scholarly journals Modeling and Controlling Epidemic Outbreaks: The Role of Population Size, Model Heterogeneity and Fast Response in the Case of Measles

Mathematics ◽  
2020 ◽  
Vol 8 (11) ◽  
pp. 1892
Author(s):  
Kezban Yagci Sokat ◽  
Benjamin Armbruster
Keyword(s):  
Public Health ◽  
Simulation Models ◽  
Fast Response ◽  
The United States ◽  
Public Health Response ◽  
Health Response ◽  
Detailed Simulation ◽  
Stochastic Simulation Model ◽  
Outbreak Size

Modelers typically use detailed simulation models and vary the fraction vaccinated to study outbreak control. However, there is currently no guidance for modelers on how much detail (i.e., heterogeneity) is necessary and how large a population to simulate. We provide theoretical and numerical guidance for those decisions and also analyze the benefit of a faster public health response through a stochastic simulation model in the case of measles in the United States. Theoretically, we prove that the outbreak size converges as the simulation population increases and that the outbreaks are slightly larger with a heterogeneous community structure. We find that the simulated outbreak size is not sensitive to the size of the simulated population beyond a certain size. We also observe that in case of an outbreak, a faster public health response provides benefits similar to increased vaccination. Insights from this study can inform the control and elimination measures of the ongoing coronavirus disease (COVID-19) as measles has shown to have a similar structure to COVID-19.

Not your typical “historian”

2018 ◽  
Vol 27 (5) ◽  
pp. 523-533
Author(s):  
Adrienne Lefevre ◽  
Madison Walter-Garcia ◽  
Kimberly Hanson ◽  
Julia Smith-Easley
Keyword(s):  
Public Health ◽  
Lessons Learned ◽  
Incident Management ◽  
Public Health Response ◽  
Content Type ◽  
Incident Command ◽  
Health Community ◽  
Health Response ◽  
Decision Making Processes

Purpose In the incident command system (ICS) structure, response documentation is formally found within the planning section. However, longer term emergency responses have demonstrated the need for a flexible and innovative role that encompasses a variety of activities, including response documentation, communications science, real-time evaluation of major themes, and information management. The paper aims to discuss this issue. Design/methodology/approach This need can be universally met through the functional role of “Historian,” a term specific to ICS, or in the case of public health response, incident management system (IMS). It should be noted that the Historian role discussed is not related to the academic study of history, but to archiving key successes and challenges during a response. Ideally the Historian should be activated at the start of an emergency response and remain active to capture the overall picture of the response, including internal information, such as lessons learned, response activities, and decision-making processes. Findings The Historian compiles details of response activities that inform leadership, donors and external communications products while alleviating pressures on the planning section. The primary, minimum output of an IMS Historian is a response timeline, which notes major internal and external events during a response with emphasis on major themes, lessons learned, and creating a user-friendly interface to display this information (see the list “Abbreviated Example of Hurricane Matthew Response Timeline” in the text). Originality/value In a world with competing priorities and ongoing emergencies, the Historian’s role of archiving details of response efforts can help the international public health community to share lessons learned and contribute to lower morbidity and mortality among those affected by emergencies.

scholarly journals A collaborative multiyear, multimodel assessment of seasonal influenza forecasting in the United States

2019 ◽  
Vol 116 (8) ◽  
pp. 3146-3154 ◽  
Author(s):  
Nicholas G. Reich ◽  
Logan C. Brooks ◽  
Spencer J. Fox ◽  
Sasikiran Kandula ◽  
Craig J. McGowan ◽  
...  
Keyword(s):  
Public Health ◽  
United States ◽  
Real Time ◽  
Forecast Accuracy ◽  
The United States ◽  
Public Health Response ◽  
Public Health Decision ◽  
Health Decision Making ◽  
Health Response ◽  
Health Decision

Influenza infects an estimated 9–35 million individuals each year in the United States and is a contributing cause for between 12,000 and 56,000 deaths annually. Seasonal outbreaks of influenza are common in temperate regions of the world, with highest incidence typically occurring in colder and drier months of the year. Real-time forecasts of influenza transmission can inform public health response to outbreaks. We present the results of a multiinstitution collaborative effort to standardize the collection and evaluation of forecasting models for influenza in the United States for the 2010/2011 through 2016/2017 influenza seasons. For these seven seasons, we assembled weekly real-time forecasts of seven targets of public health interest from 22 different models. We compared forecast accuracy of each model relative to a historical baseline seasonal average. Across all regions of the United States, over half of the models showed consistently better performance than the historical baseline when forecasting incidence of influenza-like illness 1 wk, 2 wk, and 3 wk ahead of available data and when forecasting the timing and magnitude of the seasonal peak. In some regions, delays in data reporting were strongly and negatively associated with forecast accuracy. More timely reporting and an improved overall accessibility to novel and traditional data sources are needed to improve forecasting accuracy and its integration with real-time public health decision making.

