A dynamic neural network model for real-time prediction of the Zika epidemic in the Americas

Abstract

BackgroundIn 2015 the Zika virus spread from Brazil throughout the Americas, posing an unprecedented challenge to the public health community. During the epidemic, international public health officials lacked reliable predictions of the outbreaks expected geographic scale and prevalence of cases, and were therefore unable to plan and allocate surveillance resources in a timely and effective manner.\n\nMethodsIn this work we present a dynamic neural network model to predict the geographic spread of outbreaks in real-time. The modeling framework is flexible in three main dimensions i) selection of the chosen risk indicator, i.e., case counts or incidence rate, ii) risk classification scheme, which defines the relative size of the high risk group, and iii) prediction forecast window (one up to 12 weeks). The proposed model can be applied dynamically throughout the course of an outbreak to identify the regions expected to be at greatest risk in the future.\n\nResultsThe model is applied to the recent Zika epidemic in the Americas at a weekly temporal resolution and country spatial resolution, using epidemiological data, passenger air travel volumes, vector habitat suitability, socioeconomic and population data for all affected countries and territories in the Americas. The model performance is quantitatively evaluated based on the predictive accuracy of the model. We show that the model can accurately predict the geographic expansion of Zika in the Americas with the overall average accuracy remaining above 85% even for prediction windows of up to 12 weeks.\n\nConclusionsSensitivity analysis illustrated the model performance to be robust across a range of features. Critically, the model performed consistently well at various stages throughout the course of the outbreak, indicating its potential value at the early stages of an epidemic. The predictive capability was superior for shorter forecast windows, and geographically isolated locations that are predominantly connected via air travel. The highly flexible nature of the proposed modeling framework enables policy makers to develop and plan vector control programs and case surveillance strategies which can be tailored to a range of objectives and resource constraints.