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Ebola is a highly infectious and often fatal zoonotic disease endemic to West and Central Africa. Local outbreaks of the disease are common, but the largest recorded Ebola epidemic originated in Guinea in December 2013, spreading to Liberia, and Sierra Leone in the following year and lasting until April 2016. The epidemic presented a serious challenge to local healthcare systems and foreign aid agencies: it degraded services, caused the loss of healthcare professionals, disrupted the economy, and reduced trust in modern healthcare. This study aims to estimate the extent to which variation in one long-term measure of the quality of local healthcare (the child vaccination rate) is a consequence of local variation in the intensity of the epidemic. Applying a "difference-in-differences" model to household survey data from before and after the epidemic, we show that in 2018-2019, overall rates of vaccination for BCG, DPT, measles, and polio are lower in Guinean and Sierra Leonean districts that had a relatively high incidence of Ebola; statistical analysis indicates that this is a causal effect. The effects of the epidemic on access to healthcare have been local effects, at least in part., (© 2024. The Author(s).)

COVID-19 has dramatically changed people's mobility geste patterns and affected the operations of different functional spots. In the environment of the successful reopening of countries around the world since 2022, it's pivotal to understand whether the reopening of different types of locales poses a threat of wide epidemic transmission. In this paper, by establishing an epidemiological model based on mobile network data, combining the data handed by the Safegraph website, and taking into account the crowd inflow characteristics and the changes of susceptible and latent populations, the trends of the number of crowd visits and the number of epidemic infections at different functional points of interest after the perpetration of continuing strategies were simulated. The model was also validated with daily new cases in ten metropolitan areas in the United States from March to May 2020, and the results showed that the model fitted the evolutionary trend of realistic data more accurately. Further, the points of interest were classified into risk levels, and the corresponding reopening minimum standard prevention and control measures were proposed to be implemented according to different risk levels. The results showed that restaurants and gyms became high-risk points of interest after the perpetration of the continuing strategy, especially the general dine-in restaurants were at higher risk levels. Religious exertion centers were the points of interest with the loftiest average infection rates after the perpetration of the continuing strategy. Points of interest such as convenience stores, large shopping malls, and pharmacies were at a lower risk for outbreak impact after the continuing strategy was enforced. Based on this, continuing forestallment and control strategies for different functional points of interest are proposed to provide decision support for the development of precise forestallment and control measures for different spots., (© 2023. The Author(s).)

Malaria is a fever condition that results from Plasmodium parasites, which are transferred to humans by the attacks of infected female Anopheles mosquitos. The deterministic compartmental model was examined using stability theory of differential equations. The reproduction number was obtained to be asymptotically stable conditions for the disease-free, and the endemic equilibria were determined. More so, the qualitatively evaluated model incorporates time-dependent variable controls which was aimed at reducing the proliferation of malaria disease. The reproduction number R o was determined to be an asymptotically stable condition for disease free and endemic equilibria. In this paper, we used various schemes such as Runge-Kutta order 4 (RK-4) and non-standard finite difference (NSFD). All of the schemes produce different results, but the most appropriate scheme is NSFD. This is true for all step sizes. Various criteria are used in the NSFD scheme to assess the local and global stability of disease-free and endemic equilibrium points. The Routh-Hurwitz condition is used to validate the local stability and Lyapunov stability theorem is used to prove the global asymptotic stability. Global asymptotic stability is proven for the disease-free equilibrium when R 0 ≤ 1 . The endemic equilibrium is investigated for stability when R 0 ≥ 1 . All of the aforementioned schemes and their effects are also numerically demonstrated. The comparative analysis demonstrates that NSFD is superior in every way for the analysis of deterministic epidemic models. The theoretical effects and numerical simulations provided in this text may be used to predict the spread of infectious diseases., (© 2024. The Author(s).)

Most of the countries in the world are affected by the coronavirus epidemic that put people in danger, with many infected cases and deaths. The crowding factor plays a significant role in the transmission of coronavirus disease. On the other hand, the vaccines of the covid-19 played a decisive role in the control of coronavirus infection. In this paper, a fractional order epidemic model (SIVR) of coronavirus disease is proposed by considering the effects of crowding and vaccination because the transmission of this infection is highly influenced by these two factors. The nonlinear incidence rate with the inclusion of these effects is a better approach to understand and analyse the dynamics of the model. The positivity and boundedness of the fractional order model is ensured by applying some standard results of Mittag Leffler function and Laplace transformation. The equilibrium points are described analytically. The existence and uniqueness of the non-integer order model is also confirmed by using results of the fixed-point theory. Stability analysis is carried out for the system at both the steady states by using Jacobian matrix theory, Routh-Hurwitz criterion and Volterra-type Lyapunov functions. Basic reproductive number is calculated by using next generation matrix. It is verified that disease-free equilibrium is locally asymptotically stable if R 0 < 1 and endemic equilibrium is locally asymptotically stable if R 0 > 1 . Moreover, the disease-free equilibrium is globally asymptotically stable if R 0 < 1 and endemic equilibrium is globally asymptotically stable if R 0 > 1 . The non-standard finite difference (NSFD) scheme is developed to approximate the solutions of the system. The simulated graphs are presented to show the key features of the NSFD approach. It is proved that non-standard finite difference approach preserves the positivity and boundedness properties of model. The simulated graphs show that the implementation of control strategies reduced the infected population and increase the recovered population. The impact of fractional order parameter α is described by the graphical templates. The future trends of the virus transmission are predicted under some control measures. The current work will be a value addition in the literature. The article is closed by some useful concluding remarks., (© 2024. The Author(s).)

Virus mutations give rise to new variants that cause multiple waves of pandemics and escalate the infected number of individuals. In this paper, we develop both a simple random network that we define as a synthesized human interaction network and an epidemiological model based on the microscopic process of disease spreading to describe the epidemic process with three variants in a population with some features of social structure. The features of social structure we take into account in the model are the average number of degrees and the frequency of contacts. This paper shows many computational results from several scenarios both in varying network structures and epidemiological parameters that cannot be obtained numerically by using the compartmental model., (© 2024. The Author(s).)

