Real-time analysis of the diphtheria outbreak in forcibly displaced Myanmar nationals in Bangladesh

Finger, Flavio; Funk, Sebastian; White, Kate; Siddiqui, Ruby; Edmunds, W. John; Kucharski, Adam J.

doi:10.1101/388645

Cited by 10 publications

(15 citation statements)

References 14 publications

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“…This definition may be practically relevant in a range of scenarios. For example, real-time analysis of a diphtheria epidemic in Cox Bazar's in Bangladesh involved assessing the number of hospital beds that were needed [46]. The number of beds required was approximated in that study by using a model to forecast disease incidence, assuming that 15% of reported cases would require treatment as inpatients with an average hospital stay of five days for each case.…”

Section: Discussionmentioning

confidence: 99%

“…Indeed, in the ongoing COVID-19 pandemic, one of the main aims of interventions in the UK has been to ensure that the number of individuals requiring intensive care unit beds remains below the total number of beds available [43][44][45]. More generally, the threshold capacity might derive from the number of available beds in hospitals or treatment units [46,47], or the availability of care workers [48]. This motivates consideration of the "concurrent size" metric above.…”

Section: Durationmentioning

confidence: 99%

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Will an outbreak exceed available resources for control? Estimating the risk from invading pathogens using practical definitions of a severe epidemic

Thompson

Gilligan

Cunniffe

2019

Preprint

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14Forecasting whether or not initial reports of disease will be followed by a major epidemic 15 is an important component of disease management. Most estimates of the probability of 16 a major epidemic involve assuming that infections occur according to a branching 17 process. Surprisingly, however, these calculations can be carried out without the factors 18 that differentiate a major epidemic from a minor outbreak ever being defined precisely. 19We assess potential implications of this lack of explicitness by considering the differences 20 between three practically relevant possible definitions of a major epidemic. Specifically, 21we consider a major epidemic as an outbreak in which: i) a large number of hosts are 22 infected simultaneously; ii) a large number of infections occur in total; and iii) disease 23 persists in the population for a long time. We calculate the probability of a major epidemic 24 under each of these definitions, initially considering the commonly used stochastic 25Susceptible-Infected-Susceptible model as a tractable case study allowing analytical 26 progress. We show how the probability of a major epidemic can either be similar to, or 27 very different from, the branching process estimate, depending on which definition of a 28 major epidemic is used. We also show, using other models, that this ambiguity continues 29 to hold in different epidemiological settings. In particular, we consider two additional 30 models: the stochastic Susceptible-Infected-Removed model, and a more complex host-31 vector model parameterised for Zika virus. Our work highlights how the precise definition 32 of a major epidemic must be considered carefully when estimating the risk posed by a 33 new outbreak. It also demonstrates that the precise definition of a major epidemic must 34 be tailored to the epidemiology of the host-pathogen system under consideration. 35 36 KEYWORDS 37 mathematical modelling; infectious disease epidemiology; major epidemic; forecasting 38 39 SHORT TITLE 40 Assessing the practically relevant risk of a major epidemic 41 42 AUTHOR SUMMARY 43When cases of disease are first reported in a new region or country, policy-makers must 44 decide if a disease control programme should be rolled out, as well as how to deploy 45 limited resources. Central to this assessment is understanding the risk of initial cases 46 generating a major epidemic as opposed to fading out as a minor outbreak in which only 47

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Section: Discussionmentioning

confidence: 99%

Section: Durationmentioning

confidence: 99%

Will an outbreak exceed available resources for control? Estimating the risk from invading pathogens using practical definitions of a severe epidemic

Thompson

Gilligan

Cunniffe

2019

Preprint

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“…Humanitarian needs assessments can be more climateinformed by including a review of the latest vulnerability and adaptation assessment or the Health National Adaptation Plan (H-NAP) as a component of their contextual assessment. Other useful resources include the UNFCCC -WHO Health and Climate Change Country Profiles that documents priority climate change and health impacts, how they are projected to develop according to different climate scenarios, and what actions are being planned or undertaken to address them [27].…”

Section: Climate-informed Humanitarian Needs Assessmentmentioning

confidence: 99%

‘Calibrating to scale: a framework for humanitarian health organizations to anticipate, prevent, prepare for and manage climate-related health risks’

et al. 2020

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Climate Change is adversely affecting health by increasing human vulnerability and exposure to climate-related stresses. Climate change impacts human health both directly and indirectly, through extreme weather events, changing distribution of health risks, increased risks of undernutrition, population displacement, and greater risks of injuries, disease, and death (Ebi, K., Campbell-Lendrum, D., & Wyns, A. The 1. 5 health report. WHO. 2018). This risk amplification is likely to increase the need for humanitarian support. Recent projections indicate that under a business as usual scenario of sustained greenhouse gas emissions, climate change could double the demand for humanitarian assistance by 2050 (World Health Organization. Operational Framework for building climate-resilient health systems. WHO. 2015). Humanitarian assistance is currently not meeting the existing needs, therefore, any additional burden is likely to be highly challenging. Global health advocates, researchers, and policymakers are calling for urgent action on climate change, yet there is little clarity on what that action practically entails for humanitarian organizations. While some humanitarian organizations may consider themselves well designed to respond, climate change as a transversal threat requires the incorporation of a resilience approach to humanitarian action and policy responses. By bringing together authors from two historically disparate fields-climate change and health, and humanitarian assistance this paper aims to increase the capacity of humanitarian organizations to protect health in an unstable climate by presenting an adapted framework. We adapted the WHO operational framework for climate-resilient health systems for humanitarian organizations and present concrete case studies to demonstrate how the framework can be implemented. Rather than suggest a redesign of humanitarian operations we recommend the application of a climate-lens to humanitarian activities, or what is also referred to as mainstreaming climate and health concerns into policies and programs. The framework serves as a starting point to encourage further dialogue, and to strengthen collaboration within, between, and beyond humanitarian organizations.

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“…1,2 Even though diphtheria can be prevented by immunization, it remains a major health problem in developing countries such as India, Thailand, and Bangladesh. [3][4][5] During an outbreak, the emergency department (ED) has an important role in identifying suspected cases and providing acute medical management, while controlling infection transmission. It needs to act fast by implementing the World Health Organization (WHO) guidelines for suspected infectious disease.…”

Section: Introductionmentioning

confidence: 99%

Triage in the Time of Diphtheria

Habib

Kurniawaty

2020

WestJEM

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Real-time analysis of the diphtheria outbreak in forcibly displaced Myanmar nationals in Bangladesh

Abstract: Background

Cited by 10 publications

References 14 publications

Will an outbreak exceed available resources for control? Estimating the risk from invading pathogens using practical definitions of a severe epidemic

Will an outbreak exceed available resources for control? Estimating the risk from invading pathogens using practical definitions of a severe epidemic

‘Calibrating to scale: a framework for humanitarian health organizations to anticipate, prevent, prepare for and manage climate-related health risks’

Triage in the Time of Diphtheria

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