Abstract

The celebrated Abakaliki smallpox data have appeared numerous times in the epidemic modelling literature, but in almost all cases only a specific subset of the data is considered. The only previous analysis of the full data set relied on approximation methods to derive a likelihood and did not assess model adequacy. The data themselves continue to be of interest due to concerns about the possible re-emergence of smallpox as a bioterrorism weapon. We present the first full Bayesian statistical analysis using data-augmentation Markov chain Monte Carlo methods which avoid the need for likelihood approximations and which yield a wider range of results than previous analyses. We also carry out model assessment using simulation-based methods. Our findings suggest that the outbreak was largely driven by the interaction structure of the population, and that the introduction of control measures was not the sole reason for the end of the epidemic. We also obtain quantitative estimates of key quantities including reproduction numbers.

Highlights

  • IntroductionThe vast majority of cases were members of the Faith Tabernacle Church (FTC), a religious organisation whose members refused vaccination

  • In 1967, an outbreak of smallpox occurred in the Nigerian town of Abakaliki

  • Our aim is to perform Bayesian inference for the unknown model parameters given the data, which consist of rash times for all infectives, knowledge of the population structure and vaccination status of individuals

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Summary

Introduction

The vast majority of cases were members of the Faith Tabernacle Church (FTC), a religious organisation whose members refused vaccination. A World Health Organization (WHO) report (Thompson and Foege, 1968) describes the outbreak, with information on the time series of case detections and their place of dwelling (compound), vaccination status, and FTC membership. The outbreak has inherent historical interest as it occurred during the WHO smallpox eradication programme initiated in 1959. Smallpox was declared eradicated in 1980, it regained attention as a potential bioterrorism weapon in the early 2000s Henderson and Arita, 2014; Eto et al, 2015; World Health Organisation, 2015 and references therein). Public health planning for potential future smallpox outbreaks requires estimates of the parameters governing disease transmission, and being able to accurately obtain such quantities from available data is of considerable importance

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