Imperial College London
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Dr Natsuko Imai

Faculty of Medicine, School of Public Health

Honorary Senior Research Fellow
 
 
 
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Contact

 

n.imai Website

 
 
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Location

 

G26Medical SchoolSt Mary's Campus

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Summary

 

Publications

Citation

BibTex format

@article{Djaafara:2020:aje/kwaa212,
author = {Djaafara, B and Imai, N and Hamblion, E and Impouma, B and Donnelly, C and Cori, A},
doi = {aje/kwaa212},
journal = {American Journal of Epidemiology},
pages = {642--651},
title = {A quantitative framework for defining the end of an infectious disease outbreak: application to Ebola virus disease},
url = {http://dx.doi.org/10.1093/aje/kwaa212},
volume = {190},
year = {2020}
}
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RIS format (EndNote, RefMan)

TY  - JOUR
AB  - The end-of-outbreak declaration is an important step in controlling infectious disease outbreaks. Objective estimation of the confidence level that an outbreak is over is important to reduce the risk of postdeclaration flare-ups. We developed a simulation-based model with which to quantify that confidence and tested it on simulated Ebola virus disease data. We found that these confidence estimates were most sensitive to the instantaneous reproduction number, the reporting rate, and the time between the symptom onset and death or recovery of the last detected case. For Ebola virus disease, our results suggested that the current World Health Organization criterion of 42 days since the recovery or death of the last detected case is too short and too sensitive to underreporting. Therefore, we suggest a shift to a preliminary end-of-outbreak declaration after 63 days from the symptom onset day of the last detected case. This preliminary declaration should still be followed by 90 days of enhanced surveillance to capture potential flare-ups of cases, after which the official end of the outbreak can be declared. This sequence corresponds to more than 95% confidence that an outbreak is over in most of the scenarios examined. Our framework is generic and therefore could be adapted to estimate end-of-outbreak confidence for other infectious diseases.
AU  - Djaafara,B
AU  - Imai,N
AU  - Hamblion,E
AU  - Impouma,B
AU  - Donnelly,C
AU  - Cori,A
DO  - aje/kwaa212
EP  - 651
PY  - 2020///
SN  - 0002-9262
SP  - 642
TI  - A quantitative framework for defining the end of an infectious disease outbreak: application to Ebola virus disease
T2  - American Journal of Epidemiology
UR  - http://dx.doi.org/10.1093/aje/kwaa212
UR  - https://academic.oup.com/aje/article/190/4/642/5922782
UR  - http://hdl.handle.net/10044/1/81340
VL  - 190
ER  -
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