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BackgroundMeasles cases continue to occur among susceptible individuals despite the elimination of endemic measles transmission in the United States. Clustering of disease susceptibility can threaten herd immunity and impact the likelihood of disease outbreaks in a highly vaccinated population. Previous studies have examined the role of contact tracing to control infectious diseases among clustered populations, but have not explicitly modeled the public health response using an agent-based model.MethodsWe developed an agent-based simulation model of measles transmission using the Framework for Reconstructing Epidemiological Dynamics (FRED) and the Synthetic Population Database maintained by RTI International. The simulation of measles transmission was based on interactions among individuals in different places: households, schools, daycares, workplaces, and neighborhoods. The model simulated different levels of immunity clustering, vaccination coverage, and contact investigations with delays caused by individuals' behaviors and/or the delay in a health department's response. We examined the effects of these characteristics on the probability of uncontrolled measles outbreaks and the outbreak size in 365 days after the introduction of one index case into a synthetic population.ResultsWe found that large measles outbreaks can be prevented with contact investigations and moderate contact rates by having (1) a very high vaccination coverage (≥ 95%) with a moderate to low level of immunity clustering (≤ 0.5) for individuals aged less than or equal to 18 years, or (2) a moderate vaccination coverage (85% or 90%) with no immunity clustering for individuals (≤ 18 years of age), a short intervention delay, and a high probability that a contact can be traced. Without contact investigations, measles outbreaks may be prevented by the highest vaccination coverage with no immunity clustering for individuals (≤ 18 years of age) with moderate contact rates; but for the highest contact rates, even the highest coverage with no immunity clustering for individuals (≤ 18 years of age) cannot completely prevent measles outbreaks.ConclusionsThe simulation results demonstrated the importance of vaccination coverage, clustering of immunity, and contact investigations in preventing uncontrolled measles outbreaks.

Abstract Background During the 2009 H1N1 influenza epidemic, policy makers debated over whether, when, and how long to close schools. While closing schools could have reduced influenza transmission thereby preventing cases, deaths, and health care costs, it may also have incurred substantial costs from increased childcare needs and lost productivity by teachers and other school employees. Methods A combination of agent-based and Monte Carlo economic simulation modeling was used to determine the cost-benefit of closing schools (vs. not closing schools) for different durations (range: 1 to 8 weeks) and symptomatic case incidence triggers (range: 1 to 30) for the state of Pennsylvania during the 2009 H1N1 epidemic. Different scenarios varied the basic reproductive rate (R0) from 1.2, 1.6, to 2.0 and used case-hospitalization and case-fatality rates from the 2009 epidemic. Additional analyses determined the cost per influenza case averted of implementing school closure. Results For all scenarios explored, closing schools resulted in substantially higher net costs than not closing schools. For R0 = 1.2, 1.6, and 2.0 epidemics, closing schools for 8 weeks would have resulted in median net costs of $21.0 billion (95% Range: $8.0 - $45.3 billion). The median cost per influenza case averted would have been $14,185 ($5,423 - $30,565) for R0 = 1.2, $25,253 ($9,501 - $53,461) for R0 = 1.6, and $23,483 ($8,870 - $50,926) for R0 = 2.0. Conclusions Our study suggests that closing schools during the 2009 H1N1 epidemic could have resulted in substantial costs to society as the potential costs of lost productivity and childcare could have far outweighed the cost savings in preventing influenza cases.

Background: Measles cases continue to occur among susceptible individuals despite the elimination of endemic measles transmission in the United States. Clustering of disease susceptibility can threaten herd immunity and impact the likelihood of disease outbreaks in a highly vaccinated population. Previous studies have examined the role of contact tracing to control infectious diseases among clustered populations, but have not explicitly modeled the public health response using an agent-based model. Methods: We developed an agent-based simulation model of measles transmission using the Framework for Reconstructing Epidemiological Dynamics (FRED) and the Synthetic Population Database maintained by RTI International. The simulation of measles transmission was based on interactions among individuals in different places: households, schools, daycares, workplaces, and neighborhoods. The model simulated different levels of immunity clustering, vaccination coverage, and contact investigations with delays caused by individuals' behaviors and/or the delay in a health department's response. We examined the effects of these characteristics on the probability of uncontrolled measles outbreaks and the outbreak size in 365 days after the introduction of one index case into a synthetic population. Results: We found that large measles outbreaks can be prevented with contact investigations and moderate contact rates by having (1) a very high vaccination coverage (≥ 95%) with a moderate to low level of immunity clustering (≤ 0.5) for individuals aged less than or equal to 18 years, or (2) a moderate vaccination coverage (85% or 90%) with no immunity clustering for individuals (≤18 years of age), a short intervention delay, and a high probability that a contact can be traced. Without contact investigations, measles outbreaks may be prevented by the highest vaccination coverage with no immunity clustering for individuals (≤18 years of age) with moderate contact rates; but for the highest contact rates, even the highest coverage with no immunity clustering for individuals (≤18 years of age) cannot completely prevent measles outbreaks. Conclusions: The simulation results demonstrated the importance of vaccination coverage, clustering of immunity, and contact investigations in preventing uncontrolled measles outbreaks. [ABSTRACT FROM AUTHOR]