The Zika virus (ZIKV) is a serious global public health crisis. A major control challenge is its multiple transmission modes. This paper aims to simulate the transmission patterns of ZIKV using a dynamic process-based epidemiological model written in ordinary differential equations, which incorporates the human-to-mosquito infection by bites and sewage, mosquito-to-human infection by bites, and human-to-human infection by sex. Mathematical analyses are carried out to calculate the basic reproduction number and backward bifurcation, and prove the existence and stability of the equilibria. The model is validated with infection data by applying it to the 2015-2016 ZIKV epidemic in Brazil. The results indicate that the reproduction number is estimated to be 2.13, in which the contributions by mosquito bite, sex and sewage account for 85.7%, 3.5% and 10.8%, respectively. This number and the morbidity rate are most sensitive to parameters related to mosquito ecology, rather than asymptomatic or human-to-human transmission. Multiple transmission routes and suitable temperature exacerbate ZIKV infection in Brazil, and the vast majority of human infection cases were prevented by the intervention implemented. These findings may provide new insights to improve the risk assessment of ZIKV infection., (© 2024. The Author(s).)

Current link prediction strategies are about finding new probable strong relations to establish or weak ones to remove. An interesting strategy is utilizing link prediction to prioritize the edges in the network and finding newly probable established relations. In this paper we will introduce and explain RLP, reverse link prediction, as a new paradigm, and use popular basic scoring methods including CN, JC, AA, RA, and PA, as its core to examine. The test cases are nine datasets. Half of them are contact networks in different levels from personal contact to aviation, and another half is for covering different test situations. After reviewing the edge removal based epidemic mitigation methods, we show that RLP can be used to decrease the epidemics spreading speed as a general method with various link prediction algorithms, and here in this paper, preferential attachment (PA) has the best results overall. But the results heavily depend on the nature of the examined networks: regular, scale-free or small-world. We also propose an easy to understand criteria, path count, for comparing the efficacy of epidemics mitigation methods. RLP can be extended to use other link prediction scoring methods in various types of graphs as well. [ABSTRACT FROM AUTHOR]

Epidemic spatial–temporal risk analysis, e.g., infectious number forecasting, is a mainstream task in the multivariate time series research field, which plays a crucial role in the public health management process. With the rise of deep learning methods, many studies have focused on the epidemic prediction problem. However, recent primary prediction techniques face two challenges: the overcomplicated model and unsatisfactory interpretability. Therefore, this paper proposes an Interpretable Spatial IDentity (ISID) neural network to predict infectious numbers at the regional weekly level, which employs a light model structure and provides post-hoc explanations. First, this paper streamlines the classical spatio-temporal identity model (STID) and retains the optional spatial identity matrix for learning the contagion relationship between regions. Second, the well-known SHapley Additive explanations (SHAP) method was adopted to interpret how the ISID model predicts with multivariate sliding-window time series input data. The prediction accuracy of ISID is compared with several models in the experimental study, and the results show that the proposed ISID model achieves satisfactory epidemic prediction performance. Furthermore, the SHAP result demonstrates that the ISID pays particular attention to the most proximate and remote data in the input sequence (typically 20 steps long) while paying little attention to the intermediate steps. This study contributes to reliable and interpretable epidemic prediction through a more coherent approach for public health experts. [ABSTRACT FROM AUTHOR]

Taking major emergencies as the research background, the transmission mechanism for panic spread and the decision behaviour of the opinion field are explored in this paper. By using evolutionary game theory to explore the game relationship between the official opinion field and the public opinion field and by considering the existence of strategy dependency in the same game group, the dependence coefficient is introduced to improve replicator dynamics. The dynamic delayed SEIR evolutionary game model is built by combining the epidemic model with the delay effect within the group, and the stability of the proposed model is analysed. The research results show that the strategy dependency among the same game group has positive and negative effects on the evolution process. The evolution of the dynamic delayed panic SEIR evolutionary game spread model under the effect of a positive effect is simulated. The results suggest that the official opinion field and the public opinion field should actively deal with emergencies, formulate effective control strategies to make the panic within the group disappear, and provide theoretical guidance for the relevant government to formulate plans., (© 2023. Springer Nature Limited.)

Human monkeypox is a very unusual virus that can devastate society. Early identification and diagnosis are essential to treat and manage an illness effectively. Human monkeypox disease detection using deep learning models has attracted increasing attention recently. The virus that causes monkeypox may be passed to people, making it a zoonotic illness. The latest monkeypox epidemic has hit more than 40 nations. Computer-assisted approaches using Deep Learning techniques for automatically identifying skin lesions have shown to be a viable alternative in light of the fast proliferation and ever-growing problems of supplying PCR (Polymerase Chain Reaction) Testing in places with limited availability. In this research, we introduce a deep learning model for detecting human monkeypoxes that is accurate and resilient by tuning its hyper-parameters. We employed a mixture of convolutional neural networks and transfer learning strategies to extract characteristics from medical photos and properly identify them. We also used hyperparameter optimization strategies to fine-tune the Model and get the best possible results. This paper proposes a Yolov5 model-based method for differentiating between chickenpox and Monkeypox lesions on skin pictures. The Roboflow skin lesion picture dataset was subjected to three different hyperparameter tuning strategies: the SDG optimizer, the Bayesian optimizer, and Learning without Forgetting. The proposed Model had the highest classification accuracy (98.18%) when applied to photos of monkeypox skin lesions. Our findings show that the suggested Model surpasses the current best-in-class models and may be used in clinical settings for actual Human Monkeypox disease detection and diagnosis., (© 2023. Springer Nature Limited.)

Human mobility is a key driver of infectious disease spread. Recent literature has uncovered a clear pattern underlying the complexity of human mobility in cities: [Formula: see text], the product of distance traveled r and frequency of return f per user to a given location, is invariant across space. This paper asks whether the invariant [Formula: see text] also serves as a driver for epidemic spread, so that the risk associated with human movement can be modeled by a unifying variable [Formula: see text]. We use two large-scale datasets of individual human mobility to show that there is in fact a simple relation between r and f and both speed and spatial dispersion of disease spread. This discovery could assist in modeling spread of disease and inform travel policies in future epidemics-based not only on travel distance r but also on frequency of return f., (© 2023. Springer Nature Limited.)

