Intensity Of Outbreaks Research Articles

Effects of stochastic perturbation and vaccinated age on a vector-borne epidemic model with saturation incidence rate

For reasons that the universality of stochastic perturbation and heterogeneity in the spread of vector-borne epidemic diseases, we formulate a stochastic vector-borne epidemic model with age-structure to discuss the effects of these factors. By constructing appropriate Lyapunov functions, the existence and uniqueness of global positive solutions of this model are derived. Further, we obtained some sufficient conditions for the extinction of the disease. In addition, the existence of a unique stationary distribution is studied which leads to the persistence of disease. Some numerical simulations are carried to explain our theoretical results. This implicates that, under the effects of these factors, the intensity and timing of outbreaks of the disease are unpredictable.

Utilization of Mobility Data in the Fight Against COVID-19.

Utilization of Mobility Data in the Fight Against COVID-19.

Salvage harvest planning for spruce budworm outbreak using multistage stochastic programming

Forest supply chain planning must deal with many natural disturbance uncertainties such as fires, insects, and windthrow. One important consideration is wood infestation by invasive insects, as it causes environmental and economic harm. An example of invasive insects in Eastern Canada is the spruce budworm (Choristoneura fumiferana (Clemens)), which is the most destructive insect in North America’s conifer stands. In 2017, more than 5 million ha of forest were defoliated by spruce budworm in Quebec. Repeated defoliation causes tree mortality, reduction of growth rates, and reduced lumber quality. Consequently, different wood qualities with greatly varied values are found in the forest. Changes in the outbreak intensity impact wood values throughout the forest. One of the common actions to mitigate the economic and environmental damages is salvage harvesting. However, because of the large uncertainties and lack of detailed information, it is a difficult problem to model. We propose a multistage stochastic mixed-integer programming model for harvest scheduling under various outbreak intensities. The objective is to maximize revenues of wood value minus logistic costs while satisfying demand for wood in the industry. The results show that when there is an outbreak throughout the forest, the priority for salvage harvesting is to focus on forest areas with the lowest level of infestation.

О ПРИЧИНАХ ПОТЕПЛЕНИЯ КЛИМАТА НА ОСНОВЕ ИЗУЧЕНИЯ ИСТОРИИ ЧЕТВЕРТИЧНЫХ ОЛЕДЕНЕНИЙ КАВКАЗА (НА ПРИМЕРЕ МЕЖДУРЕЧЬЯ ТЕРЕКА И АНДИЙСКОГО КОЙСУ)

The Greater Caucasus experienced repeated glaciation during the Quaternary (early, middle, upper Pleistocene, late Glacial, and late Holocene), which occurred under changing climatic conditions and differentiated tectonic movements. These glaciations, of course, are associated with changes in terrain, the formation of new deposits, transgressions and regressions of the Caspian Sea, changes in vegetation and soil types, so the problem of glaciation affects all earth Sciences to varying degrees. The study of Quaternary glaciation, especially Holocene glaciation, is currently relevant for understanding climate change. Against the background of significant climate fluctuations within the epochs of glaciation, there are smaller cooling phases that cause the temporary onset of glaciers. Short-term climate fluctuations are manifested in oscillations – minor fluctuations in the languages of glaciers. All this indicates that the climate undergoes significant changes in a short time, which are reflected in the morphosculpture of the terrain, the latest deposits and modern precipitation. Glaciation of the Greater Caucasus in the Prikazbeksky region reached its maximum in the middle Pleistocene,when glaciers went far into the Ossetian basin. All these traces have been preserved due to the lower capacity of the Chanty-Argun glacier and its fluvioglacial flow, which developed during the late Pleistocene epoch. Volcanic activity, especially active in the late Pliocene and continuing up to the present time, is associated with the late horn stage of development of the Caucasus. The formation of the Rukhs-Dzuar molass formation more than 2 km thick in the late Pleistocene in the Ossetian basin of the Tersky-Caspian flexure is associated with the activity of volcanoes in the Kazbek volcanic region. In the early Pleistocene, volcanic activity on the BC decreased significantly. The most intense outbreak of volcanism in the Kazbek and Elbrus volcanic regions occurred at the beginning of the late Pleistocene, which roughly coincided with the maximum phase of the late Pleistocene (Bezengian) glaciation. Then, in the second half of the late Pleistocene, volcanic activity was manifested on the mount Kazbek. The last outbreak of volcanic activity occurred in the Holocene no more than 2-3 thousand years ago. Fresh lavas are available on Elbrus, Kazbek, in the Terek valley near villages. Sioni and on the Kel volcanic plateau. Fumarolic activity still continues on Elbrus. Thus, in the Kazbek region, eruptions occurred from the late Pliocene to the late Holocene inclusive. Keywords: Pleistocene, Holocene, glaciation stages, nival-glacial processes, causes of glaciations, climate change, anthropogenic factors, natural factors, Earth degassing, magmatogenic degassing branch, seismotectonic degassing branch, greenhouse gases, newest geodynamics, volcanism, mud regimes, volcanism, methane hydrates, land degradation, water reclamation.

