Dataset Information

Refining Reproduction Number Estimates to Account for Unobserved Generations of Infection in Emerging Epidemics.

ABSTRACT:

Background

Estimating the transmissibility of infectious diseases is key to inform situational awareness and for response planning. Several methods tend to overestimate the basic (R0) and effective (Rt) reproduction numbers during the initial phases of an epidemic. In this work we explore the impact of incomplete observations and underreporting of the first generations of infections during the initial epidemic phase.

Methods

We propose a debiasing procedure that utilizes a linear exponential growth model to infer unobserved initial generations of infections and apply it to EpiEstim. We assess the performance of our adjustment using simulated data, considering different levels of transmissibility and reporting rates. We also apply the proposed correction to severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) incidence data reported in Italy, Sweden, the United Kingdom, and the United States.

Results

In all simulation scenarios, our adjustment outperforms the original EpiEstim method. The proposed correction reduces the systematic bias, and the quantification of uncertainty is more precise, as better coverage of the true R0 values is achieved with tighter credible intervals. When applied to real-world data, the proposed adjustment produces basic reproduction number estimates that closely match the estimates obtained in other studies while making use of a minimal amount of data.

Conclusions

The proposed adjustment refines the reproduction number estimates obtained with the current EpiEstim implementation by producing improved, more precise estimates earlier than with the original method. This has relevant public health implications.

SUBMITTER: Brizzi A

PROVIDER: S-EPMC9402635 | biostudies-literature | 2022 Aug

REPOSITORIES: biostudies-literature

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Publications

Refining Reproduction Number Estimates to Account for Unobserved Generations of Infection in Emerging Epidemics.

Brizzi Andrea A O'Driscoll Megan M Dorigatti Ilaria I

Clinical infectious diseases : an official publication of the Infectious Diseases Society of America 20220801 1

<h4>Background</h4>Estimating the transmissibility of infectious diseases is key to inform situational awareness and for response planning. Several methods tend to overestimate the basic (R0) and effective (Rt) reproduction numbers during the initial phases of an epidemic. In this work we explore the impact of incomplete observations and underreporting of the first generations of infections during the initial epidemic phase.<h4>Methods</h4>We propose a debiasing procedure that utilizes a linear ...[more]

PMID: 35176766

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Project description:BackgroundDengue, an infectious tropical disease, has recently emerged as one of the most important mosquito-borne viral diseases in the world. We perform a retrospective analysis of the 2011 dengue fever epidemic in Pakistan in order to assess the transmissibility of the disease. We obtain estimates of the basic reproduction number R 0 from epidemic data using different methodologies applied to different epidemic models in order to evaluate the robustness of our estimate.ResultsWe first estimate model parameters by fitting a deterministic ODE vector-host model for the transmission dynamics of single-strain dengue to the epidemic data, using both a basic ordinary least squares (OLS) as well as a generalized least squares (GLS) scheme. Moreover, we perform the same analysis for a direct-transmission ODE model, thereby allowing us to compare our results across different models. In addition, we formulate a direct-transmission stochastic model for the transmission dynamics of dengue and obtain parameter estimates for the stochastic model using Markov chain Monte Carlo (MCMC) methods. In each of the cases we have considered, the estimate for the basic reproduction number R 0 is initially greater than unity leading to an epidemic outbreak. However, control measures implemented several weeks after the initial outbreak successfully reduce R 0 to less than unity, thus resulting in disease elimination. Furthermore, it is observed that there is strong agreement in our estimates for the pre-control value of R 0, both across different methodologies as well across different models. However, there are also significant differences between our estimates for the post-control value of the basic reproduction number across the two different models.ConclusionIn conclusion, we have obtained robust estimates for the value of the basic reproduction number R 0 associated with the 2011 dengue fever epidemic before the implementation of public health control measures. Furthermore, we have shown that there is close agreement between our estimates for the post-control value of R 0 across the different methodologies. Nevertheless, there are also significant differences between the estimates for the post-control value of R 0 across the two different models.

Project description:Early estimates of the transmission potential of emerging and re-emerging infections are increasingly used to inform public health authorities on the level of risk posed by outbreaks. Existing methods to estimate the reproduction number generally assume exponential growth in case incidence in the first few disease generations, before susceptible depletion sets in. In reality, outbreaks can display subexponential (i.e. polynomial) growth in the first few disease generations, owing to clustering in contact patterns, spatial effects, inhomogeneous mixing, reactive behaviour changes or other mechanisms. Here, we introduce the generalized growth model to characterize the early growth profile of outbreaks and estimate the effective reproduction number, with no need for explicit assumptions about the shape of epidemic growth. We demonstrate this phenomenological approach using analytical results and simulations from mechanistic models, and provide validation against a range of empirical disease datasets. Our results suggest that subexponential growth in the early phase of an epidemic is the rule rather the exception. Mechanistic simulations show that slight modifications to the classical susceptible-infectious-removed model result in subexponential growth, and in turn a rapid decline in the reproduction number within three to five disease generations. For empirical outbreaks, the generalized-growth model consistently outperforms the exponential model for a variety of directly and indirectly transmitted diseases datasets (pandemic influenza, measles, smallpox, bubonic plague, cholera, foot-and-mouth disease, HIV/AIDS and Ebola) with model estimates supporting subexponential growth dynamics. The rapid decline in effective reproduction number predicted by analytical results and observed in real and synthetic datasets within three to five disease generations contrasts with the expectation of invariant reproduction number in epidemics obeying exponential growth. The generalized-growth concept also provides us a compelling argument for the unexpected extinction of certain emerging disease outbreaks during the early ascending phase. Overall, our approach promotes a more reliable and data-driven characterization of the early epidemic phase, which is important for accurate estimation of the reproduction number and prediction of disease impact.

Dataset Information

Refining Reproduction Number Estimates to Account for Unobserved Generations of Infection in Emerging Epidemics.

Background

Methods

Results

Conclusions

Publications

Refining Reproduction Number Estimates to Account for Unobserved Generations of Infection in Emerging Epidemics.

Similar Datasets

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