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Forecasting disease risk for increased epidemic preparedness in public health

Emerging infectious diseases pose a growing threat to human populations. Many of the world's epidemic diseases (particularly those transmitted by intermediate hosts) are known to be highly sensitive to long-term changes in climate and short-term fluctuations in the weather. The application of environmental data to the study of disease offers the capability to demonstrate vector-environment relationships and potentially forecast the risk of disease outbreaks or epidemics. Accurate disease forecasting models would markedly improve epidemic prevention and control capabilities. This chapter examines the potential for epidemic forecasting and discusses the issues associated with the development of global networks for surveillance and prediction. Existing global systems for epidemic preparedness focus on disease surveillance using either expert knowledge or statistical modelling of disease activity and thresholds to identify times and areas of risk. Predictive health information systems would use monitored environmental variables, linked to a disease system, to be observed and provide prior information of outbreaks. The components and varieties of forecasting systems are discussed with selected examples, along with issues relating to further development.

Disease Outbreaks↗

HI-STAR. Health Improvements through Space Technologies and Resources: Executive Summary

Our mission is to develop and promote a global strategy to help combat malaria using space technology. Like the tiny yet powerful mosquito, HI-STAR (Health Improvements Through Space Technologies and Resources) is a small program that aspires to make a difference. Timely detection of malaria danger zones is essential to help health authorities and policy makers make decisions about how to manage limited resources for combating malaria. In 2001, the technical support network for prevention and control of malaria epidemics published a study. HI-STAR focuses on malaria because it is the most common and deadly of the vector-borne diseases. Malaria also shares many commonalities with other diseases, which means the global strategy developed here may also be applicable to other parasitic diseases. HI-STAR would like to contribute to the many malaria groups already making great strides in the fight against malaria. Some examples include: Roll Back Malaria, The Special Program for Research and Training in Tropical Diseases (TDR) and the Multilateral Initiative on Malaria (MIM). Other important groups that are among the first to include space technologies in their model include: The Center for Health Application of Aerospace Related Technologies (CHAART) and Mapping Malaria Risk in Africa (MARA). Malaria is a complex and multi-faceted disease. Combating it must therefore be equally versatile. HI-STAR incorporates an interdisciplinary, international, intercultural approach.called 'Malaria Early Warning Systems; Concepts, Indicators and Partners.' This study, funded by Roll Back Malaria, a World Health Organization initiative, offers a framework for a monitoring and early warning system. HI-STAR seeks to build on this proposal and enhance the space elements of the suggested framework. It is the work of fifty-three professionals and students from the International Space University's 2002 Summer Session Program held in California, USA.

Finarelli, Margaret G.↗

Enhancing Human Health Using Space Imagery: Summary of Research

The International Space University (ISU) 2002 Summer Session was conducted in Pomona, California, June 29-August 30, 2002. Ninety-nine professionals and students from thirty-one countries attended the Summer Session. More than half of these students participated in the Student Research Design Project entitled, "HI-STAR: Health Improvements through Space Technologies and Resources." ISU's interdisciplinary Student Research Design Projects are intended to have great educational value for the participants and, at the same time, to result in a product that will be useful to the field. The HI-STAR project was a success on both counts. The mission of the ISU students' effort on HI-STAR was to develop and promote a global strategy to help combat malaria using space technology. Like the tiny yet powerful mosquito, HI-STAR is a small program that aspires to make a difference. Timely detection of malaria danger zones is essential to help health authorities and policy makers make decisions about how to manage limited resources for combating malaria. In 2001, the technical support network for prevention and control of malaria epidemics published a study called "Malaria Early Warning Systems: Concepts, Indicators and Partners." This study, funded by Roll Back Malaria, a World Health Organization initiative, offered a framework for a monitoring and early warning system. HI-STAR seeks to build on this proposal and enhance the space elements of the suggested framework. Malaria disease dynamics and distributions are related to environmental variables. From space, environmental conditions that support the growth of mosquito populations can be monitored, Malaria-specific information can be gathered from satellite-borne remote sensing instruments and ground-based sensors. This information can be integrated via geographic information systems (GIS) into a Malaria Information System (MIS) that can provide assessment analyses and risk maps as output. HI-STAR defines and suggests the development of an active MIS as a low-cost tool to help organizations plan their efforts to fight malaria.

