the role of a vertex in the outbreak. Our work also confirms an extremely clear separation between the early die-off (from the outbreak failing to take hold in the population) and the later extinctions (corresponding to rare stochastic events of several consecutive transmission events failing to occur).Comment: Bug fixes from the first versio

The outbreak of SARS at Tan Tock Seng Hospital--relating epidemiology to control.

INTRODUCTION: The outbreak of severe acute respiratory syndrome (SARS) began after the index case was admitted on 1 March 2003. We profile the cases suspected to have acquired the infection in Tan Tock Seng Hospital (TTSH), focussing on major transmission foci, and also describe and discuss the impact of our outbreak control measures. MATERIALS AND METHODS: Using the World Health Organization (WHO) case definitions for probable SARS adapted to the local context, we studied all cases documented to have passed through TTSH less than 10 days prior to the onset of fever. Key data were collected in liaison with clinicians and through a team of onsite epidemiologists. RESULTS: There were 105 secondary cases in TTSH. Healthcare staff (57.1%) formed the majority, followed by visitors (30.5%) and inpatients (12.4%). The earliest case had onset of fever on 4 March 2003, and the last case, on 5 April 2003. Eighty-nine per cent had exposures to 7 wards which had cases of SARS that were not isolated on admission. In 3 of these wards, major outbreaks resulted, each with more than 20 secondary cases. Attack rates amongst ward-based staff ranged from 0% to 32.5%. Of 13 inpatients infected, only 4 (30.8%) had been in the same room or cubicle as the index case for the ward. CONCLUSIONS: The outbreak of SARS at TTSH showed the challenges of dealing with an emerging infectious disease with efficient nosocomial spread. Super-spreading events and initial delays in outbreak response led to widespread dissemination of the outbreak to multiple wards

Stratified dispersal and increasing genetic variation during the invasion of Central Europe by the western corn rootworm, Diabrotica virgifera virgifera

Invasive species provide opportunities for investigating evolutionary aspects of colonization processes, including initial foundations of populations and geographic expansion. Using microsatellite markers and historical information, we characterized the genetic patterns of the invasion of the western corn rootworm (WCR), a pest of corn crops, in its largest area of expansion in Europe: Central and South-Eastern (CSE) Europe. We found that the invaded area probably corresponds to a single expanding population resulting from a single introduction of WCR and that gene flow is geographically limited within the population. In contrast to what is expected in classical colonization processes, an increase in genetic variation was observed from the center to the edge of the outbreak. Control measures against WCR at the center of the outbreak may have decreased effective population size in this area which could explain this observed pattern of genetic variation. We also found that small remote outbreaks in southern Germany and north-eastern Italy most likely originated from long-distance dispersal events from CSE Europe. We conclude that the large European outbreak is expanding by stratified dispersal, involving both continuous diffusion and discontinuous long-distance dispersal. This latter mode of dispersal may accelerate the expansion of WCR in Europe in the future

Recent examples of mesoscale numerical forecasts of severe weather events along the east coast

Mesoscale numerical forecasts utilizing the Mesoscale Atmospheric Simulation System (MASS) are documented for two East Coast severe weather events. The two events are the thunderstorm and heavy snow bursts in the Washington, D.C. - Baltimore, MD region on 8 March 1984 and the devastating tornado outbreak across North and South Carolina on 28 March 1984. The forecasts are presented to demonstrate the ability of the model to simulate dynamical interactions and diabatic processes and to note some of the problems encountered when using mesoscale models for day-to-day forecasting

News discourses on distant suffering: A critical discourse analysis of the 2003 SARS outbreak

News carries a unique signifying power, a power to represent events in particular ways (Fairclough, 1995). Applying Critical Discourse Analysis and Chouliaraki's theory on the mediation of suffering (2006), this article explores the news representation of the 2003 global SARS outbreak. Following a case-based methodology, we investigate how two Belgian television stations have covered the international outbreak of SARS. By looking into the mediation of four selected discursive moments, underlying discourses of power, hierarchy and compassion were unraveled. The analysis further identified the key role of proximity in international news reporting and supports the claim that Western news media mainly reproduce a Euro-American centered world order. This article argues that news coverage of international crises such as SARS constructs and maintains the socio-cultural difference between 'us' and 'them' as well as articulating global power hierarchies and a division of the world in zones of poverty and prosperity, danger and safety

