Automatic case cluster detection using hospital electronic health record data

Case detection through contact tracing is a key intervention during an infectious disease outbreak. However, contact tracing is an intensive process where a given contact tracer must locate not only confirmed cases but also identify and interview known contacts. Often these data are manually recorded. During emerging outbreaks, the number of contacts could expand rapidly and beyond this, when focused on individual transmission chains, larger patterns may not be identified. Understanding if particular cases can be clustered and linked to a common source can help to prioritize contact tracing effects and understand underlying risk factors for large spreading events. Electronic health records systems are used by the vast majority of private healthcare systems across the USA, providing a potential way to automatically detect outbreaks and connect cases through already collected data. In this analysis, we propose an algorithm to identify case clusters within a community during an infectious disease outbreak using Bayesian probabilistic case linking and explore how this approach could supplement outbreak responses; especially when human contact tracing resources are limited.

A Semiparametric Bayesian Approach to Epidemics, with Application to the Spread of the Coronavirus MERS in South Korea in 2015

We consider incomplete observations of stochastic processes governing the spread of infectious diseases through finite populations by way of contact. We propose a flexible semiparametric modeling framework with at least three advantages. First, it enables researchers to study the structure of a population contact network and its impact on the spread of infectious diseases. Second, it can accommodate short- and long-tailed degree distributions and detect potential superspreaders, who represent an important public health concern. Third, it addresses the important issue of incomplete data. Starting from first principles, we show when the incomplete-data generating process is ignorable for the purpose of Bayesian inference for the parameters of the population model. We demonstrate the semiparametric modeling framework by simulations and an application to the partially observed MERS epidemic in South Korea in 2015. We conclude with an extended discussion of open questions and directions for future research.

EpiExploreR: A Shiny Web Application for the Analysis of Animal Disease Data

Emerging and re-emerging infectious diseases are a significant public and animal health threat. In some zoonosis, the early detection of virus spread in animals is a crucial early warning for humans. The analyses of animal surveillance data are therefore of paramount importance for public health authorities to identify the appropriate control measure and intervention strategies in case of epidemics. The interaction among host, vectors, pathogen and environment require the analysis of more complex and diverse data coming from different sources. There is a wide range of spatiotemporal methods that can be applied as a surveillance tool for cluster detection, identification of risk areas and risk factors and disease transmission pattern evaluation. However, despite the growing effort, most of the recent integrated applications still lack of managing simultaneously different datasets and at the same time making available an analytical tool for a complete epidemiological assessment. In this paper, we present EpiExploreR, a user-friendly, flexible, R-Shiny web application. EpiExploreR provides tools integrating common approaches to analyze spatiotemporal data on animal diseases in Italy, including notified outbreaks, surveillance of vectors, animal movements data and remotely sensed data. Data exploration and analysis results are displayed through an interactive map, tables and graphs. EpiExploreR is addressed to scientists and researchers, including public and animal health professionals wishing to test hypotheses and explore data on surveillance activities.