Finarelli, Margaret G.↗

Meningitis and Climate: From Science to Practice

Meningococcal meningitis is a climate sensitive infectious disease. The regional extent of the Meningitis Belt in Africa, where the majority of epidemics occur, was originally defined by Lapeysonnie in the 1960s. A combination of climatic and environmental conditions and biological and social factors have been associated to the spatial and temporal patterns of epidemics observed since the disease first emerged in West Africa over a century ago. However, there is still a lack of knowledge and data that would allow disentangling the relative effects of the diverse risk factors upon epidemics. The Meningitis Environmental Risk Information Technologies Initiative (MERIT), a collaborative research-to-practice consortium, seeks to inform national and regional prevention and control strategies across the African Meningitis Belt through the provision of new data and tools that better determine risk factors. In particular MERIT seeks to consolidate a body of knowledge that provides evidence of the contribution of climatic and environmental factors to seasonal and year-to-year variations in meningococcal meningitis incidence at both district and national scales. Here we review recent research and practice seeking to provide useful information for the epidemic response strategy of National Ministries of Health in the Meningitis Belt of Africa. In particular the research and derived tools described in this paper have focused at "getting science into policy and practice" by engaging with practitioner communities under the umbrella of MERIT to ensure the relevance of their work to operational decision-making. We limit our focus to that of reactive vaccination for meningococcal meningitis. Important but external to our discussion is the development and implementation of the new conjugate vaccine, which specifically targets meningococcus A

Mineral dust↗

The Effect of Regional Climate Variability on Outbreak of Bartonellosis Epidemics in Peru

Bartonellosis is a vector-borne, highly fatal, emerging infectious disease, which has been known in the Peruvian Andes since the early 1600s and has continued to be a problem in many mountain valleys in Peru and other Andean South American countries. The causative bacterium, Bartonella bacilliformis (Bb), is believed to be transmitted to humans by bites of the sand fly Lutzomyia verrucarum. According to available medical records, the transmission of infection often occurs in river valleys of the Andes Mountains at an altitude between 800 and 3500 meters above sea level. It shows a seasonal pattern, which usually begins to rise in December, peaks in February and March, and is at its lowest from July until November. The epidemics of bartonellosis also vary interannually, occurring every four to eight years, and appear to be associated with the El Nino cycle. In response to the National Oceanic and Atmospheric Administration (NOAA) announcement on climate variability and human health, which was constructed to stimulate integrated multidisciplinary research in the area of climate variability and health interactions, we have conducted a study to investigate the relationship between the El Nino induced regional climate variation and the outbreak of bartonellosis epidemics in Peru. Two test sites, Caraz and Cusco, were selected for this study. According to reports, Caraz has a long-standing history of endemic transmission and Cusco, which is located about five degrees poleward of Caraz, had no recorded epidemics until the most recent 1997/1998 El Nino event. The goal of this study is to clarify the relative importance of climatic risk factors for each area that could be predicted in advance, thus allowing implementation of cost-effective control measures, which would reduce disease morbidity and mortality.

Zhou, Jia-Yu↗

Modeling Influenza Transmission Using Environmental Parameters

Influenza is an acute viral respiratory disease that has significant mortality, morbidity and economic burden worldwide. It infects approximately 5-15% of the world population, and causes 250,000 500,000 deaths each year. The role of environments on influenza is often drawn upon the latitude variability of influenza seasonality pattern. In regions with temperate climate, influenza epidemics exhibit clear seasonal pattern that peak during winter months, but it is not as evident in the tropics. Toward this end, we developed mathematical model and forecasting capabilities for influenza in regions characterized by warm climate Hong Kong (China) and Maricopa County (Arizona, USA). The best model for Hong Kong uses Land Surface Temperature (LST), precipitation and relative humidity as its covariates. Whereas for Maricopa County, we found that weekly influenza cases can be best modelled using mean air temperature as its covariates. Our forecasts can further guides public health organizations in targeting influenza prevention and control measures such as vaccination.

Soebiyanto, Radina P.↗

Obesity-related cardiovascular risk factors: intervention recommendations to decrease adolescent obesity

The incidence of adolescent obesity is increasing dramatically in the United States with associated risks of hypertension, adverse lipid profiles, and Type II diabetes. Unless reversed, this trend predicts an epidemic of adult cardiovascular disease. Interventions at home, at school, and in the community are required to empower teens to increase physical activity and to modify eating habits. This article describes assessment for obesity-related health problems as well as scientific guidelines and research-based intervention strategies to decrease obesity in adolescents.

Review↗