Among the most important questions that await an answer in seismology, perhaps one is whether there is a correlation between the magnitudes of two successive seismic events. The answer to this question is considered of fundamental importance given the potential effect in forecasting models, such as Epidemic Type Aftershock Sequence models. After a meta-analysis of 29 papers, we speculate that given the lack of studies carried out with realistic physical models and given the possible bias due to the lack of events recorded in the experimental seismic catalogs, important improvements are necessary on both fronts to be sure to provide a statistically relevant answer. [ABSTRACT FROM AUTHOR]

Attacks on networks is a very important issue in developing strategies of eradicating spreads of malicious phenomena in networks, such as epidemics and fake information. This field of research is referred to as networks immunization. The traditional approach to evaluating the effectiveness of attacks on networks focuses on measuring macro parameters related to the entire attack, such as the critical probability of a percolation occurrence in the network [Formula: see text] and the relative size of the largest component in the network, known as the giant component, but not considering the attack on a micro perspective, which is the analysis of node removals, during an attack, themselves, their characteristics and results. In this paper we present and apply the last method of focusing on the micro scale of an attack. Based on the theory of percolation in networks, we analyze the phenomenon of an avalanche which results due to a single node removal from a network. An avalanche is a state in which a removal of a single node from the giant component of a network leads to the disconnection of additional nodes. This process significantly contributes to the fragmentation (immunization) of the network, comparing to the impact of the initial node removal alone. Specifically, we focus on the size parameter of an avalanche, which is the number of nodes that are disconnected from the giant component due to a single node removal. Relating to a random attack on a network of the type of Cayley tree, we derive analytically the distribution of the sizes of avalanches that occur during the entire attack on it, until the network is dismantled (immunized) and the attack is terminated., (© 2023. The Author(s).)

To model the COVID-19 infection and develop effective control measures, this paper proposes an SEIR-type epidemic model considering the impact of face-mask wearing and vaccination. Firstly, the effective reproduction number and the threshold conditions are obtained. Secondly, based on the data of South Korea from January 20, 2022 to March 21, 2022, the model parameters are estimated. Finally, a sensitivity analysis and the numerical study are conducted. The results show that the face-mask wearing is associated with [Formula: see text] and [Formula: see text] reductions in the numbers of cumulative cases and newly confirmed cases, respectively, after a period of 60 days, when the face mask wearing rate increases by [Formula: see text]. Furthermore, the vaccination rate is associated with [Formula: see text] and [Formula: see text] reductions in the numbers of cumulative cases and the newly confirmed cases, respectively, after the same period of 60 days when the vaccination rate is increased by [Formula: see text]. A combined measure involving face-mask wearing and vaccination may be more effective and reasonable in preventing and controlling this infection. It is also suggested that disease control departments should strongly recommended the wearing of face masks s as well as vaccination to prevent the unvaccinated people from becoming infected., (© 2023. The Author(s).)

Plant diseases introduce significant yield and quality losses to the food production industry, worldwide. Early identification of an epidemic could lead to more effective management of the disease and potentially reduce yield loss and limit excessive input costs. Image processing and deep learning techniques have shown promising results in distinguishing healthy and infected plants at early stages. In this paper, the potential of four convolutional neural network models, including Xception, Residual Networks (ResNet)50, EfficientNetB4, and MobileNet, in the detection of rust disease on three commercially important field crops was evaluated. A dataset of 857 positive and 907 negative samples captured in the field and greenhouse environments were used. Training and testing of the algorithms were conducted using 70% and 30% of the data, respectively where the performance of different optimizers and learning rates were tested. Results indicated that EfficientNetB4 model was the most accurate model (average accuracy = 94.29%) in the disease detection followed by ResNet50 (average accuracy = 93.52%). Adaptive moment estimation (Adam) optimizer and learning rate of 0.001 outperformed all other corresponding hyperparameters. The findings from this study provide insights into the development of tools and gadgets useful in the automated detection of rust disease required for precision spraying., (© 2023. The Author(s).)

The risk of epidemic spread of diseases in livestock poses a threat to animal and often also human health. Important for the assessment of the effect of control measures is a statistical model quantification of between-farm transmission during epidemics. In particular, quantification of the between-farm transmission kernel has proven its importance for a range of different diseases in livestock. In this paper we explore if a comparison of the different transmission kernels yields further insight. Our comparison identifies common features that connect across the different pathogen-host combinations analyzed. We conjecture that these features are universal and thereby provide generic insights. Comparison of the shape of the spatial transmission kernel suggests that, in absence of animal movement bans, the distance dependence of transmission has a universal shape analogous to Lévy-walk model descriptions of human movement patterns. Also, our analysis suggests that interventions such as movement bans and zoning, through their impact on these movement patterns, change the shape of the kernel in a universal fashion. We discuss how the generic insights suggested can be of practical use for assessing risks of spread and optimizing control measures, in particular when outbreak data is scarce., (© 2023. The Author(s).)

To quantitatively evaluate the impact of domestic aviation control measures on the spread of COVID-19 in China. The number of international flights from March to September 2019 simulated the number of flights from March to September 2020 without implementing aviation control measures. In addition, the proportion of asymptomatic persons and the delay in case reporting were adjusted to estimate the prevalence of each country during the same period and calculate the estimated imported cases. The estimated imported cases were assigned each day with weight, and the estimated daily reported cases were obtained based on the actual daily number of domestic cases in China. Effective Reproduction Number ([Formula: see text]) was calculated based on delayed distribution, Basic Reproductive Number ([Formula: see text]) distribution, and generation time distribution were reported in previous studies. Gaussian Process was used to estimate the effect of time-varying on [Formula: see text], and the estimated [Formula: see text] was compared with the actual [Formula: see text]. The estimated imported cases increased significantly compared with the actual number of imported cases. The estimated imported cases were mainly concentrated in North America and Europe from March to April and gradually increased in many East Asian countries from May to September. The difference between predicted [Formula: see text] and actual [Formula: see text] was statistically significant. The estimated imported cases and the estimated [Formula: see text] have increased compared to the actual situation. This paper quantitatively proves that Chinese aviation control measures significantly suppress the COVID-19 epidemic, which is conducive to promoting and applying this measure., (© 2022. The Author(s).)

A better understanding of various patterns in the coronavirus disease 2019 (COVID-19) spread in different parts of the world is crucial to its prevention and control. Motivated by the previously developed Global Epidemic and Mobility (GLEaM) model, this paper proposes a new stochastic dynamic model to depict the evolution of COVID-19. The model allows spatial and temporal heterogeneity of transmission parameters and involves transportation between regions. Based on the proposed model, this paper also designs a two-step procedure for parameter inference, which utilizes the correlation between regions through a prior distribution that imposes graph Laplacian regularization on transmission parameters. Experiments on simulated data and real-world data in China and Europe indicate that the proposed model achieves higher accuracy in predicting the newly confirmed cases than baseline models., (© 2022. The Author(s).)

