Junling Ma

Generality of the Final Size Formula for an Epidemic of a Newly Invading Infectious Disease

The well-known formula for the final size of an epidemic was published by Kermack and McKendrick in 1927. Their analysis was based on a simple susceptible-infected-recovered (SIR) model that assumes exponentially distributed infectious periods. More recent analyses have established that the standard final size formula is valid regardless of the distribution of infectious periods, but that it fails to be correct in the presence of certain kinds of heterogeneous mixing (e.g., if there is a core group, as for sexually transmitted diseases). We review previous work and establish more general conditions under which Kermack and McKendricks formula is valid. We show that the final size formula is unchanged if there is a latent stage, any number of distinct infectious stages and/or a stage during which infectives are isolated (the durations of each stage can be drawn from any integrable distribution). We also consider the possibility that the transmission rates of infectious individuals are arbitrarily distributed—allowing, in particular, for the existence of super-spreaders—and prove that this potential complexity has no impact on the final size formula. Finally, we show that the final size formula is unchanged even for a general class of spatial contact structures. We conclude that whenever a new respiratory pathogen emerges, an estimate of the expected magnitude of the epidemic can be made as soon the basic reproduction number ℝ0 can be approximated, and this estimate is likely to be improved only by more accurate estimates of ℝ0, not by knowledge of any other epidemiological details.

Effective degree network disease models

An effective degree approach to modeling the spread of infectious diseases on a network is introduced and applied to a disease that confers no immunity (a Susceptible-Infectious-Susceptible model, abbreviated as SIS) and to a disease that confers permanent immunity (a Susceptible-Infectious-Recovered model, abbreviated as SIR). Each model is formulated as a large system of ordinary differential equations that keeps track of the number of susceptible and infectious neighbors of an individual. From numerical simulations, these effective degree models are found to be in excellent agreement with the corresponding stochastic processes of the network on a random graph, in that they capture the initial exponential growth rates, the endemic equilibrium of an invading disease for the SIS model, and the epidemic peak for the SIR model. For each of these effective degree models, a formula for the disease threshold condition is derived. The threshold parameter for the SIS model is shown to be larger than that derived from percolation theory for a model with the same disease and network parameters, and consequently a disease may be able to invade with lower transmission than predicted by percolation theory. For the SIR model, the threshold condition is equal to that predicted by percolation theory. Thus unlike the classical homogeneous mixing disease models, the SIS and SIR effective degree models have different disease threshold conditions.

Vaccination against 2009 pandemic H1N1 in a population dynamical model of Vancouver, Canada: timing is everything

BackgroundMuch remains unknown about the effect of timing and prioritization of vaccination against pandemic (pH1N1) 2009 virus on health outcomes. We adapted a city-level contact network model to study different campaigns on influenza morbidity and mortality.MethodsWe modeled different distribution strategies initiated between July and November 2009 using a compartmental epidemic model that includes age structure and transmission network dynamics. The model represents the Greater Vancouver Regional District, a major North American city and surrounding suburbs with a population of 2 million, and is parameterized using data from the British Columbia Ministry of Health, published studies, and expert opinion. Outcomes are expressed as the number of infections and deaths averted due to vaccination.ResultsThe model output was consistent with provincial surveillance data. Assuming a basic reproduction number = 1.4, an 8-week vaccination campaign initiated 2 weeks before the epidemic onset reduced morbidity and mortality by 79-91% and 80-87%, respectively, compared to no vaccination. Prioritizing children and parents for vaccination may have reduced transmission compared to actual practice, but the mortality benefit of this strategy appears highly sensitive to campaign timing. Modeling the actual late October start date resulted in modest reductions in morbidity and mortality (13-25% and 16-20%, respectively) with little variation by prioritization scheme.ConclusionDelays in vaccine production due to technological or logistical barriers may reduce potential benefits of vaccination for pandemic influenza, and these temporal effects can outweigh any additional theoretical benefits from population targeting. Careful modeling may provide decision makers with estimates of these effects before the epidemic peak to guide production goals and inform policy. Integration of real-time surveillance data with mathematical models holds the promise of enabling public health planners to optimize the community benefits from proposed interventions before the pandemic peak.