An outbreak of serotype-1 sequence type 306 invasive pneumococcal disease in an Australian Indigenous population.

Between 2010 and 2013, an outbreak of serotype-1 sequence type 306 (ST306) invasive pneumococcal disease (IPD) occurred primarily in remote locations of Northern and Central Australia. This is a descriptive study of the epidemiology of the outbreak using nationwide IPD surveillance data, supplemented with more detailed data held by affected jurisdictions, and of the response to the outbreak, including vaccination strategies. In the year the outbreak peaked (2011), serotype-1 IPD incidence was over 30-fold higher in the affected regions than in the rest of Australia (incidence rate ratio: 30.7 [95% CI 20.1-48.9]). The study includes 245 cases of serotype-1 IPD from the outbreak regions, with 75.5% identified as Indigenous. No reported cases of serotype-1 IPD occurred in young children who had completed either a 10- or 13-valent pneumococcal conjugate vaccine schedule. However serotype-1 IPD did occur in older children who had previously received 23-valent pneumococcal polysaccharide vaccine. Development of public-health-focused national IPD management guidelines, including suitable vaccine strategies for consistent use nationwide, could potentially decrease the duration and intensity of similar outbreaks in the future.

Predictability of European Winters 2017/2018 and 2018/2019: Contrasting influences from the Tropics and stratosphere

AbstractThe European winters of 2017–18 and 2018–19 were not climatically extreme, but both winters had a major sudden stratospheric warming (SSW). In February 2018, an SSW led to an intense cold outbreak across Europe and further spells of cold weather in March. The SSW of January 2019, although well predicted and expected to increase the chance of a cold end to winter, apparently produced little impact. In this study, we examine the performance of the Met Office seasonal prediction system in these winters, and the influences that led to these outcomes. To achieve this latter objective, sets of numerical experiments are performed in which the tropical troposphere and the extratropical stratosphere are relaxed towards their observed state, allowing the influence of each on the North Atlantic‐European atmospheric circulation to be identified. Using these experiments, we show that the SSWs had similar impacts in each case, creating a signal of easterly surface wind anomalies in the weeks following the event. In contrast, tropical influences were opposite in the two winters, acting to strengthen the easterly signal at the end of February 2018 and opposing it in January 2019. The different apparent responses to the two events therefore came about largely through tropical tropospheric variability. Furthermore, we highlight the importance of a very strong cycle of the Madden‐Julian Oscillation (MJO) in late January and early February 2018 as an important driver for the February 2018 SSW. MJO teleconnections appear to have been critical in creating the large mid‐latitude wave 2 amplitude that has been identified as the immediate cause of this event.

