Abstract
BackgroundIn a new influenza pandemic, travel data such as arrival times of cases seeded by the originating country can be regarded as a combination of the epidemic size and the mobility networks of infections connecting the originating country with other regions. It can be a complete and timely source for estimating the basic reproduction number (R0), a key indicator of disease transmissibility.MethodIn this study, we developed a likelihood-based method using arrival times of infected cases in different countries to estimate R0 for influenza pandemics. A simulation was conducted to assess the performance of the proposed method. We further applied the method to the outbreak of the influenza pandemic A/H1N1 in Mexico.ResultsIn the numerical application, the estimated R0 was equal to 1.69 with a 95% confidence interval (1.65, 1.73). For the simulation results, the estimations were robust to the decline of travel rate and other parameter assumptions. Nevertheless, the estimates were moderately sensitive to the assumption of infectious duration. Generally, the findings were in line with other relevant studies.ConclusionsOur approach as well as the estimate is potential to assist officials in planning control and prevention measures. Improved coordination to streamline or even centralize surveillance of imported cases among countries will thus be beneficial to public health.
Highlights
In a new influenza pandemic, travel data such as arrival times of cases seeded by the originating country can be regarded as a combination of the epidemic size and the mobility networks of infections connecting the originating country with other regions
We developed a likelihood-based method to estimate the R0 for a new influenza pandemic using the information of imported cases i.e. time of the first introduction of infected individuals in different countries seeded by the originating country
The results showed that with a low transmissibility, small samples could still achieve a stable precision level, for example, the 95% Credible intervals (CrI) were around 1.19 to 1.22 when n ≥ 8 in the setting of R0 = 1.2
Summary
In a new influenza pandemic, travel data such as arrival times of cases seeded by the originating country can be regarded as a combination of the epidemic size and the mobility networks of infections connecting the originating country with other regions. It can be a complete and timely source for estimating the basic reproduction number (R0), a key indicator of disease transmissibility. In responding to infectious disease outbreaks in the 21st century, a reliable method to estimate the transmission intensity during the early phases of a new influenza pandemic is critical. One of the caveats of using ILI surveillance data is the underreporting several approaches were developed to adjust this problem [6]
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