Estimating incidence of infection from diverse data sources: Zika virus in Puerto Rico, 2016

Emerging epidemics are challenging to track. Only a subset of cases is recognized and reported, as seen with the Zika virus (ZIKV) epidemic where large proportions of infection were asymptomatic. However, multiple imperfect indicators of infection provide an opportunity to estimate the underlying incidence of infection. We developed a modeling approach that integrates a generic Time-series Susceptible-Infected-Recovered epidemic model with assumptions about reporting biases in a Bayesian framework and applied it to the 2016 Zika epidemic in Puerto Rico using three indicators: suspected arboviral cases, suspected Zika-associated Guillain-Barré Syndrome cases, and blood bank data. Using this combination of surveillance data, we estimated the peak of the epidemic occurred during the week of August 15, 2016 (the 33rd week of year), and 120 to 140 (50% credible interval [CrI], 95% CrI: 97 to 170) weekly infections per 10,000 population occurred at the peak. By the end of 2016, we estimated that approximately 890,000 (95% CrI: 660,000 to 1,100,000) individuals were infected in 2016 (26%, 95% CrI: 19% to 33%, of the population infected). Utilizing multiple indicators offers the opportunity for real-time and retrospective situational awareness to support epidemic preparedness and response.

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Estimating incidence of infection from diverse data sources: Zika virus in Puerto Rico, 2016

10.1101/2020.10.14.20212134 ◽

2020 ◽

Author(s):

Talia M. Quandelacy ◽

Jessica M. Healy ◽

Bradford Greening ◽

Dania M. Rodriguez ◽

Koo-Whang Chung ◽

...

Keyword(s):

Time Series ◽

Puerto Rico ◽

Zika Virus ◽

Epidemic Model ◽

Situational Awareness ◽

Credible Interval ◽

Data Sources ◽

Multiple Indicators ◽

Diverse Data ◽

Generic Time

AbstractEmerging epidemics are challenging to track. Only a subset of cases is recognized and reported, as seen with the Zika virus (ZIKV) epidemic where large proportions of infection were asymptomatic. However, multiple imperfect indicators of infection provide an opportunity to estimate the underlying incidence of infection. We developed a modeling approach that integrates a generic Time-series Susceptible-Infected-Recovered epidemic model with assumptions about reporting biases in a Bayesian framework and applied it to the 2016 Zika epidemic in Puerto Rico using three indicators: suspected arboviral cases, suspected Zika-associated Guillain-Barré Syndrome cases, and blood bank data. Using this combination of surveillance data, we estimated the peak of the epidemic occurred during the week of August 15, 2016 (the 33rd week of year), and 120 to 140 (50% credible interval [CrI], 95% CrI: 97 to 170) weekly infections per 10,000 population occurred at the peak. By the end of 2016, we estimated that approximately 890,000 (95% CrI: 660,000 to 1,100,000) individuals were infected in 2016 (26%, 95% CrI: 19% to 33%, of the population infected). Utilizing multiple indicators offers the opportunity for real-time and retrospective situational awareness to support epidemic preparedness and response.

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The CAMELS-CL dataset: catchment attributes and meteorology for large sample studies – Chile dataset

Hydrology and Earth System Sciences ◽

10.5194/hess-22-5817-2018 ◽

2018 ◽

Vol 22 (11) ◽

pp. 5817-5846 ◽

Cited By ~ 47

Author(s):

Camila Alvarez-Garreton ◽

Pablo A. Mendoza ◽

Juan Pablo Boisier ◽

Nans Addor ◽

Mauricio Galleguillos ◽

...

Keyword(s):

Time Series ◽

Arid Regions ◽

Snow Water Equivalent ◽

Potential Evapotranspiration ◽

Data Sources ◽

Large Sample ◽

Daily Streamflow ◽

Multiple Data ◽

Diverse Data ◽

High Elevations

Abstract. We introduce the first catchment dataset for large sample studies in Chile. This dataset includes 516 catchments; it covers particularly wide latitude (17.8 to 55.0∘ S) and elevation (0 to 6993 m a.s.l.) ranges, and it relies on multiple data sources (including ground data, remote-sensed products and reanalyses) to characterise the hydroclimatic conditions and landscape of a region where in situ measurements are scarce. For each catchment, the dataset provides boundaries, daily streamflow records and basin-averaged daily time series of precipitation (from one national and three global datasets), maximum, minimum and mean temperatures, potential evapotranspiration (PET; from two datasets), and snow water equivalent. We calculated hydro-climatological indices using these time series, and leveraged diverse data sources to extract topographic, geological and land cover features. Relying on publicly available reservoirs and water rights data for the country, we estimated the degree of anthropic intervention within the catchments. To facilitate the use of this dataset and promote common standards in large sample studies, we computed most catchment attributes introduced by Addor et al. (2017) in their Catchment Attributes and MEteorology for Large-sample Studies (CAMELS) dataset, and added several others. We used the dataset presented here (named CAMELS-CL) to characterise regional variations in hydroclimatic conditions over Chile and to explore how basin behaviour is influenced by catchment attributes and water extractions. Further, CAMELS-CL enabled us to analyse biases and uncertainties in basin-wide precipitation and PET. The characterisation of catchment water balances revealed large discrepancies between precipitation products in arid regions and a systematic precipitation underestimation in headwater mountain catchments (high elevations and steep slopes) over humid regions. We evaluated PET products based on ground data and found a fairly good performance of both products in humid regions (r>0.91) and lower correlation (r<0.76) in hyper-arid regions. Further, the satellite-based PET showed a consistent overestimation of observation-based PET. Finally, we explored local anomalies in catchment response by analysing the relationship between hydrological signatures and an attribute characterising the level of anthropic interventions. We showed that larger anthropic interventions are correlated with lower than normal annual flows, runoff ratios, elasticity of runoff with respect to precipitation, and flashiness of runoff, especially in arid catchments. CAMELS-CL provides unprecedented information on catchments in a region largely underrepresented in large sample studies. This effort is part of an international initiative to create multi-national large sample datasets freely available for the community. CAMELS-CL can be visualised from http://camels.cr2.cl and downloaded from https://doi.pangaea.de/10.1594/PANGAEA.894885.