Extending the climatological concept of ‘Detection and Attribution’ to global change ecology in the Anthropocene

Abstract Research into global change ecology is motivated by the need to understand the role of humans in changing biotic systems. Mechanistic understanding of ecological responses requires the separation of different climatic parameters and processes that often operate on diverse spatiotemporal scales. Yet most environmental studies do not distinguish the effects of internal climate variability from those caused by external, natural (e.g. volcanic, solar, orbital) or anthropogenic (e.g. greenhouse gases, ozone, aerosols, land‐use) forcing factors. We suggest extending the climatological concept of ‘Detection and Attribution’ (DA) to unravel abiotic drivers of ecological dynamics in the Anthropocene. We therefore apply DA to quantify the relative roles of natural versus industrial temperature change on elevational shifts in the outbreak epicentres of the larch budmoth (LBM; Zeiraphera diniana or griseana Gn.); the classic example of a cyclic forest defoliating insect. Our case study shows that anthropogenic warming shifts the epicentre of travelling LBM waves upward, which disrupts the intensity of population outbreaks that occurred regularly over the past millennium in the European Alps. Our findings demonstrate the ability of DA to detect ecological responses beyond internal system variability, to attribute them to specific external climate forcing factors and to identify climate‐induced ecological tipping points. In order to implement the climatological concept of ‘Detection and Attribution’ successfully into modern global change ecology, future studies should combine high‐resolution paleoenvironmental reconstructions and state‐of‐the‐art climate model simulations to inform inference‐based ecosystem models. A free Plain Language Summary can be found within the Supporting Information of this article.

Association between mobility patterns and COVID-19 transmission in the USA: a mathematical modelling study

BackgroundWithin 4 months of COVID-19 first being reported in the USA, it spread to every state and to more than 90% of all counties. During this period, the US COVID-19 response was highly decentralised, with stay-at-home directives issued by state and local officials, subject to varying levels of enforcement. The absence of a centralised policy and timeline combined with the complex dynamics of human mobility and the variable intensity of local outbreaks makes assessing the effect of large-scale social distancing on COVID-19 transmission in the USA a challenge.MethodsWe used daily mobility data derived from aggregated and anonymised cell (mobile) phone data, provided by Teralytics (Zürich, Switzerland) from Jan 1 to April 20, 2020, to capture real-time trends in movement patterns for each US county, and used these data to generate a social distancing metric. We used epidemiological data to compute the COVID-19 growth rate ratio for a given county on a given day. Using these metrics, we evaluated how social distancing, measured by the relative change in mobility, affected the rate of new infections in the 25 counties in the USA with the highest number of confirmed cases on April 16, 2020, by fitting a statistical model for each county.FindingsOur analysis revealed that mobility patterns are strongly correlated with decreased COVID-19 case growth rates for the most affected counties in the USA, with Pearson correlation coefficients above 0·7 for 20 of the 25 counties evaluated. Additionally, the effect of changes in mobility patterns, which dropped by 35–63% relative to the normal conditions, on COVID-19 transmission are not likely to be perceptible for 9–12 days, and potentially up to 3 weeks, which is consistent with the incubation time of severe acute respiratory syndrome coronavirus 2 plus additional time for reporting. We also show evidence that behavioural changes were already underway in many US counties days to weeks before state-level or local-level stay-at-home policies were implemented, implying that individuals anticipated public health directives where social distancing was adopted, despite a mixed political message.InterpretationThis study strongly supports a role of social distancing as an effective way to mitigate COVID-19 transmission in the USA. Until a COVID-19 vaccine is widely available, social distancing will remain one of the primary measures to combat disease spread, and these findings should serve to support more timely policy making around social distancing in the USA in the future.FundingNone.

