The Impact of the Unstructured Contacts Component in Influenza Pandemic Modeling
Authored by Marco Ajelli, Stefano Merler
Date Published: 2008
DOI: 10.1371/journal.pone.0001519
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Abstract
Individual based models have become a valuable tool for modeling the
spatiotemporal dynamics of epidemics, e. g. influenza pandemic, and for
evaluating the effectiveness of intervention strategies. While specific
contacts among individuals into diverse environments (family, school/workplace) can be modeled in a standard way by employing
available socio-demographic data, all the other (unstructured) contacts
can be dealt with by adopting very different approaches. This can be
achieved for instance by employing distance-based models or by choosing
unstructured contacts in the local communities or by employing commuting
data. Methods/Results. Here we show how diverse choices can lead to
different model outputs and thus to a different evaluation of the
effectiveness of the containment/mitigation strategies. Sensitivity
analysis has been conducted for different values of the first generation
index G(0), which is the average number of secondary infections
generated by the first infectious individual in a completely susceptible
population and by varying the seeding municipality. Among the different
considered models, attack rate ranges from 19.1\% to 25.7\% for G(0)=
1.1, from 47.8\% to 50.7\% for G(0)= 1.4 and from 62.4\% to 67.8\% for
G(0)= 1.7. Differences of about 15 to 20 days in the peak day have been
observed. As regards spatial diffusion, a difference of about 100 days
to cover 200 km for different values of G(0) has been observed.
Conclusion. To reduce uncertainty in the models it is thus important to
employ data, which start being available, on contacts on neglected but
important activities (leisure time, sport mall, restaurants, etc.) and
time-use data for improving the characterization of the unstructured
contacts. Moreover, all the possible effects of different assumptions
should be considered for taking public health decisions: not only
sensitivity analysis to various model parameters should be performed, but intervention options should be based on the analysis and comparison
of different modeling choices.
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