Shaman, J. | Search bioRxiv

bioRxiv2018

Forecasting seasonal influenza in the U.S.: A collaborative multi-year, multi-model assessment of forecast performance

Influenza infects an estimated 9 to 35 million individuals each year in the United States and is a contributing cause for between 12,000 and 56,000 deaths annually. Seasonal outbreaks of influenza are common in temperate regions of the world, with highest incidence typically occurring in colder and drier months of the year. Real-time forecasts of influenza transmission can inform public health response to outbreaks. We present the results of a multi-institution collaborative effort to standardize the collection and evaluation of forecasting models for influenza in the US for the 2010/2011 through 2016/2017 influenza seasons. For these seven seasons, we assembled weekly real-time forecasts of 7 targets of public health interest from 22 different models. We compared forecast accuracy of each model relative to a historical baseline seasonal average. Across all regions of the US, over half of the models showed consistently better performance than the historical baseline when forecasting incidence of influenza-like illness 1, 2 and 3 weeks ahead of available data and when forecasting the timing and magnitude of the seasonal peak. In some regions, delays in data reporting were strongly and negatively associated with forecast accuracy. More timely reporting and an improved overall accessibility to novel and traditional data sources are needed to improve forecasting accuracy and its integration with real-time public health decision-making.

epidemiology↗

bioRxiv2017

Conjunction of Factors Triggering Waves of Seasonal Influenza

Understanding the subtle confluence of factors triggering pan-continental, seasonal epidemics of influenza-like illness is an extremely important problem, with the potential to save tens of thousands of lives and billions of dollars every year in the US alone. Beginning with several large, longitudinal datasets on putative factors and clinical data on the disease and health status of over 150 million human subjects observed over a decade, we investigated the source and the mechanistic triggers of epidemics. Our analysis included insurance claims for a significant cross-section of the US population in the past decade, human movement patterns inferred from billions of tweets, whole-US weekly weather data covering the same time span as the medical records, data on vaccination coverage over the same period, and sequence variations of key viral proteins. We also explicitly accounted for the spatio-temporal auto-correlations of infectious waves, and a host of socioeconomic and demographic factors. We carried out multiple orthogonal statistical analyses on these diverse, large geo-temporal datasets to bolster and corroborate our findings. We conclude that the initiation of a pan-continental influenza wave emerges from the simultaneous realization of a complex set of conditions, the strongest predictor groups are as follows, ranked by importance: (1) the host populations socio- and ethno-demographic properties; (2) weather variables pertaining to relevant area specific humidity, temperature, and solar radiation; (3) the virus antigenic drift over time; (4) the host populations land-based travel habits, and; (5) the spatio-temporal dynamics immediate history, as reflected in the influenza wave autocorrelation. The models we infer are demonstrably predictive (area under the Receiver Operating Characteristic curve {approx} 80%) when tested with out-of-sample data, opening the door to the potential formulation of new population-level intervention and mitigation policies.

epidemiology↗