Enterics

  • A modular approach to integrating multiple data sources into real-time clinical prediction for pediatric diarrhea

    Traditional clinical prediction models focus on parameters of the individual patient. For infectious diseases, sources external to the patient, including characteristics of prior patients and seasonal factors, may improve predictive performance. We describe the development of a predictive model that integrates multiple sources of data in a principled statistical framework using a post-test odds formulation.…

  • Mathematical modeling of endemic cholera transmission

    Mathematical modeling can be used to project the impact of mass vaccination on cholera transmission. Here, we discuss 2 examples for which indirect protection from mass vaccination needs to be considered. In the first, we show that nonvaccinees can be protected by mass vaccination campaigns. This additional benefit of indirect protection improves the cost-effectiveness of…

  • A modular approach to integrating multiple data sources into real-time clinical prediction for pediatric diarrhea

    Traditional clinical prediction models focus on parameters of the individual patient. For infectious diseases, sources external to the patient, including characteristics of prior patients and seasonal factors, may improve predictive performance. We describe the development of a predictive model that integrates multiple sources of data in a principled statistical framework using a post-test odds formulation.…

  • Multiscale model for forecasting Sabin 2 vaccine virus household and community transmission

    Since the global withdrawal of Sabin 2 oral poliovirus vaccine (OPV) from routine immunization, the Global Polio Eradication Initiative (GPEI) has reported multiple circulating vaccine-derived poliovirus type 2 (cVDPV2) outbreaks. Here, we generated an agent-based, mechanistic model designed to assess OPV-related vaccine virus transmission risk in populations with heterogeneous immunity, demography, and social mixing patterns.…

  • The cost of building an environmental surveillance system for typhoid

    Introduction The typhoid conjugate vaccine is a safe and effective method for preventing Salmonella enterica serovar Typhi (typhoid) and the WHO’s guidance supports its use in locations with ongoing transmission. However, many countries lack a robust clinical surveillance system, making it challenging to determine where to use the vaccine. Environmental surveillance is an alternative approach…

  • Cost-effectiveness of using environmental surveillance to target the roll-out typhoid conjugate vaccine

    Highlights • Environmental surveillance is an alternative to case-based surveillance. • Vaccine targeted to high-risk populations is less expensive than national campaigns. • Surveillance-based vaccine introductions are more cost-effective than blanket decisions. • Environmental surveillance is valuable, even if costs are higher than anticipated.

  • A modular approach to integrating multiple data sources into real-time clinical prediction for pediatric diarrhea

    Traditional clinical prediction models focus on parameters of the individual patient. For infectious diseases, sources external to the patient, including characteristics of prior patients and seasonal factors, may improve predictive performance. We describe the development of a predictive model that integrates multiple sources of data in a principled statistical framework using a post-test odds formulation.…

  • Community structure mediates Sabin 2 polio vaccine virus transmission

    Since the global withdrawal of Sabin 2 oral poliovirus vaccine (OPV) from routine immunization, the Global Polio Eradication Initiative (GPEI) has reported multiple circulating vaccine-derived poliovirus type 2 (cVDPV2) outbreaks. cVDPV2 outbreaks are controlled with mass Sabin 2 OPV vaccination campaigns, which carry a small but serious risk of seeding future cVDPV2 outbreaks. Accurate forecasting…

  • From Vaccine to Pathogen: Modeling Sabin 2 Vaccine Virus Reversion and Evolutionary Epidemiology

    The oral poliovirus vaccines (OPV) are one of most effective disease eradication tools in public health. However, the Sabin 2 vaccine strain can revert attenuation and cause outbreaks of circulating, vaccine-derived poliovirus (cVDPV2) that are clinically indistinguishable from wild poliovirus (WPV). Accurately assessing cVDP2 risk requires disentangling the complex interaction between epidemiology and evolutionary biology.…

  • The seasonality of diarrheal pathogens: A retrospective study of seven sites over three years

    Background: Pediatric diarrhea can be caused by a wide variety of pathogens, from bacteria to viruses to protozoa. Pathogen prevalence is often described as seasonal, peaking annually and associated with specific weather conditions. Although many studies have described the seasonality of diarrheal disease, these studies have occurred predominantly in temperate regions. In tropical and resource-constrained…