Modeling Pandemics, or, How Mathematics Changes the World

Modeling Pandemics, or, How Mathematics Changes the World Nathaniel Hupert (bio) it is a truism that mathematics laid the foundation for key advances in human achievement—agriculture, commerce, exploration, splitting the atom, the Internet—but rarely has there been a time when so few mathematical equations have so greatly changed the course of global events as in the winter of 2020.1 Pandemic models of the SARSCoV-2 virus, the cause of the infelicitously named COVID-19 disease that has gripped the world this year, have led to lockdowns of one sort or another in most countries of the world regardless of economic status or location. Some nations' responses come directly from central casting, so to speak: Germany with its comprehensive testing and top-notch clinical care; Taiwan with its remarkably efficient case finding and isolation. Others, however, have gone distinctly against type: Sweden with its seemingly (but not actually) laissez-faire approach; the United States playing perpetual catch-up after a series of out-of-character lapses from the vaunted Centers for Disease Control and Preventioncompounded by an ongoing crisis of leadership. Yet the constant across these and other nations' mobilizations is reliance on the work of a small band of mathematicians, physicists, and statisticians—mostly situated in London, Boston, Hong Kong, and Seattle; and largely using similar theoretical constructs based on the SEIR (susceptible, exposed, infectious, recovered) dynamic infectious disease model, which originated in the early twentieth century—who [End Page 253] within weeks of the first illnesses projected a combination of high case fatality and rapid propagation that quickly pushed aside any of the standard methods of policy deliberation: weighing costs and benefits, segmentation of interventions by risk group, and so on. The prospect of a 1918-like global death wave, reified by numbers and graphics and interactive websites, and quickly validated by peer review and university-backed press releases, was compelling enough that the global economy was reduced to a subset of "essential" local economies. One need only look up in spring 2020 to see what mathematics has wrought—clear skies without contrails, thanks to the more than 90 percent reduction in global air travel. How different from the early 1980s, when the human immunodeficiency virus (HIV) was for years ignored in plain sight, its lethal path traced mainly through already marginalized groups that had to fight for recognition and reaction from political and health authorities, as so eloquently described in many of the articles reprinted here. Yet here, too, there are emerging similarities between the AIDS and COVID crises, since all health catastrophes eventually compound the misery of the most vulnerable in society. Already in a number of high-income countries, the COVID pandemic has settled heavily on those who are least able to escape its path—individuals who due either to debility or destitution have to live or work in facilities where assurance of their health and safety lies in the hands of others. In the United States, for example, longterm care facilities now account for over half of the deaths from SARS-CoV-2 in many states, while prisons and slaughterhouses have been the sites of its most intense outbreaks. But worse is to come: the magnitude of the economic shock will, of course, be transmitted not to those holding the reins of the economy but to those already under its thumb. Virtually none of the models predicting COVID deaths factored in the long-term health and well-being of individuals whose lives are being transformed by the lockdowns and the consequent loss of livelihood. Paradoxically, the global reaction to a clinical disease whose age-predilection is clearly [End Page 254] skewed to the oldest among us may have its most widespread and durable impact on the youngest, factoring in the health and economic opportunity costs of the "lost spring" of 2020. Given our ongoing destruction of the natural world (a rampage that this global pause may give us a remarkable and unexpected opportunity to gauge), pandemics like COVID are likely to be more of a constant than an exception as we fully inhabit the Anthropocene. It is perhaps too low a bar to ask that, if anything valuable is to be learned...

The Significance of Fleas (Siphonaptera) in the Natural Plague Foci

The role of fleas in the manifestations of plague epizootics in the natural plague foci in Russia and adjacent states is discussed. The specific conditions of pathogen transmission in each focus are determined by the vital activities of several species of fleas that are parasites of the main plague carrier. These fleas have the nidicolous type of parasitism, facilitating wide spread of the plague microbe in the focus. Most of the natural plague foci include more than one vector species. The most intense epizootic outbreaks in each focus occur during the periods of active feeding and reproduction of the flea vectors.

Variation in host home range size decreases rabies vaccination effectiveness by increasing the spatial spread of rabies virus.

Animal movement influences the spatial spread of directly transmitted wildlife disease through host–host contact structure. Wildlife disease hosts vary in home range‐associated foraging and social behaviours, which may increase the spread and intensity of disease outbreaks. The consequences of variation in host home range movement and space use on wildlife disease dynamics are poorly understood, but could help to predict disease spread and determine more effective disease management strategies.We developed a spatially explicit individual‐based model to examine the effect of spatiotemporal variation in host home range size on the spatial spread rate, persistence and incidence of rabies virus (RABV) in raccoons (Procyon lotor). We tested the hypothesis that variation in home range size increases RABV spread and decreases vaccination effectiveness in host populations following pathogen invasion into a vaccination zone.We simulated raccoon demography and RABV dynamics across a range of magnitudes and variances in weekly home range size for raccoons. We examined how variable home range size influenced the relative effectiveness of three components of oral rabies vaccination (ORV) programmes targeting raccoons—timing and frequency of bait delivery, width of the ORV zone and proportion of hosts immunized.Variability in weekly home range size increased RABV spread rates by 1.2‐fold to 5.2‐fold compared to simulations that assumed a fixed home range size. More variable host home range sizes decreased relative vaccination effectiveness by 71% compared to less variable host home range sizes under conventional vaccination conditions. We found that vaccination timing was more influential for vaccination effectiveness than vaccination frequency or vaccination zone width.Our results suggest that variation in wildlife home range movement behaviour increases the spatial spread and incidence of RABV. Our vaccination results underscore the importance of prioritizing individual‐level space use and movement data collection to understand wildlife disease dynamics and plan their effective control and elimination.

