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Biology subjects

Eisenberg, M. C.

Publications and source records attributed to Eisenberg, M. C..

4 recordsLinked to original sources

Surveillance of H5 HPAI in Michigan using retail milk

An outbreak of highly pathogenic avian influenza virus (HPAI) H5N1 in dairy cattle in the United States has spread to at least 136 dairy herds in 11 states. Due to a lack of testing, it has been difficult to determine the number of farms affected and the extent of intrastate spread. We report a pilot study of real time RT-PCR (rRT-PCR) detection of influenza A virus (IAV) in milk purchased from local markets across Michigan. Two out of 13 samples were positive for IAV nucleic acid, suggestive of HPAI H5N1 infection in the originating herds. This small study of a convenience sample suggests that milk-based surveillance might be useful if applied systematically either at dairy processors or point of sale.

microbiology↗

Modeling cholera transmission and vaccination in a refugee camp

BackgroundCholera remains a major public health concern, particularly in refugee camps, which may contend with overcrowding and scarcity of resources. Maela, the largest long-standing refugee camp in Thailand, experienced four cholera outbreaks between 2005 and 2010. In 2013, a cholera vaccine campaign was implemented in the camp. To assist in the evaluation of the campaign and planning for subsequent campaigns, we developed a mathematical model of cholera in Maela. MethodsWe formulated a Susceptible-Infectious-Water-Recovered-based cholera transmission model and estimated parameters using incidence data from 2010. We next evaluated the reduction in cases conferred by several immunization strategies, varying timing, effectiveness, and resources (i.e., vaccine availability). Finally, we generated post-campaign case forecasts, to determine whether a booster campaign was needed. ResultsWe found that preexposure vaccination can substantially reduce the risk of cholera even when the < 50% of the population is given the full two-dose series. Additionally, the preferred number of doses per person should be considered in the context of one vs. two dose effectiveness and vaccine availability. For reactive vaccination, a trade-off between timing and effectiveness was revealed, indicating that it may be beneficial to give one dose to more people rather than two doses to fewer people, given that a two-dose schedule would incur a delay in administration of the second dose. Forecasting using realistic coverage levels predicted that there was no need for a booster campaign in 2014 (consistent with our predictions, there was not a cholera epidemic in the 2014 season). ConclusionsOur analyses suggest that vaccination in conjunction with ongoing water sanitation and hygiene efforts provides an effective strategy for cholera outbreaks in refugee camps. Effective preexposure vaccination depends on timing and effectiveness. If a camp is facing an outbreak, delayed distribution of vaccines can substantially alter the effectiveness of reactive vaccination, suggesting that quick distribution of vaccines may be more important than ensuring every individual receives both vaccine doses.

epidemiology↗

Insights into Hepatitis C Transmission in Young Persons who Inject Drugs: Results From a Dynamic Modeling Approach Informed by State-Level Public Health Surveillance Data

Rising use of heroin and prescription opioids are major contributors to increases in Hepatitis C Virus (HCV) incidence in US young adults since the late 1990s. How best to interrupt transmission and decrease HCV prevalence in young persons who inject drugs (PWID) is uncertain, but modeling studies in older populations support interventions that increase HCV treatment among all PWID. We developed a transmission model of young (aged 15-30 years) PWID, which we fit to state-level US HCV surveillance data, and simulated the potential impact of primary (reducing injection initiation), secondary (increasing cessation, reducing injection partners, or reducing injection drug use relapse), and tertiary (HCV treatment) interventions on incident and prevalent HCV cases. Interventions with primary prevention initiatives (reducing injection initiation) yielded concurrent reductions to HCV incidence and prevalence. Treatment of former PWID led to prevalence reductions but did not reduce incidence. Treatment of current and former PWID without other interventions led to incidence reductions in scenarios with high injection initiation rates, high syringe sharing, and low relapse rates after injection cessation. While these results are specific to Michigan, our approach could be applied in other states conducting HCV surveillance to identify local-level intervention opportunities.

epidemiology↗

Practical unidentifiability of a simple vector-borne disease model: implications for parameter estimation and intervention assessment

BackgroundMathematical modeling has an extensive history in vector-borne disease epidemiology, and is increasingly used for prediction, intervention design, and understanding mechanisms. Many of these studies rely on parameter estimation to link models and data, and to tailor predictions and counterfactuals to specific settings. However, few studies have formally evaluated whether vector-borne disease models can properly estimate the parameters of interest given the constraints of a particular dataset.\n\nMethodology/Principle FindingsIdentifiability methods allow us to examine whether model parameters can be estimated uniquely--a lack of consideration of such issues can result in misleading or incorrect parameter estimates and model predictions. Here, we evaluate both structural (theoretical) and practical identifiability of a commonly used compartmental model of mosquitoborne disease, using 2010 dengue epidemic in Taiwan as a case study. We show that while the model is structurally identifiable, it is practically unidentifiable under a range of human and mosquito time series measurement scenarios. In particular, the transmission parameters form a practically identifiable combination and thus cannot be estimated separately, which can lead to incorrect predictions of the effects of interventions. However, in spite of unidentifiability of the individual parameters, the basic reproduction number was successfully estimated across the unidentifiable parameter ranges. These identifiability issues can be resolved by directly measuring several additional human and mosquito life-cycle parameters both experimentally and in the field.\n\nConclusionsWhile we only consider the simplest case for the model, without explicit environmental drivers, we show that a commonly used model of vector-borne disease is unidentifiable from human and mosquito incidence data, making it difficult or impossible to estimate parameters or assess intervention strategies. This work illustrates the importance of examining identifiability when linking models with data to make predictions, and particularly highlights the importance of combining experimental, field, and case data if we are to successfully estimate epidemiological and ecological parameters using models.\n\nAuthor SummaryMathematical models have seen increasing use in understanding transmission processes, developing interventions, and predicting disease incidence and prevalence. Vector-borne diseases in particular present both a challenge and an opportunity for modeling, due to the complex interactions between host and vector species. A key step in many of these studies is connecting transmission models with data to infer parameters and make useful predictions, which requires careful consideration of identifiability and uncertainty of the model parameters. Whether due to intrinsic limitations of the model structure, or practical limitations of the data collected, is common that many different parameter values may yield the same or very similar fits to the data, making it impossible to successfully estimate the parameters. This issue of parameter unidentifiability can have broad implications for our ability to draw conclusions from mechanistic models--in some cases making it difficult or impossible to generate specific predictions, forecasts, or parameter estimates from a given model and data. Here, we evaluate these questions for a commonly-used model of vectorborne disease, examining how parameter uncertainty and unidentifiability can affect intervention predictions, estimation of the basic reproduction number, and other public health conclusions drawn from the model.

epidemiology↗