Title
Detecting Presymptomatic Infection Is Necessary To Forecast Major Epidemics In The Earliest Stages Of Infectious Disease Outbreaks
Abstract
We assess how presymptomatic infection affects predictability of infectious disease epidemics. We focus on whether or not a major outbreak (i.e. an epidemic that will go on to infect a large number of individuals) can be predicted reliably soon after initial cases of disease have appeared within a population. For emerging epidemics, significant time and effort is spent recording symptomatic cases. Scientific attention has often focused on improving statistical methodologies to estimate disease transmission parameters from these data. Here we show that, even if symptomatic cases are recorded perfectly, and disease spread parameters are estimated exactly, it is impossible to estimate the probability of a major outbreak without ambiguity. Our results therefore provide an upper bound on the accuracy of forecasts of major outbreaks that are constructed using data on symptomatic cases alone. Accurate prediction of whether or not an epidemic will occur requires records of symptomatic individuals to be supplemented with data concerning the true infection status of apparently uninfected individuals. To forecast likely future behavior in the earliest stages of an emerging outbreak, it is therefore vital to develop and deploy accurate diagnostic tests that can determine whether asymptomatic individuals are actually uninfected, or instead are infected but just do not yet show detectable symptoms.
Year
DOI
Venue
2016
10.1371/journal.pcbi.1004836
PLOS COMPUTATIONAL BIOLOGY
Field
DocType
Volume
Asymptomatic,Population,Transmission (mechanics),Disease,Biology,Epidemiology,Intensive care medicine,Outbreak,Bioinformatics,Infectious Disease Epidemiology,Virology,Infectious disease (medical specialty)
Journal
12
Issue
ISSN
Citations 
4
1553-734X
2
PageRank 
References 
Authors
0.53
0
3
Name
Order
Citations
PageRank
Robin N. Thompson121.88
Christopher A. Gilligan23710.33
Nik J. Cunniffe393.20