Warming counteracts defoliation-induced mismatch by increasing herbivore-plant phenological synchrony.

Climate change is altering phenology; however, the magnitude of this change varies among taxa. Compared with phenological mismatch between plants and herbivores, synchronization due to climate has been less explored, despite its potential implications for trophic interactions. The earlier budburst induced by defoliation is a phenological strategy for plants against herbivores. Here, we tested whether warming can counteract defoliation-induced mismatch by increasing herbivore-plant phenological synchrony. We compared the larval phenology of spruce budworm and budburst in balsam fir, black spruce, and white spruce saplings subjected to defoliation in a controlled environment at temperatures of 12, 17, and 22°C. Budburst in defoliated saplings occurred 6-24days earlier than in the controls, thus mismatching needle development from larval feeding. This mismatch decreased to only 3-7days, however, when temperatures warmed by 5 and 10°C, leading to a resynchronization of the host with spruce budworm larvae. The increasing synchrony under warming counteracts the defoliation-induced mismatch, disrupting trophic interactions and energy flow between forest ecosystem and insect populations. Our results suggest that the predicted warming may improve food quality and provide better growth conditions for larval development, thus promoting longer or more intense insect outbreaks in the future.

Carfentanil Outbreak - Florida, 2016-2017.

Increased prevalence of illicitly manufactured fentanyl and fentanyl analogs has contributed substantially to overdose deaths in the United States (1-3). On October 26, 2015, CDC issued a Health Advisory regarding rapid increases in deaths involving fentanyl. This CDC Health Advisory has been updated twice to address increases in fentanyl and fentanyl analog overdoses and their co-occurrence with nonopioids (4). Deaths involving carfentanil, an analog reportedly 10,000 times more potent than morphine and 100 times more potent than fentanyl, were first reported in Florida, Michigan, and Ohio in 2016 and described in an August 2016 CDC Health Advisory (1,5). Carfentanil is used to rapidly immobilize large animals in veterinary medicine and has no U.S. approved therapeutic use in humans. Carfentanil's street price per dose is likely lower than that of heroin. During 2016 and 2017, an outbreak of carfentanil-involved fatal overdoses in Florida emerged, and the Medical Examiner jurisdiction serving Sarasota, Manatee, and DeSoto counties (the Sarasota area) was the outbreak epicenter. This report describes toxicology profiles, sociodemographic information, and geographic distributions of carfentanil-involved fatal overdoses (carfentanil deaths) in the Sarasota area compared with those in the rest of Florida (i.e., all Florida counties excluding Sarasota area) from January 2016 to December 2017. The Sarasota area accounted for 19.0% of 1,181 statewide carfentanil deaths that occurred during this time and experienced a peak in carfentanil deaths preceding the larger Florida outbreak. The report of a single carfentanil death from August to December 2017 (compared with 73 reported deaths during the same period in 2016) appeared to mark the end of the outbreak in the area. The threat of such rapid, intense fatal overdose outbreaks highlights the need for accelerated reporting, reliable data sharing systems, and novel proactive surveillance to support targeted prevention and response efforts by public health and safety organizations (6).

