Counting and Accounting During an Outbreak: a Case Study of Measles in 2015-2016 Mongolia
Restricted (Penn State Only)
- Author:
- Dec Peevey, Dominika
- Graduate Program:
- Ecology (MS)
- Degree:
- Master of Science
- Document Type:
- Master Thesis
- Date of Defense:
- September 26, 2022
- Committee Members:
- Matthew Joseph Ferrari, Thesis Advisor/Co-Advisor
Jessica Maral Conway, Committee Member
Jason Kaye, Program Head/Chair
Ottar N Bjornstad, Thesis Advisor/Co-Advisor
Sagan Friant, Committee Member - Keywords:
- Outbreak
Disease Surveillance
Measles
Reported Cases
Hybrid Surveillance
Vaccination - Abstract:
- Infectious disease outbreaks persist globally for reasons ranging from emerging infectious diseases for which vaccines and therapies have not been developed to inadequate vaccination of at-risk individuals from historic and well-documented infectious agents. Surveillance for these infectious agents requires coordination between local, national, and global agencies. Emergency response campaigns must be coordinated among these same agencies to minimize morbidity and mortality locally, and limit potential regional spread. This research focuses on integrating clinical and diagnostic surveillance for disease surveillance and evaluating the impact of outbreak response campaigns. Specifically, I (i) utilize several predictive diagnostic models to estimate the reported burden of disease (RBOD) and (ii) evaluate the impact of two different outbreak response campaigns (ORCs) using methods that can be used in line with an outbreak and without the need for a control location or time. While methods for both surveillance and estimating of campaign impact can be generalized to any infectious agent and subsequent disease, here we will discuss a case study of a Mongolian measles outbreak between 2015 and 2016. I estimate that clinical surveillance alone overestimated the magnitude of measles infection in the 2015-2016 outbreak by 1.5-1.9 times. Both ORCs had positive impacts on the relative risk of the targeted age groups, but the second campaign was more successful in reducing the risk of infection in the whole age range as well as in temporally proximate age groups. The growth rate of the outbreak did not show significant reductions that could be explained by the ORCs indicating limited indirect reduction of transmission in non-target age groups.