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Estimating Contraceptive Needs and Increasing Access to Contraception in Response to the Zika Virus Disease Outbreak — Puerto Rico, 2016

MMWR Morbidity and Mortality Weekly Report ◽

10.15585/mmwr.mm6512e1er ◽

2016 ◽

Vol 65 (12) ◽

Author(s):

Naomi K. Tepper ◽

Howard I. Goldberg ◽

Manuel I. Vargas Bernal ◽

Brenda Rivera ◽

Meghan T. Frey ◽

...

Keyword(s):

Puerto Rico ◽

Zika Virus ◽

Virus Disease ◽

Disease Outbreak ◽

Access To Contraception

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TIME SERIES DISPLACEMENT MAPS FOR THE 2019-2020 PUERTO RICO EARTHQUAKE SEQUENCE

10.1130/abs/2020am-351498 ◽

2020 ◽

Author(s):

Zelalem Demissie ◽

◽

Daniel A. Laó-Dávila ◽

Liang Xue ◽

Glyn Rimmington ◽

...

Keyword(s):

Time Series ◽

Puerto Rico ◽

Earthquake Sequence ◽

Displacement Maps

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EXPRESS: The Role of Patient Satisfaction in Hospitals’ Medicare Reimbursements

Journal of Public Policy & Marketing ◽

10.1177/0743915620984723 ◽

2020 ◽

pp. 074391562098472

Author(s):

Lu Liu ◽

Dinesh K. Gauri ◽

Rupinder P. Jindal

Keyword(s):

Patient Satisfaction ◽

Pain Management ◽

Hospital Care ◽

Pay For Performance ◽

Data Sources ◽

Satisfaction Survey ◽

The Us ◽

Performance System ◽

Diverse Data

Medicare uses a pay-for-performance program to reimburse hospitals. One of the key input measures in the performance formula is patient satisfaction with their hospital care. Physicians and hospitals, however, have raised concerns especially about questions related to patient satisfaction with pain management during hospitalization. They report feeling pressured to prescribe opioids to alleviate pain and boost satisfaction survey scores for higher reimbursements. This over-prescription of opioids has been cited as a cause of current opioid crisis in the US. Due to these concerns, Medicare stopped using pain management questions as inputs in its payment formula. We collected multi-year data from six diverse data sources, employed propensity score matching to obtain comparable groups, and estimated difference-in-difference models to show that, in fact, pain management was the only measure to improve in response to pay-for-performance system. No other input measure showed significant improvement. Thus, removing pain management from the formula may weaken the effectiveness of HVBP program at improving patient satisfaction, which is one of the key goals of the program. We suggest two divergent paths for Medicare to make the program more effective.

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Transmission Potential of Zika Virus by Aedes aegypti (Diptera: Culicidae) and Ae. mediovittatus (Diptera: Culicidae) Populations From Puerto Rico

Journal of Medical Entomology ◽

10.1093/jme/tjaa286 ◽

2021 ◽

Author(s):

Rebecca A Zimler ◽

Donald A Yee ◽

Barry W Alto

Keyword(s):

Puerto Rico ◽

Aedes Aegypti ◽

Zika Virus ◽

Mosquito Species ◽

The United States ◽

Infection Rates ◽

Transmission Potential ◽

Transmission Rates ◽

Higher Doses ◽

Local Transmission

Abstract Recurrence of local transmission of Zika virus in Puerto Rico is a major public health risk to the United States, where mosquitoes Aedes aegypti (Linnaeus) and Aedes mediovittatus (Coquillett) are abundant. To determine the extent to which Ae. mediovittatus are capable of transmitting Zika virus and the influence of viremia, we evaluated infection and transmission in Ae. mediovittatus and Ae. aegypti from Puerto Rico using serial dilutions of infectious blood. Higher doses of infectious blood resulted in greater infection rates in both mosquitoes. Aedes aegypti females were up to twice as susceptible to infection than Ae. mediovittatus, indicating a more effective midgut infection barrier in the latter mosquito species. Aedes aegypti exhibited higher disseminated infection (40–95%) than Ae. mediovittatus (<5%), suggesting a substantial midgut escape barrier in Ae. mediovittatus. For Ae. aegypti, transmission rates were low over a range of doses of Zika virus ingested, suggesting substantial salivary gland barriers.

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