Inferring the causes of the three waves of the 1918 influenza pandemic in England and Wales

Past influenza pandemics appear to be characterized by multiple waves of incidence, but the mechanisms that account for this phenomenon remain unclear. We propose a simple epidemic model, which incorporates three factors that might contribute to the generation of multiple waves: (i) schools opening and closing, (ii) temperature changes during the outbreak, and (iii) changes in human behaviour in response to the outbreak. We fit this model to the reported influenza mortality during the 1918 pandemic in 334 UK administrative units and estimate the epidemiological parameters. We then use information criteria to evaluate how well these three factors explain the observed patterns of mortality. Our results indicate that all three factors are important but that behavioural responses had the largest effect. The parameter values that produce the best fit are biologically reasonable and yield epidemiological dynamics that match the observed data well.

Mechanistic modelling of the three waves of the 1918 influenza pandemic

Influenza pandemics through history have shown very different patterns of incidence, morbidity and mortality. In particular, pandemics in different times and places have shown anywhere from one to three “waves” of incidence. Understanding the factors that underlie variability in temporal patterns, as well as patterns of morbidity and mortality, is important for public health planning. We use a likelihood-based approach to explore different potential explanations for the three waves of incidence and mortality seen in the 1918 influenza pandemic in London, England. Our analysis suggests that temporal variation in transmission rate provides the best proximate explanation and that the variation in transmission required to generate these three epidemic waves is within biologically plausible values.

Survival and Stationary Distribution Analysis of a Stochastic Competitive Model of Three Species in a Polluted Environment

In this paper, we develop and study a stochastic model for the competition of three species with a generalized dose–response function in a polluted environment. We first carry out the survival analysis and obtain sufficient conditions for the extinction, non-persistence, weak persistence in the mean, strong persistence in the mean and stochastic permanence. The threshold between weak persistence in the mean and extinction is established for each species. Then, using Hasminskii’s methods and a Lyapunov function, we derive sufficient conditions for the existence of stationary distribution for each population. Numerical simulations are carried out to support our theoretical results, and some biological significance is presented.

Reconstructing influenza incidence by deconvolution of daily mortality time series

We propose a mathematically straightforward method to infer the incidence curve of an epidemic from a recorded daily death curve and time-to-death distribution; the method is based on the Richardson–Lucy deconvolution scheme from optics. We apply the method to reconstruct the incidence curves for the 1918 influenza epidemic in Philadelphia and New York State. The incidence curves are then used to estimate epidemiological quantities, such as daily reproductive numbers and infectivity ratios. We found that during a brief period before the official control measures were implemented in Philadelphia, the drop in the daily number of new infections due to an average infector was much larger than expected from the depletion of susceptibles during that period; this finding was subjected to extensive sensitivity analysis. Combining this with recorded evidence about public behavior, we conclude that public awareness and change in behavior is likely to have had a major role in the slowdown of the epidemic even in a city whose response to the 1918 influenza epidemic is considered to have been among the worst in the U.S.

Effective degree household network disease model

An ordinary differential equation (ODE) epidemiological model for the spread of a disease that confers immunity, such as influenza, is introduced incorporating both network topology and households. Since most individuals of a susceptible population are members of a household, including the household structure as an aspect of the contact network in the population is of significant interest. Epidemic curves derived from the model are compared with those from stochastic simulations, and shown to be in excellent agreement. Expressions for disease threshold parameters of the ODE model are derived analytically and interpreted in terms of the household structure. It is shown that the inclusion of households can slow down or speed up the disease dynamics, depending on the variance of the inter-household degree distribution. This model illustrates how households (clusters) can affect disease dynamics in a complicated way.

Estimating Initial Epidemic Growth Rates

The initial exponential growth rate of an epidemic is an important measure of disease spread, and is commonly used to infer the basic reproduction number

Model for disease dynamics of a waterborne pathogen on a random network

\mathcal{R}_{0}