Inferring the risk factors behind the geographical spread and transmission of Zika in the Americas.

BACKGROUND:An unprecedented Zika virus epidemic occurred in the Americas during 2015-2016. The size of the epidemic in conjunction with newly recognized health risks associated with the virus attracted significant attention across the research community. Our study complements several recent studies...

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Bibliographic Details
Published in:PLOS Neglected Tropical Diseases
Main Authors: Lauren M Gardner, András Bóta, Karthik Gangavarapu, Moritz U G Kraemer, Nathan D Grubaugh
Format: Article in Journal/Newspaper
Language:English
Published: Public Library of Science (PLoS) 2018
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Online Access:https://doi.org/10.1371/journal.pntd.0006194
https://doaj.org/article/2face3a14e184368b305c74b825e7575
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Summary:BACKGROUND:An unprecedented Zika virus epidemic occurred in the Americas during 2015-2016. The size of the epidemic in conjunction with newly recognized health risks associated with the virus attracted significant attention across the research community. Our study complements several recent studies which have mapped epidemiological elements of Zika, by introducing a newly proposed methodology to simultaneously estimate the contribution of various risk factors for geographic spread resulting in local transmission and to compute the risk of spread (or re-introductions) between each pair of regions. The focus of our analysis is on the Americas, where the set of regions includes all countries, overseas territories, and the states of the US. METHODOLOGY/PRINCIPAL FINDINGS:We present a novel application of the Generalized Inverse Infection Model (GIIM). The GIIM model uses real observations from the outbreak and seeks to estimate the risk factors driving transmission. The observations are derived from the dates of reported local transmission of Zika virus in each region, the network structure is defined by the passenger air travel movements between all pairs of regions, and the risk factors considered include regional socioeconomic factors, vector habitat suitability, travel volumes, and epidemiological data. The GIIM relies on a multi-agent based optimization method to estimate the parameters, and utilizes a data driven stochastic-dynamic epidemic model for evaluation. As expected, we found that mosquito abundance, incidence rate at the origin region, and human population density are risk factors for Zika virus transmission and spread. Surprisingly, air passenger volume was less impactful, and the most significant factor was (a negative relationship with) the regional gross domestic product (GDP) per capita. CONCLUSIONS/SIGNIFICANCE:Our model generates country level exportation and importation risk profiles over the course of the epidemic and provides quantitative estimates for the likelihood of introduced Zika virus ...