As a highly contagious livestock viral disease, foot-and-mouth disease poses a great threat to the beef-cattle industry. Direct animal movement is always considered as a major route for between-farm transmission of FMD virus. Sharing contaminated equipment and vehicles have also attracted increasing interests as an indirect but considerable route for FMD virus transmission. With the rapid development of communication technologies, information-sharing techniques have been used to control epidemics. In this paper, we built farm-level time-series three-layer networks to simulate the between-farm FMD virus transmission in southwest Kansas by cattle movements (direct-contact layer) and truck visits (indirect-contact layer) and evaluate the impact of information-sharing techniques (information-sharing layer) on mitigating the epidemic. Here, the information-sharing network is defined as the structure that enables the quarantine of farms that are connected with infected farms. When a farm is infected, its infection status is shared with the neighboring farms in the information-sharing network, which in turn become quarantined. The results show that truck visits can enlarge the epidemic size and prolong the epidemic duration of the FMD outbreak by cattle movements, and that the information-sharing technique is able to mitigate the epidemic. The mitigation effect of the information-sharing network varies with the information-sharing network topology and different participation levels. In general, an increased participation leads to a decreased epidemic size and an increased quarantine size. We compared the mitigation performance of three different information-sharing networks (random network, contact-based network, and distance-based network) and found the outbreak on the network with contact-based information-sharing layer has the smallest epidemic size under almost any participation level and smallest quarantine size with high participation. Furthermore, we explored the potential economic loss from the infection and the quarantine. By varying the ratio of the average loss of quarantine to the loss of infection, we found high participation results in reduced economic losses under the realistic assumption that culling costs are much greater than quarantine costs., (© 2022. The Author(s).)

Jiangxi is one of the provinces in China most seriously affected by the haemorrhagic fever with renal syndrome (HFRS) epidemic. The aim of this paper was to systematically explore the HFRS epidemic in Jiangxi from the perspective of Hantavirus (HV) prevalence in rodents and humans and virus molecular characteristics. Individual information on all HFRS cases in Jiangxi from 2005 to 2021 was extracted from the China Information System for Disease Control and Prevention. All S and M fragment sequences of the Seoul virus and Hantan virus strains uploaded by Jiangxi and its neighbouring provinces and some representative sequences from provinces in China or some countries of Southeast Asia with the highest HV prevalence were retrieved and downloaded from NCBI GenBank. Periodogram and spatial autocorrelation were adopted for temporal periodicity and spatial clustering analysis of the HFRS epidemic. Joinpoint regression was utilized to explore the changing morbidity trend patterns of HFRS. Multiple sequence alignment and amino acid variation analysis were used to explore the homology and variation of strain prevalence in Jiangxi. Based on monthly morbidity time series, the periodogram analysis showed that the prevalence of HFRS had periodicities of 6 months and 12 months. Spatial autocorrelation analysis showed that HFRS distributed in Jiangxi was not random, with a "High-High" clustering area around Gaoan County. HFRS morbidity among the 0 ~ 15-year-old and ~ 61-year-old or older populations in Jiangxi increased significantly during the period of 2008–2015. Generally, HFRS morbidity was significantly positively correlated with the index of rat with virus (IRV) (r = 0.742) in the counties surrounding Gaoan from 2005 to 2019. HTNV strains in Jiangxi were in one independent branch, while the SEOV strains in Jiangxi were relatively more diverse. Both the YW89-15 and GAW30/2021 strains shared approximately 85% nucleotide homology and approximately 97% amino acid homology with their corresponding standard strains and vaccine strains. GAW30/2021 and YW89-15 had some amino acid site variations in nucleoprotein, glycoprotein precursor and RNA-dependent polymerase with their corresponding vaccine strains Z10 (HTNV) and Z37 (SEOV). The HFRS epidemic in Jiangxi has obvious temporal periodicity and spatial clustering, and the significant increase in the non-Immunization Expanded Program (EPI) targeted population (children and elderly) suggests that HFRS vaccination in this population needs to be considered. Although applying the EPI played a certain role in curbing the incidence of HFRS in Jiangxi from the perspective of ecological epidemiology, HTNV and SEOV strains prevalent in Jiangxi have some amino acid site variations compared to their corresponding vaccine strains, suggesting that HV variation needs to be continuously monitored in the future to observe vaccine protective efficiency. [ABSTRACT FROM AUTHOR]

Influenza is an infectious disease that leads to an estimated 5 million cases of severe illness and 650,000 respiratory deaths worldwide each year. The early detection and prediction of influenza outbreaks are crucial for efficient resource planning to save patient's lives and healthcare costs. We propose a new data-driven methodology for influenza outbreak detection and prediction at very local levels. A doctor's diagnostic dataset of influenza-like illness from more than 3000 clinics in Malaysia is used in this study because these diagnostic data are reliable and can be captured promptly. A new region index (RI) of the influenza outbreak is proposed based on the diagnostic dataset. By analysing the anomalies in the weekly RI value, potential outbreaks are identified using statistical methods. An ensemble learning method is developed to predict potential influenza outbreaks. Cross-validation is conducted to optimize the hyperparameters of the ensemble model. A testing data set is used to provide an unbiased evaluation of the model. The proposed methodology is shown to be sensitive and accurate at influenza outbreak prediction, with average of 75% recall, 74% precision, and 83% accuracy scores across five regions in Malaysia. The results are also validated by Google Flu Trends data, news reports, and surveillance data released by World Health Organization. [ABSTRACT FROM AUTHOR]

The mobility data of citizens provide important information on the epidemic spread including Covid-19. However, the privacy versus security dilemma hinders the utilization of such data. This paper proposed a method to generate pseudo mobility data on a per-agent basis, utilizing the actual geographical environment data provided by LBS to generate the agent-specific mobility trajectories and export them as GPS-like data. Demographic characteristics such as behavior patterns, gender, age, vaccination, and mask-wearing status are also assigned to the agents. A web-based data generator was implemented, enabling users to make detailed settings to meet different research needs. The simulated data indicated the usability of the proposed methods. [ABSTRACT FROM AUTHOR]