Historical parallels, Ebola virus disease and cholera: understanding community distrust and social violence with epidemics

In the three West African countries most affected by the recent Ebola virus disease (EVD) outbreak, resistance to public health measures contributed to the startling speed and persistence of this epidemic in the region. But how do we explain this resistance, and how have people in these communities understood their actions? By comparing these recent events to historical precedents during Cholera outbreaks in Europe in the 19th century we show that these events have not been new to history or unique to Africa. Community resistance must be analysed in context and go beyond simple single-variable determinants. Knowledge and respect of the cultures and beliefs of the afflicted is essential for dealing with threatening disease outbreaks and their potential social violence

Towards cross-lingual alerting for bursty epidemic events

Background: Online news reports are increasingly becoming a source for event based early warning systems that detect natural disasters. Harnessing the massive volume of information available from multilingual newswire presents as many challenges as opportunities due to the patterns of reporting complex spatiotemporal events. Results: In this article we study the problem of utilising correlated event reports across languages. We track the evolution of 16 disease outbreaks using 5 temporal aberration detection algorithms on text-mined events classified according to disease and outbreak country. Using ProMED reports as a silver standard, comparative analysis of news data for 13 languages over a 129 day trial period showed improved sensitivity, F1 and timeliness across most models using cross-lingual events. We report a detailed case study analysis for Cholera in Angola 2010 which highlights the challenges faced in correlating news events with the silver standard. Conclusions: The results show that automated health surveillance using multilingual text mining has the potential to turn low value news into high value alerts if informed choices are used to govern the selection of models and data sources. An implementation of the C2 alerting algorithm using multilingual news is available at the BioCaster portal http://born.nii.ac.jp/?page=globalroundup

The role of regional surveillance networks in enhancing global outbreak reporting

BACKGROUND: The Program for Monitoring Emerging Diseases (ProMED) is a moderated electronic reporting system dedicated to the rapid, global dissemination of outbreak reports. Its moderators are globally diverse, carefully selected, highly trained specialists. To improve cross-border communication and rapidly identify regional health threats, ProMED created regional networks where locally-based moderators use their access to local and regional medical and public health networks and media sources to obtain information not readily available outside of their region. In this analysis, we assess the impact of the establishment of ProMED's Middle East/North Africa (MENA) and South Asia (SoAs) regional networks in April 2014 on ProMED's outbreak reports for these regions. METHODS & MATERIALS: Outbreak reports in countries within the two regions were extracted from ProMED's database, and included country, disease name, species type, spatial coordinates, and report issue date. Data analysis included visualizing spatial information, identifying unique reports, and reporting trends per country and region. Data processing and analysis were conducted using R 3.4.0 statistical software. Rates of outbreak events per total number of ProMED reports per year were calculated to adjust for temporal trends in the total number of reports posted on ProMED. Rate comparison used a two-sided t-test; P < 0.05 was considered statistically significant. RESULTS: The mean monthly incidence of ProMED reports concerning outbreaks in the MENA region increased from 28 reports (May 2012 - April 2014) to 83 reports after the establishment of the networks (May 2014 - April 2016), and from 29 reports to 101 reports concerning outbreaks in the SoAs region over the same time period. The number of reports per total number of ProMED reports increased by 259% for MENA, and 289% for SoAs (P < 0.01). MENA reports most often addressed MERS (32.3%), foot-and-mouth disease (7.0%), avian influenza (6.7%), and measles (3.8%); whereas SoAs most often addressed dengue (14.9%), anthrax (7.3%), Japanese encephalitis (7.0%), CCHF (4.9%), and rabies (4.8%). CONCLUSION: The establishment of MENA and SoAs regional networks with locally-based, expert moderators resulted in a significant increase in ProMED's outbreak reports from these regions and an increased flow of disease information across regional borders and to the global public health community