Forecasting the 2013-2014 influenza season using Wikipedia.

Infectious diseases are one of the leading causes of morbidity and mortality around the world; thus, forecasting their impact is crucial for planning an effective response strategy. According to the Centers for Disease Control and Prevention (CDC), seasonal influenza affects 5% to 20% of the U.S. population and causes major economic impacts resulting from hospitalization and absenteeism. Understanding influenza dynamics and forecasting its impact is fundamental for developing prevention and mitigation strategies. We combine modern data assimilation methods with Wikipedia access logs and CDC influenza-like illness (ILI) reports to create a weekly forecast for seasonal influenza. The methods are applied to the 2013-2014 influenza season but are sufficiently general to forecast any disease outbreak, given incidence or case count data. We adjust the initialization and parametrization of a disease model and show that this allows us to determine systematic model bias. In addition, we provide a way to determine where the model diverges from observation and evaluate forecast accuracy. Wikipedia article access logs are shown to be highly correlated with historical ILI records and allow for accurate prediction of ILI data several weeks before it becomes available. The results show that prior to the peak of the flu season, our forecasting method produced 50% and 95% credible intervals for the 2013-2014 ILI observations that contained the actual observations for most weeks in the forecast. However, since our model does not account for re-infection or multiple strains of influenza, the tail of the epidemic is not predicted well after the peak of flu season has passed.

Results from the centers for disease control and prevention's predict the 2013-2014 Influenza Season Challenge.

BACKGROUND: Early insights into the timing of the start, peak, and intensity of the influenza season could be useful in planning influenza prevention and control activities. To encourage development and innovation in influenza forecasting, the Centers for Disease Control and Prevention (CDC) organized a challenge to predict the 2013-14 Unites States influenza season. METHODS: Challenge contestants were asked to forecast the start, peak, and intensity of the 2013-2014 influenza season at the national level and at any or all Health and Human Services (HHS) region level(s). The challenge ran from December 1, 2013-March 27, 2014; contestants were required to submit 9 biweekly forecasts at the national level to be eligible. The selection of the winner was based on expert evaluation of the methodology used to make the prediction and the accuracy of the prediction as judged against the U.S. Outpatient Influenza-like Illness Surveillance Network (ILINet). RESULTS: Nine teams submitted 13 forecasts for all required milestones. The first forecast was due on December 2, 2013; 3/13 forecasts received correctly predicted the start of the influenza season within one week, 1/13 predicted the peak within 1 week, 3/13 predicted the peak ILINet percentage within 1 %, and 4/13 predicted the season duration within 1 week. For the prediction due on December 19, 2013, the number of forecasts that correctly forecasted the peak week increased to 2/13, the peak percentage to 6/13, and the duration of the season to 6/13. As the season progressed, the forecasts became more stable and were closer to the season milestones. CONCLUSION: Forecasting has become technically feasible, but further efforts are needed to improve forecast accuracy so that policy makers can reliably use these predictions. CDC and challenge contestants plan to build upon the methods developed during this contest to improve the accuracy of influenza forecasts.

Comparing dengue and chikungunya emergence and endemic transmission in A. aegypti and A. albopictus.

Chikungunya and dengue are re-emerging mosquito-borne infectious diseases that are of increasing concern as human travel and expanding mosquito ranges increase the risk of spread. We seek to understand the differences in transient and endemic behavior of chikungunya and dengue; risk of emergence for different virus-vector assemblages; and the role that virus evolution plays in disease dynamics and risk. To address these questions, we adapt a mathematical mosquito-borne disease model to chikungunya and dengue in Aedes aegypti and Aedes albopictus mosquitoes. We derive analytical threshold conditions and important dimensionless parameters for virus transmission; perform sensitivity analysis on quantities of interest such as the basic reproduction number, endemic equilibrium, and first epidemic peak; and compute distributions for the quantities of interest across parameter ranges. We found that chikungunya and dengue exhibit different transient dynamics and long-term endemic levels. While the order of most sensitive parameters is preserved across vector-virus combinations, the magnitude of sensitivity is different across scenarios, indicating that risk of invasion or an outbreak can change with vector-virus assemblages. We found that the dengue - A. aegypti and new Rèunion strain of chikungunya - A. albopictus systems represent the highest risk across the range of parameters considered. These results inform future experimental and field research efforts and point toward effective mitigation strategies adapted to each disease.

Optimizing human activity patterns using global sensitivity analysis.

Implementing realistic activity patterns for a population is crucial for modeling, for example, disease spread, supply and demand, and disaster response. Using the dynamic activity simulation engine, DASim, we generate schedules for a population that capture regular (e.g., working, eating, and sleeping) and irregular activities (e.g., shopping or going to the doctor). We use the sample entropy (SampEn) statistic to quantify a schedule's regularity for a population. We show how to tune an activity's regularity by adjusting SampEn, thereby making it possible to realistically design activities when creating a schedule. The tuning process sets up a computationally intractable high-dimensional optimization problem. To reduce the computational demand, we use Bayesian Gaussian process regression to compute global sensitivity indices and identify the parameters that have the greatest effect on the variance of SampEn. We use the harmony search (HS) global optimization algorithm to locate global optima. Our results show that HS combined with global sensitivity analysis can efficiently tune the SampEn statistic with few search iterations. We demonstrate how global sensitivity analysis can guide statistical emulation and global optimization algorithms to efficiently tune activities and generate realistic activity patterns. Though our tuning methods are applied to dynamic activity schedule generation, they are general and represent a significant step in the direction of automated tuning and optimization of high-dimensional computer simulations.

Forecasting seasonal influenza with a state-space SIR model.

Seasonal influenza is a serious public health and societal problem due to its consequences resulting from absenteeism, hospitalizations, and deaths. The overall burden of influenza is captured by the Centers for Disease Control and Prevention's influenza-like illness network, which provides invaluable information about the current incidence. This information is used to provide decision support regarding prevention and response efforts. Despite the relatively rich surveillance data and the recurrent nature of seasonal influenza, forecasting the timing and intensity of seasonal influenza in the U.S. remains challenging because the form of the disease transmission process is uncertain, the disease dynamics are only partially observed, and the public health observations are noisy. Fitting a probabilistic state-space model motivated by a deterministic mathematical model [a susceptible-infectious-recovered (SIR) model] is a promising approach for forecasting seasonal influenza while simultaneously accounting for multiple sources of uncertainty. A significant finding of this work is the importance of thoughtfully specifying the prior, as results critically depend on its specification. Our conditionally specified prior allows us to exploit known relationships between latent SIR initial conditions and parameters and functions of surveillance data. We demonstrate advantages of our approach relative to alternatives via a forecasting comparison using several forecast accuracy metrics.

A network-patch methodology for adapting agent-based models for directly transmitted disease to mosquito-borne disease.

Mosquito-borne diseases cause significant public health burden and are widely re-emerging or emerging. Understanding, predicting, and mitigating the spread of mosquito-borne disease in diverse populations and geographies are ongoing modelling challenges. We propose a hybrid network-patch model for the spread of mosquito-borne pathogens that accounts for individual movement through mosquito habitats, extending the capabilities of existing agent-based models (ABMs) to include vector-borne diseases. The ABM are coupled with differential equations representing 'clouds' of mosquitoes in patches accounting for mosquito ecology. We adapted an ABM for humans using this method and investigated the importance of heterogeneity in pathogen spread, motivating the utility of models of individual behaviour. We observed that the final epidemic size is greater in patch models with a high risk patch frequently visited than in a homogeneous model. Our hybrid model quantifies the importance of the heterogeneity in the spread of mosquito-borne pathogens, guiding mitigation strategies.