The novel coronavirus pneumonia (COVID-19) outbreak that emerged in late 2019 has posed a severe threat to human health and social and economic development, and thus has become a major public health crisis affecting the world. The spread of COVID-19 in population and regions is a typical geographical process, which is worth discussing from the geographical perspective. This paper focuses on Shandong province, which has a high incidence, though the first Chinese confirmed case was reported from Hubei province. Based on the data of reported confirmed cases and the detailed information of cases collected manually, we used text analysis, mathematical statistics and spatial analysis to reveal the demographic characteristics of confirmed cases and the spatio-temporal evolution process of the epidemic, and to explore the comprehensive mechanism of epidemic evolution and prevention and control. The results show that: (1) the incidence rate of COVID-19 in Shandong is 0.76/100,000. The majority of confirmed cases are old and middle-aged people who are infected by the intra-province diffusion, followed by young and middle-aged people who are infected outside the province. (2) Up to February 5, the number of daily confirmed cases shows a trend of "rapid increase before slowing down", among which, the changes of age and gender are closely related to population migration, epidemic characteristics and intervention measures. (3) Affected by the regional economy and population, the spatial distribution of the confirmed cases is obviously unbalanced, with the cluster pattern of "high–low" and "low–high". (4) The evolution of the migration pattern, affected by the geographical location of Wuhan and Chinese traditional culture, is dominated by "cross-provincial" and "intra-provincial" direct flow, and generally shows the trend of "southwest → northeast". Finally, combined with the targeted countermeasures of "source-flow-sink", the comprehensive mechanism of COVID-19 epidemic evolution and prevention and control in Shandong is revealed. External and internal prevention and control measures are also figured out. [ABSTRACT FROM AUTHOR]

We deal in this paper with a diffusive SIR epidemic model described by reaction-diffusion equations involving a fractional derivative. The existence and uniqueness of the solution are shown, next to the boundedness of the solution. Further, it has been shown that the global behavior of the solution is governed by the value of [Formula: see text], which is known in epidemiology by the basic reproduction number. Indeed, using the Lyapunov direct method it has been proved that the disease will extinct for [Formula: see text] for any value of the diffusion constants. For [Formula: see text], the disease will persist and the unique positive equilibrium is globally stable. Some numerical illustrations have been used to confirm our theoretical results., (© 2022. The Author(s).)

Identifying influential spreaders is an important task in controlling the spread of information and epidemic diseases in complex networks. Many recent studies have indicated that the identification of influential spreaders is dependent on the spreading dynamics. Finding a general optimal order of node importance ranking is difficult because of the complexity of network structures and the physical background of dynamics. In this paper, we use four metrics, namely, betweenness, degree, H-index, and coreness, to measure the central attributes of nodes for constructing the disease spreading models and target immunization strategies. Numerical simulations show that spreading processes based on betweenness centrality lead to the widest range of propagation and the smallest epidemic threshold for all six networks (including four real networks and two BA scale-free networks generated according to Barabasi-Albert algorithm). The target immunization strategy based on the betweenness centrality of nodes is the most effective for BA scale-free networks but displays poor immune effect for real networks in identifying the most important spreaders for disease control. The immunization strategy based on node degrees is the most effective for the four real networks. Findings show that the target immune strategy based on the betweenness centrality of nodes works best for standard scale-free networks, whereas that based on node degrees works best for other nonstandard scale-free networks. The results can provide insights into understanding the different metrics of measuring node importance in disease transmission and control., (© 2022. The Author(s).)

The 2018-2020 Ebola virus disease epidemic in Democratic Republic of the Congo (DRC) resulted in 3481 cases (probable and confirmed) and 2299 deaths. In this paper, we use a novel statistical method to analyze the individual-level incidence and hospitalization data on DRC Ebola victims. Our analysis suggests that an increase in the rate of quarantine and isolation that has shortened the infectiousness period by approximately one day during the epidemic's third and final wave was likely responsible for the eventual containment of the outbreak. The analysis further reveals that the total effective population size or the average number of individuals at risk for the disease exposure in three epidemic waves over the period of 24 months was around 16,000-a much smaller number than previously estimated and likely an evidence of at least partial protection of the population at risk through ring vaccination and contact tracing as well as adherence to strict quarantine and isolation policies., (© 2022. The Author(s).)

In recent years, research on methods for locating a source of spreading phenomena in complex networks has seen numerous advances. Such methods can be applied not only to searching for the "patient zero" in epidemics, but also finding the true sources of false or malicious messages circulating in the online social networks. Many methods for solving this problem have been established and tested in various circumstances. Yet, we still lack reviews that would include a direct comparison of efficiency of these methods. In this paper, we provide a thorough comparison of several observer-based methods for source localisation on complex networks. All methods use information about the exact time of spread arrival at a pre-selected group of vertices called observers. We investigate how the precision of the studied methods depends on the network topology, density of observers, infection rate, and observers' placement strategy. The direct comparison between methods allows for an informed choice of the methods for applications or further research. We find that the Pearson correlation based method and the method based on the analysis of multiple paths are the most effective in networks with synthetic or real topologies. The former method dominates when the infection rate is low; otherwise, the latter method takes over., (© 2022. The Author(s).)

COVID-19 pandemic response with non-pharmaceutical interventions is an intrinsic control problem. Governments weigh social distancing policies to avoid overload in the health system without significant economic impact. The mutability of the SARS-CoV-2 virus, vaccination coverage, and mobility restriction measures change epidemic dynamics over time. A model-based control strategy requires reliable predictions to be efficient on a long-term basis. In this paper, a SEIR-based model is proposed considering dynamic feedback estimation. State and parameter estimations are performed on state estimators using augmented states. Three methods were implemented: constrained extended Kalman filter (CEKF), CEKF and smoother (CEKF & S), and moving horizon estimator (MHE). The parameters estimation was based on vaccine efficacy studies regarding transmissibility, severity of the disease, and lethality. Social distancing was assumed as a measured disturbance calculated using Google mobility data. Data from six federative units from Brazil were used to evaluate the proposed strategy. State and parameter estimations were performed from 1 October 2020 to 1 July 2021, during which Zeta and Gamma variants emerged. Simulation results showed that lethality increased between 11 and 30% for Zeta mutations and between 44 and 107% for Gamma mutations. In addition, transmissibility increased between 10 and 37% for the Zeta variant and between 43 and 119% for the Gamma variant. Furthermore, parameter estimation indicated temporal underreporting changes in hospitalized and deceased individuals. Overall, the estimation strategy showed to be suitable for dynamic feedback as simulation results presented an efficient detection and dynamic characterization of circulating variants. [ABSTRACT FROM AUTHOR]