scholarly journals Clinical Response, Outbreak Investigation, and Epidemiology of the Fungal Meningitis Epidemic in the United States: Systematic Review

2015 ◽  
Vol 10 (1) ◽  
pp. 145-151 ◽  
Author(s):  
Kaja M. Abbas ◽  
Nargesalsadat Dorratoltaj ◽  
Margaret L. O’Dell ◽  
Paige Bordwine ◽  
Thomas M. Kerkering ◽  
...  
Keyword(s):  
Public Health ◽  
United States ◽  
Systematic Review ◽  
Clinical Response ◽  
Policy Development ◽  
The United States ◽  
Outbreak Investigation ◽  
Public Health Response ◽  
Fungal Meningitis ◽  
Health Response

AbstractWe conducted a systematic review of the 2012–2013 multistate fungal meningitis epidemic in the United States from the perspectives of clinical response, outbreak investigation, and epidemiology. Articles focused on clinical response, outbreak investigation, and epidemiology were included, whereas articles focused on compounding pharmacies, legislation and litigation, diagnostics, microbiology, and pathogenesis were excluded. We reviewed 19 articles by use of the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) framework. The source of the fungal meningitis outbreak was traced to the New England Compounding Center in Massachusetts, where injectable methylprednisolone acetate products were contaminated with the predominant pathogen, Exserohilum rostratum. As of October 23, 2013, the final case count stood at 751 patients and 64 deaths, and no additional cases are anticipated. The multisectoral public health response to the fungal meningitis epidemic from the hospitals, clinics, pharmacies, and the public health system at the local, state, and federal levels led to an efficient epidemiological investigation to trace the outbreak source and rapid implementation of multiple response plans. This systematic review reaffirms the effective execution of a multisectoral public health response and efficient delivery of the core functions of public health assessment, policy development, and service assurances to improve population health.(Disaster Med Public Health Preparedness. 2016;10:145–151)

New decade, new response: Altering the public health response to toxigenic cutaneous diphtheria

2020 ◽  
Vol 30 (Supplement_5) ◽  
Author(s):  
N C Marshall ◽  
M Baxi ◽  
C MacDonald ◽  
C Sikora ◽  
G J Tyrrell
Keyword(s):  
Public Health ◽  
Respiratory Disease ◽  
Diphtheria Toxin ◽  
Laboratory Testing ◽  
Asymptomatic Carrier ◽  
Public Health Response ◽  
Vaccination Rates ◽  
The Public ◽  
Health Response

Abstract Background Classical diphtheria is a potentially fatal respiratory disease mediated by the diphtheria toxin of Corynebacterium diphtheriae. Due to high vaccination rates against this toxin in Canada, the national incidence of respiratory diphtheria is near zero, and the toxin plays no recognized role in cutaneous diphtheria. Therefore, in this study, we assessed the diagnostic and public health benefits of diphtheria toxin testing and cutaneous diphtheria investigations in a highly vaccinated population. Methods Over the last 10 years, we retrospectively determined: the number of C. diphtheriae isolates identified in the province of Alberta, Canada; the disease state of each individual tested (disease vs asymptomatic carrier); the source (cutaneous vs respiratory); and the number of toxin tests performed. Results In 10 years, zero cases of respiratory diphtheria and three cases of toxigenic cutaneous diphtheria were identified. Despite zero cases of respiratory disease, diphtheria toxin testing significantly increased (p = 0.0001), with 86% of toxin tests performed on cutaneous isolates. Subsequent public health investigations of each case of toxigenic cutaneous diphtheria mandated the collection of 315 total specimens from 92 individuals, revealing low rates of C. diphtheriae colonization among contacts and no further cases. Conclusions This study challenges the value of reflexive diphtheria toxin testing in uncomplicated cutaneous diphtheria among highly vaccinated populations. Cutaneous diphtheria investigations demanded disproportionate public health and laboratory resources and demonstrated a discrepancy between toxin pathophysiology and disease. Therefore, we recommend stewarding diphtheria toxin tests for toxin-mediated disease forms and ensuring adequate vaccination. This approach would spare public health and laboratory resources by customizing responses around the role of the diphtheria toxin in each form of disease. Key messages Investigations for cutaneous diphtheria increased demand for toxin testing in Alberta, Canada, though the toxin plays no role in this form of disease. In populations with high vaccination rates against diphtheria toxoid, cutaneous diphtheria cases do not require additional laboratory testing for the presence of the diphtheria toxin.