Future Reductions in Polar Cold Air Mass and Cold Air Outbreaks Revealed From Isentropic Analysis

AbstractThis study quantifies future changes in the polar cold air mass (PCAM) below a threshold potential temperature of 280 K and its horizontal fluxes, which are an indicator for the intensity of cold air outbreaks, by analyzing the outputs from five climate models from the Fifth Coupled Model Intercomparison Project. Under the business‐as‐usual scenario, the multimodel means of the wintertime total hemispheric PCAM decrease by 37% in the Northern Hemisphere and by 34% in the Southern Hemisphere by the end of the 21st century. The midlatitude equatorward PCAM fluxes are projected to decrease significantly by around 2050. This is primarily due to the reduction of the PCAM and to a lesser extent due to the weakening of the extratropical meridional circulation. Finally, intermodel differences in the total hemispheric PCAM reduction are shown to be linearly related to the climate sensitivity to the global mean surface air temperature.

Balancing Personal Privacy and Public Safety During COVID-19: The Case of South Korea.

There has been vigorous debate on how different countries responded to the COVID-19 pandemic. To secure public safety, South Korea actively used personal information at the risk of personal privacy whereas France encouraged voluntary cooperation at the risk of public safety. In this article, after a brief comparison of contextual differences with France, we focus on South Korea’s approaches to epidemiological investigations. To evaluate the issues pertaining to personal privacy and public health, we examine the usage patterns of original data, de-identification data, and encrypted data. Our specific proposal discusses the COVID index, which considers collective infection, outbreak intensity, availability of medical infrastructure, and the death rate. Finally, we summarize the findings and lessons for future research and the policy implications.

Impacts of Desert Dust Outbreaks on Air Quality in Urban Areas

Air pollution has many adverse effects on health and is associated with an increased risk of mortality. Desert dust outbreaks contribute directly to air pollution by increasing particulate matter concentrations. We investigated the influence of desert dust outbreaks on air quality in Santa Cruz de Tenerife, a city located in the dust export pathway off the west coast of North Africa, using air-quality observations from a six-year period (2012–2017). During winter intense dust outbreaks PM 10 mean (24-h) concentrations increased from 14 μ g m − 3 to 98 μ g m − 3 , on average, and PM 2 . 5 mean (24-h) concentrations increased from 6 μ g m − 3 to 32 μ g m − 3 . Increases were less during summer outbreaks, with a tripling of PM 10 and PM 2 . 5 daily mean concentrations. We found that desert dust outbreaks reduced the height of the marine boundary layer in our study area by >45%, on average, in summer and by ∼25%, on average, in winter. This thinning of the marine boundary layer was associated with an increase of local anthropogenic pollution during dust outbreaks. NO 2 and NO mean concentrations more than doubled and even larger relative increases in black carbon were observed during the more intense summer dust outbreaks; increases also occurred during the winter outbreaks but were less than in summer. This has public health implications; local anthropogenic emissions need to be reduced even further in areas that are impacted by desert dust outbreaks to reduce adverse health effects.

TRIA-Net: 10 years of collaborative research on turning risk into action for the mountain pine beetle epidemic

Forest insects are showing increasing intensity of outbreaks and expanded ranges, and this has become a major challenge for forest managers. An understanding of these systems often depends upon detailed examination of complex interactions involving multiple organisms. In 2013, a team of researchers formed TRIA-Net, an NSERC support Strategic Network, with the explicit goal of exploring such interactions in the mountain pine beetle (MPB; Dendroctonus ponderosae Hopkins, 1902) – pine (Pinus sp.) – blue stain fungi (Ophiostomatales) system. Contributions of this network include novel genetic and genomic resources and insights, as well as exploration of how landscape structure affects MPB movements. This review highlights the unique contributions of TRIA-Net to our understanding of the MPB outbreak system. We also highlight how the insights we generated can be used to inform management strategies — including assessing stand susceptibility, predicting spread, and developing better monitoring approaches — and how the approach taken by the TRIA project can be used as a model for tackling other challenging forest insect outbreaks.