Early warning tools are crucial for the timely application of intervention strategies and the mitigation of the adverse health, social and economic effects associated with outbreaks of epidemic potential such as COVID-19. This paper introduces, the Epidemic Volatility Index (EVI), a new, conceptually simple, early warning tool for oncoming epidemic waves. EVI is based on the volatility of newly reported cases per unit of time, ideally per day, and issues an early warning when the volatility change rate exceeds a threshold. Data on the daily confirmed cases of COVID-19 are used to demonstrate the use of EVI. Results from the COVID-19 epidemic in Italy and New York State are presented here, based on the number of confirmed cases of COVID-19, from January 22, 2020, until April 13, 2021. Live daily updated predictions for all world countries and each of the United States of America are publicly available online. For Italy, the overall sensitivity for EVI was 0.82 (95% Confidence Intervals: 0.75; 0.89) and the specificity was 0.91 (0.88; 0.94). For New York, the corresponding values were 0.55 (0.47; 0.64) and 0.88 (0.84; 0.91). Consecutive issuance of early warnings is a strong indicator of main epidemic waves in any country or state. EVI's application to data from the current COVID-19 pandemic revealed a consistent and stable performance in terms of detecting new waves. The application of EVI to other epidemics and syndromic surveillance tasks in combination with existing early warning systems will enhance our ability to act swiftly and thereby enhance containment of outbreaks. [ABSTRACT FROM AUTHOR]

COVID-19 disease caused by the novel SARS-CoV-2 coronavirus has already brought unprecedented challenges for public health and resulted in huge numbers of cases and deaths worldwide. In the absence of effective vaccine, different countries have employed various other types of non-pharmaceutical interventions to contain the spread of this disease, including quarantines and lockdowns, tracking, tracing and isolation of infected individuals, and social distancing measures. Effectiveness of these and other measures of disease containment and prevention to a large degree depends on good understanding of disease dynamics, and robust mathematical models play an important role in forecasting its future dynamics. In this paper we focus on Ukraine, one of Europe's largest countries, and develop a mathematical model of COVID-19 dynamics, using latest data on parameters characterising clinical features of disease. For improved accuracy, our model includes age-stratified disease parameters, as well as age- and location-specific contact matrices to represent contacts. We show that the model is able to provide an accurate short-term forecast for the numbers and age distribution of cases and deaths. We also simulated different lockdown scenarios, and the results suggest that reducing work contacts is more efficient at reducing the disease burden than reducing school contacts, or implementing shielding for people over 60.

Internet technologies have demonstrated their value for the early detection and prediction of epidemics. In diverse cases, electronic surveillance systems can be created by obtaining and analyzing on-line data, complementing other existing monitoring resources. This paper reports the feasibility of building such a system with search engine and social network data. Concretely, this study aims at gathering evidence on which kind of data source leads to better results. Data have been acquired from the Internet by means of a system which gathered real-time data for 23 weeks. Data on influenza in Greece have been collected from Google and Twitter and they have been compared to influenza data from the official authority of Europe. The data were analyzed by using two models: the ARIMA model computed estimations based on weekly sums and a customized approximate model which uses daily sums. Results indicate that influenza was successfully monitored during the test period. Google data show a high Pearson correlation and a relatively low Mean Absolute Percentage Error (R = 0.933, MAPE = 21.358). Twitter results are slightly better (R = 0.943, MAPE = 18.742). The alternative model is slightly worse than the ARIMA(X) (R = 0.863, MAPE = 22.614), but with a higher mean deviation (abs. mean dev: 5.99% vs 4.74%).

Most popular statistical models in epidemic evolution focus on the dynamics of average relevant quantities and overlooks the role of small fluctuations on the model parameters. Models for Covid-19 are no exception. In this paper we show that the role of time-correlated fluctuations, far from being negligible, can in fact determine the spreading of an epidemic and, most importantly, the resurgence of the exponential diffusion in the presence of time-limited episodes in promiscuity behaviours. The results found in this work are not only relevant and specific for the Covid-19 epidemic but are more general and can be applied to other epidemics. [ABSTRACT FROM AUTHOR]

The current outbreak of coronavirus disease 2019 (COVID-19) has become a global crisis due to its quick and wide spread over the world. A good understanding of the dynamic of the disease would greatly enhance the control and prevention of COVID19. However, to the best of our knowledge, the unique features of the outbreak have limited the applications of all existing dynamic models. In this paper, a novel stochastic model was proposed aiming to account for the unique transmission dynamics of COVID-19 and capture the effects of intervention measures implemented in Mainland China. We found that: (1) instead of aberration, there was a remarkable amount of asymptomatic virus carriers, (2) a virus carrier with symptoms was approximately twice more likely to pass the disease to others than that of an asymptomatic virus carrier, (3) the transmission rate reduced significantly since the implementation of control measures in Mainland China, and (4) it was expected that the epidemic outbreak would be contained by early March in the selected provinces and cities in China. [ABSTRACT FROM AUTHOR]

In this paper, we present a regime-switching SIR epidemic model with a ratio-dependent incidence rate and degenerate diffusion. We utilize the Markov semigroup theory to obtain the existence of a unique stable stationary distribution. We prove that the densities of the distributions of the solutions can converge in L 1 to an invariant density under certain condition. Moreover, the sufficient conditions for the extinction of the disease, which means the disease will die out with probability one, are given in two cases. Meanwhile, we obtain a threshold parameter which can be utilized in identifying the stochastic extinction and persistence of the disease. Some numerical simulations are given to illustrate the analytical results.

In this paper, we consider the yearly influenza epidemic, as reflected in the seasonal surveillance data compiled by the CDC (Center for Disease Control and Prevention, USA) and we explore a new methodology for comparing specific features of these data. In particular, we focus on the ten HHS (Health and Human Services) regions, and how the incidence data evolves in these regions. In order to perform the comparisons, we consider the relative distribution of weekly new cases over one season and replace the crude data with predicted values. These predictions are obtained after fitting a negative binomial regression model that controls for important covariates. The prediction is computed on a 'generic' set of covariate values that takes into account the relative size (population wise) of the regions to be compared. The main results are presented in graphical form, that quickly emphasizes relevant features of the seasonal data and facilitates the comparisons.