scholarly journals Cost of Public Health Response and Outbreak Control With a Third Dose of Measles-Mumps-Rubella Vaccine During a University Mumps Outbreak—Iowa, 2015–2016

2018 ◽  
Vol 5 (10) ◽  
Author(s):  
Mona Marin ◽  
Tricia L Kitzmann ◽  
Lisa James ◽  
Patricia Quinlisk ◽  
Wade K Aldous ◽  
...  
Keyword(s):  
Public Health ◽  
Vaccine Coverage ◽  
The United States ◽  
Mmr Vaccine ◽  
Public Health Response ◽  
University Of Iowa ◽  
Outbreak Control ◽  
Response Planning ◽  
Health Response ◽  
The University

Abstract Background The United States is experiencing mumps outbreaks in settings with high 2-dose measles-mumps-rubella (MMR) vaccine coverage, mainly universities. The economic impact of mumps outbreaks on public health systems is largely unknown. During a 2015–2016 mumps outbreak at the University of Iowa, we estimated the cost of public health response that included a third dose of MMR vaccine. Methods Data on activities performed, personnel hours spent, MMR vaccine doses administered, miles traveled, hourly earnings, and unitary costs were collected using a customized data tool. These data were then used to calculate associated costs. Results Approximately 6300 hours of personnel time were required from state and local public health institutions and the university, including for vaccination and laboratory work. Among activities demanding time were case/contact investigation (36%), response planning/coordination (20%), and specimen testing and report preparation (13% each). A total of 4736 MMR doses were administered and 1920 miles traveled. The total cost was >$649 000, roughly equally distributed between standard outbreak control activities and third-dose MMR vaccination (55% and 45%, respectively). Conclusions Public health response to the mumps outbreak at the University of Iowa required important amounts of personnel time and other resources. Associated costs were sizable enough to affect other public health activities.

Racial/Ethnic and Age Differences in the Direct and Indirect Effects of the COVID-19 Pandemic on US Mortality

2022 ◽  
Vol 112 (1) ◽  
pp. 154-164
Author(s):  
Lauren C. Zalla ◽  
Grace E. Mulholland ◽  
Lindsey M. Filiatreau ◽  
Jessie K. Edwards
Keyword(s):  
Public Health ◽  
Native Americans ◽  
Indirect Effects ◽  
Excess Mortality ◽  
The United States ◽  
Direct And Indirect Effects ◽  
Public Health Response ◽  
Health Response ◽  
Race Ethnicity ◽  
Expected Mortality

Objectives. To estimate the direct and indirect effects of the COVID-19 pandemic on overall, race/ethnicity‒specific, and age-specific mortality in 2020 in the United States. Methods. Using surveillance data, we modeled expected mortality, compared it to observed mortality, and estimated the share of “excess” mortality that was indirectly attributable to the pandemic versus directly attributed to COVID-19. We present absolute risks and proportions of total pandemic-related mortality, stratified by race/ethnicity and age. Results. We observed 16.6 excess deaths per 10 000 US population in 2020; 84% were directly attributed to COVID-19. The indirect effects of the pandemic accounted for 16% of excess mortality, with proportions as low as 0% among adults aged 85 years and older and more than 60% among those aged 15 to 44 years. Indirect causes accounted for a higher proportion of excess mortality among racially minoritized groups (e.g., 32% among Black Americans and 23% among Native Americans) compared with White Americans (11%). Conclusions. The effects of the COVID-19 pandemic on mortality and health disparities are underestimated when only deaths directly attributed to COVID-19 are considered. An equitable public health response to the pandemic should also consider its indirect effects on mortality. (Am J Public Health. 2022;112(1):154–164. https://doi.org/10.2105/AJPH.2021.306541 )

Sign in / Sign up

Export Citation Format

Share Document