Economic constraints as drivers of coffee rust epidemics in Nicaragua

Coffee rust (Hemileia vastatrix) epidemics of an intensity never seen before have hit Central America since 2012. This study set out to identify management and socio-economic factors that facilitate coffee rust development in Nicaragua and to learn how farmers perceive these epidemics. To that end, we conducted a series of interviews with farmers and carried out field observations a year after the peak of the 2012-13 epidemic. Twenty-nine pairs of plots (a pair was one heavily hit plot and another slightly hit plot in the same location) in the municipalities of Jinotega, Tuma-La Dalia and San Ramón were characterized for their management and coffee rust impact. This information was completed through interviews with the farmers. In addition, farmers provided their perception of the reasons for differences of coffee rust intensities between plots and information about their socio-economic situation. From multivariate analyses, we deduced that young coffee trees, timely applications of fungicides based on disease monitoring, shade pruning, and soil and foliar fertilizers seemed to be key practices in managing coffee rust. These practices were well known by the farmers, but socio-economic difficulties severely held back their application, as revealed by a mental model approach. Low coffee economic resources were particularly mentioned by farmers as a constraint to applying the practices needed to manage coffee rust. The highest coffee rust intensities and impacts were found in plots where the farmers, in general, had no education, no training, a low number of direct technical advices, and low incomes. To our knowledge, this is the first time that poor economic conditions have been related to the development of intense plant disease outbreaks. These relationships indicated that technical solutions to manage coffee rust are not sufficient and that economic solutions, where the market has a crucial role to play, need to be implemented.

Climate drives spatial variation in Zika epidemics in Latin America.

Between 2015 and 2017, Zika virus spread rapidly through populations in the Americas with no prior exposure to the disease. Although climate is a known determinant of many Aedes-transmitted diseases, it is currently unclear whether climate was a major driver of the Zika epidemic and how climate might have differentially impacted outbreak intensity across locations within Latin America. Here, we estimated force of infection for Zika over time and across provinces in Latin America using a time-varying susceptible–infectious–recovered model. Climate factors explained less than 5% of the variation in weekly transmission intensity in a spatio-temporal model of force of infection by province over time, suggesting that week to week transmission within provinces may be too stochastic to predict. By contrast, climate and population factors were highly predictive of spatial variation in the presence and intensity of Zika transmission among provinces, with pseudo-R2 values between 0.33 and 0.60. Temperature, temperature range, rainfall and population size were the most important predictors of where Zika transmission occurred, while rainfall, relative humidity and a nonlinear effect of temperature were the best predictors of Zika intensity and burden. Surprisingly, force of infection was greatest in locations with temperatures near 24°C, much lower than previous estimates from mechanistic models, potentially suggesting that existing vector control programmes and/or prior exposure to other mosquito-borne diseases may have limited transmission in locations most suitable for Aedes aegypti, the main vector of Zika, dengue and chikungunya viruses in Latin America.

Intense interseasonal influenza outbreaks, Australia, 2018/19.

BackgroundInterseasonal influenza outbreaks are not unusual in countries with temperate climates and well-defined influenza seasons. Usually, these are small and diminish before the main influenza season begins. However, the 2018/19 summer-autumn interseasonal influenza period in Australia saw unprecedented large and widespread influenza outbreaks.AimOur objective was to determine the extent of the intense 2018/19 interseasonal influenza outbreaks in Australia epidemiologically and examine the genetic, antigenic and structural properties of the viruses responsible for these outbreaks.MethodsThis observational study combined the epidemiological and virological surveillance data obtained from the Australian Government Department of Health, the New South Wales Ministry of Health, sentinel outpatient surveillance, public health laboratories and data generated by the World Health Organization Collaborating Centre for Reference and Research on Influenza in Melbourne and the Singapore Agency for Science, Technology and Research.ResultsThere was a record number of laboratory-confirmed influenza cases during the interseasonal period November 2018 to May 2019 (n= 85,286; 5 times the previous 3-year average) and also more institutional outbreaks, hospitalisations and deaths, than what is normally seen.ConclusionsThe unusually large interseasonal influenza outbreaks in 2018/19 followed a mild 2018 influenza season and resulted in a very early start to the 2019 influenza season across Australia. The reasons for this unusual event have yet to be fully elucidated but are likely to be a complex mix of climatic, virological and host immunity-related factors. These outbreaks reinforce the need for year-round surveillance of influenza, even in temperate climates with strong seasonality patterns.