Analysis of the topology of transcriptional regulatory networks (TRNs) is an effective way to study the regulatory interactions between the transcription factors (TFs) and the target genes. TRNs are characterized by the abundance of motifs such as feed forward loops (FFLs), which contribute to their structural and functional properties. In this paper, we focus on the role of motifs (specifically, FFLs) in signal propagation in TRNs and the organization of the TRN topology with FFLs as building blocks. To this end, we classify nodes participating in FFLs (termed motif central nodes) into three distinct roles (namely, roles A, B and C), and contrast them with TRN nodes having high connectivity on the basis of their potential for information dissemination, using metrics such as network efficiency, path enumeration, epidemic models and standard graph centrality measures. We also present the notion of a three tier architecture and how it can help study the structural properties of TRN based on connectivity and clustering tendency of motif central nodes. Finally, we motivate the potential implication of the structural properties of motif centrality in design of efficient protocols of information routing in communication networks as well as their functional properties in global regulation and stress response to study specific disease conditions and identification of drug targets. [ABSTRACT FROM AUTHOR]

The mpox epidemic in the UK began in May 2022, with rates of new cases unexpectedly and rapidly declining during August 2022. Interpreting trends in infection requires disentangling the underlying growth rate of cases from the delay from symptom onset to presenting to healthcare. We developed a nowcasting Bayesian method which incorporates time-varying delays (EpiLine) to quantify the changes in the delay from symptom onset to healthcare presentation and the underlying mpox growth rate over the period May-August 2022 in the UK. We show that the mean delay between symptom onset and healthcare presentation for mpox in the UK decreased from 22 days in early May 2022 to 10 days by early June and 8 days in August 2022. When we account for these dynamic delays, the time-varying growth rate declined gradually and continuously in the UK during the May-August 2022 period. Not accounting for varying time delays would have incorrectly characterised the growth rate by a sharp increase followed by a rapid decline in mpox cases. Our results highlight the importance of correctly quantifying the delay between symptom onset to healthcare presentation when characterising the epidemic growth of mpox in the UK. The gradual reduction in the rate of epidemic spread, which pre-dated the vaccine roll-out, is consistent with gradual risk reduction or acquired immunity amongst the highest risk individuals. Our study highlights the need for public health agencies to record the delays from symptom onset to healthcare presentation early in an outbreak. [ABSTRACT FROM AUTHOR]

Abstract Predicting epidemic evolution is essential for making informed decisions and guiding the implementation of necessary countermeasures. Computational models are vital tools that provide insights into illness progression and enable early detection, proactive intervention, and targeted preventive measures. This paper introduces Sybil, a framework that integrates machine learning and variant-aware compartmental models, leveraging a fusion of data-centric and analytic methodologies. To validate and evaluate Sybil’s forecasts, we employed COVID-19 data from several European and U.S. states. The dataset included the number of new and recovered cases, fatalities, and variant presence over time. We evaluate the forecasting precision of Sybil in periods in which there is a change in the trend of the pandemic evolution or a new variant appears. Results demonstrate that Sybil outperforms conventional data-centric approaches, being able to forecast accurately the changes in the trend, the magnitude of these changes, and the future prevalence of new variants.

Models of biological processes are often subject to different sources of noise. Developing an understanding of the combined effects of different types of uncertainty is an open challenge. In this paper, we study a variant of the susceptible-infective-recovered model of epidemic spread, which combines both agent-to-agent heterogeneity and intrinsic noise. We focus on epidemic cycles, driven by the stochasticity of infection and recovery events, and study in detail how heterogeneity in susceptibilities and propensities to pass on the disease affects these quasi-cycles. While the system can only be described by a large hierarchical set of equations in the transient regime, we derive a reduced closed set of equations for population-level quantities in the stationary regime. We analytically obtain the spectra of quasi-cycles in the linear-noise approximation. We find that the characteristic frequency of these cycles is typically determined by population averages of susceptibilities and infectivities, but that their amplitude depends on higher-order moments of the heterogeneity. We also investigate the synchronisation properties and phase lag between different groups of susceptible and infected individuals.

In this paper, we investigate a stochastic hybrid switching DS-I-A epidemic model. The extinction and the prevalence of the disease are discussed, and so, the threshold is given. Furthermore, the sufficient conditions for the existence of positive recurrence of the solutions are established by stochastic Lyapunov functions. At last, some examples and simulations are provided to illustrate our results.

Removing influential nodes or shortcuts in a network restrains epidemic or information diffusion, but this method destroys the connectivity of the network and changes the topological structure. As an alternative, an additional field can be imposed in the network to affect node behaviors and slow down diffusion dynamics. However, little research has been performed systematically to analyze and compare these methods. This paper investigates epidemic dynamics and proposes the following four methods to restrain the diffusion process: blocking nodes, blocking edges, distracting node attention, and propagating opposite information. We compare differences in the actions of these methods, and investigate their joint effects. Through numerical experiments in a scale-free network and a real network, we observe that these methods change the spreading threshold and final extent with different conditions. The method of blocking nodes is more efficient and economical than blocking edges. Propagating opposite information can effectively prevent diffusion of target information that has a large spreading rate, whereas distracting node attention only takes effect for the information with a small rate. Meanwhile, the effects of these two methods mainly depend on their action time. From the joint effects, we can select the optimal method for different situations.

The stochastic SEIR infectious diseases model with saturated incidence rate is studied in this paper. By constructing appropriate Lyapunov functions, we show that there is a stationary distribution for the system and the ergodicity holds provided [Formula: see text] > 1. In particular, we improve the results obtained by previous studies greatly, condition in our Theorem is more concise and elegant.

Individuals change their behavior during an epidemic in response to whether they and/or those they interact with are healthy or sick. Healthy individuals may utilize protective measures to avoid contracting a disease. Sick individuals may utilize preemptive measures to avoid spreading a disease. Yet, in practice both protective and preemptive changes in behavior come with costs. This paper proposes a stochastic network disease game model that captures the self-interests of individuals during the spread of a susceptible-infected-susceptible disease. In this model, individuals strategically modify their behavior based on current disease conditions. These reactions influence disease spread. We show that there is a critical level of concern, i.e., empathy, by the sick individuals above which disease is eradicated rapidly. Furthermore, we find that risk averse behavior by the healthy individuals cannot eradicate the disease without the preemptive measures of the sick individuals. Empathy is more effective than risk-aversion because when infectious individuals change behavior, they reduce all of their potential infections, whereas when healthy individuals change behavior, they reduce only a small portion of potential infections. This imbalance in the role played by the response of the infected versus the susceptible individuals on disease eradication affords critical policy insights.

Infectious diseases risk is directly related to human life safety. After the COVID-19 pandemic, people have paid unprecedented attention to the risk of infectious diseases. Compared with treatment after the outbreak of the epidemic, identifying the influencing factors of infectious disease risk and quantitatively analyzing and assessing infectious disease risk before the outbreak of the epidemic plays an equally important role. This article focuses on the risk of irregular outbreaks of infectious diseases. On the one hand, a method based on information gain is proposed to calculate the weight of environmental factors directly related to infectious disease risk, to clarify the correlation between environmental factors and infectious disease risk. On the other hand, the risk calculation method based on risk weight number is proposed to calculate the risk level of different infectious diseases under the influence of specific environmental factors. Finally, the effectiveness and feasibility of the proposed method are verified through case analysis and discussion. By comparing it with other risk assessment methods, the advantages and disadvantages of the proposed method are demonstrated. [ABSTRACT FROM AUTHOR]

Short-term forecast of pertussis incidence is helpful for advanced warning and planning resource needs for future epidemics. By utilizing the Auto-Regressive Integrated Moving Average (ARIMA) model and Exponential Smoothing (ETS) model as alterative models with R software, this paper analyzed data from Chinese Center for Disease Control and Prevention (China CDC) between January 2005 and June 2016. The ARIMA (0,1,0)(1,1,1)12 model (AICc = 1342.2 BIC = 1350.3) was selected as the best performing ARIMA model and the ETS (M,N,M) model (AICc = 1678.6, BIC = 1715.4) was selected as the best performing ETS model, and the ETS (M,N,M) model with the minimum RMSE was finally selected for in-sample-simulation and out-of-sample forecasting. Descriptive statistics showed that the reported number of pertussis cases by China CDC increased by 66.20% from 2005 (4058 cases) to 2015 (6744 cases). According to Hodrick-Prescott filter, there was an apparent cyclicity and seasonality in the pertussis reports. In out of sample forecasting, the model forecasted a relatively high incidence cases in 2016, which predicates an increasing risk of ongoing pertussis resurgence in the near future. In this regard, the ETS model would be a useful tool in simulating and forecasting the incidence of pertussis, and helping decision makers to take efficient decisions based on the advanced warning of disease incidence.

Several West African countries - Liberia, Sierra Leone and Guinea - experienced significant morbidity and mortality during the largest Ebola epidemic to date, from late 2013 through 2015. The extent of the epidemic was fueled by outbreaks in large urban population centers as well as movement of the pathogen between populations. During the epidemic there was no known vaccine or drug, so effective disease control required coordinated efforts that include both standard medical and community practices such as hospitalization, quarantine and safe burials. Due to the high connectivity of the region, control of the epidemic not only depended on internal strategies but also was impacted by neighboring countries. In this paper, we use a deterministic framework to examine the role of movement between two populations in the overall success of practices designed to minimize the extent of Ebola epidemics. We find that it is possible for even small amounts of intermixing between populations to positively impact the control of an epidemic on a more global scale.

Information diffusion and disease spreading in communication-contact layered network are typically asymmetrically coupled with each other, in which disease spreading can be significantly affected by the way an individual being aware of disease responds to the disease. Many recent studies have demonstrated that human behavioral adoption is a complex and non-Markovian process, where the probability of behavior adoption is dependent on the cumulative times of information received and the social reinforcement effect of the cumulative information. In this paper, the impacts of such a non-Markovian vaccination adoption behavior on the epidemic dynamics and the control effects are explored. It is found that this complex adoption behavior in the communication layer can significantly enhance the epidemic threshold and reduce the final infection rate. By defining the social cost as the total cost of vaccination and treatment, it can be seen that there exists an optimal social reinforcement effect and optimal information transmission rate allowing the minimal social cost. Moreover, a mean-field theory is developed to verify the correctness of simulation results.

Quantifying the attack ratio of disease is key to epidemiological inference and public health planning. For multi-serotype pathogens, however, different levels of serotype-specific immunity make it difficult to assess the population at risk. In this paper we propose a Bayesian method for estimation of the attack ratio of an epidemic and the initial fraction of susceptibles using aggregated incidence data. We derive the probability distribution of the effective reproductive number, Rt, and use MCMC to obtain posterior distributions of the parameters of a single-strain SIR transmission model with time-varying force of infection. Our method is showcased in a data set consisting of 18 years of dengue incidence in the city of Rio de Janeiro, Brazil. We demonstrate that it is possible to learn about the initial fraction of susceptibles and the attack ratio even in the absence of serotype specific data. On the other hand, the information provided by this approach is limited, stressing the need for detailed serological surveys to characterise the distribution of serotype-specific immunity in the population.

Pierce's disease (PD) is a vector-borne disease caused by the bacteria Xylella fastidiosa, which affects grapevines in the Americas. Currently, vineyards in continental Europe, the world's largest producer of quality wine, have not yet been affected by PD. However, climate change may alter this situation. Here we incorporate the latest regional climate change projections into a climate-driven epidemiological model to assess the risk of PD epidemics in Europe for different levels of global warming. We found a significant increase in risk above + 2 ∘ C in the main wine-producing regions of France, Italy and Portugal, in addition to a critical tipping point above + 3 ∘ C for the possible spread of PD beyond the Mediterranean. The model identifies decreasing risk trends in Spain, as well as contrasting patterns across the continent with different velocities of risk change and epidemic growth rates. Although there is some uncertainty in model projections over time, spatial patterns of risk are consistent across different climate models. Our study provides a comprehensive analysis of the future of PD at multiple spatial scales (country, Protected Designation of Origin and vineyard), revealing where, why and when PD could become a new threat to the European wine industry. [ABSTRACT FROM AUTHOR]

Acute respiratory infection (ARI) is a communicable disease of the respiratory tract that implies impaired breathing. The infection can expand from one to the neighboring areas at a region-scale level through a human mobility network. Specific to this study, we leverage a record of ARI incidences in four periods of outbreaks for 42 regions in Jakarta to study its spatio-temporal spread using the concept of the epidemic forest. This framework generates a forest-like graph representing an explicit spread of disease that takes the onset time, spatio-temporal distance, and case prevalence into account. To support this framework, we use logistic curves to infer the onset time of the outbreak for each region. The result shows that regions with earlier onset dates tend to have a higher burden of cases, leading to the idea that the culprits of the disease spread are those with a high load of cases. To justify this, we generate the epidemic forest for the four periods of ARI outbreaks and identify the implied dominant trees (that with the most children cases). We find that the primary infected city of the dominant tree has a relatively higher burden of cases than other trees. In addition, we can investigate the timely ( R t ) and spatial reproduction number ( R c ) by directly evaluating them from the inferred graphs. We find that R t for dominant trees are significantly higher than non-dominant trees across all periods, with regions in western Jakarta tend to have higher values of R c . Lastly, we provide simulated-implied graphs by suppressing 50% load of cases of the primary infected city in the dominant tree that results in a reduced R c , suggesting a potential target of intervention to depress the overall ARI spread. [ABSTRACT FROM AUTHOR]