The pervasive and potentially severe economic, social, and public health consequences of infectious disease in farmed animals require that plans be in place for a rapid response. Increasingly, agent-based models are being used to analyze the spread of animal-borne infectious disease outbreaks and derive policy alternatives to control future outbreaks. Although the locations, types, and sizes of animal farms are essential model inputs, no public domain nationwide geospatial database of actual farm locations and characteristics currently exists in the United States. This report describes a novel method to develop a synthetic dataset that replicates the spatial distribution of poultry farms, as well as the type and number of birds raised on them. It combines county-aggregated poultry farm counts, land use/land cover, transportation, business, and topographic data to generate locations in the conterminous United States where poultry farms are likely to be found. Simulation approaches used to evaluate the accuracy of this method when compared to that of a random placement alternative found this method to be superior. The results suggest the viability of adapting this method to simulate other livestock farms of interest to infectious disease researchers.

In 2005, RTI International researchers developed methods to generate synthesized population data on US households for the US Synthesized Population Database. These data are used in agent-based modeling, which simulates large-scale social networks to test how changes in the behaviors of individuals affect the overall network. Group quarters are residences where individuals live in close proximity and interact frequently. Although the Synthesized Population Database represents the population living in households, data for the nation's group quarters residents are not easily quantified because of US Census Bureau reporting methods designed to protect individuals' privacy.Including group quarters population data can be an important factor in agent-based modeling because the number of residents and the frequency of their interactions are variables that directly affect modeling results. Particularly with infectious disease modeling, the increased frequency of agent interaction may increase the probability of infectious disease transmission between individuals and the probability of disease outbreaks.This report reviews our methods to synthesize data on group quarters residents to match US Census Bureau data. Our goal in developing the Group Quarters Population Database was to enable its use with RTI's US Synthesized Population Database in the Modeling of Infectious Diseases Agent Study.

Communicable-disease transmission models are useful for the testing of prevention and intervention strategies. Agent-based models (ABMs) represent a new and important class of the many types of disease transmission models in use. Agent-based disease models benefit from their ability to assign disease transmission probabilities based on characteristics shared by individual agents. These shared characteristics allow ABMs to apply transmission probabilities when agents come together in geographic space. Modeling these types of social interactions requires data, and the results of the model largely depend on the quality of these input data. We initially generated a synthetic population for the United States, in support of the Models of Infectious Disease Agent Study. Subsequently, we created shared characteristics to use in ABMs. The specific goals for this task were to assign the appropriately aged populations to schools, workplaces, and public transit. Each goal presented its own challenges and problems; therefore, we used different techniques to create each type of shared characteristic. These shared characteristics have allowed disease models to more realistically predict the spread of disease, both spatially and temporally.

By understanding the movement patterns of people, mathematical modelers can develop models that can better analyze and predict the spread of infectious diseases. People can come into close contact in their workplaces. This report describes methods to develop georeferenced commuting patterns that can be used to characterize the work-related movement of US populations and help agent-based modelers predict workplace contacts that result in disease transmission. We used a census data product called "Census Spatial Tabulation: Census Track of Work by Census Tract of Residence (STP64)" as the data source to develop commuting pattern data for agent-based synthesized populations databases and to develop map products to visualize commuting patterns in the United States. The three primary maps we developed show inbound, outbound, and net change levels of inbound versus outbound commuters by census tract for the year 2000. Net change counts of commuters are visualized as elevations. The results can be used to quantify and assign commuting patterns of synthesized populations among different census tracts.

Agent-based models simulate large-scale social systems. They assign behaviors and activities to "agents" (individuals) within the population being modeled and then allow the agents to interact with the environment and each other in complex simulations. Agent-based models are frequently used to simulate infectious disease outbreaks, among other uses.RTI used and extended an iterative proportional fitting method to generate a synthesized, geospatially explicit, human agent database that represents the US population in the 50 states and the District of Columbia in the year 2000. Each agent is assigned to a household; other agents make up the household occupants.For this database, RTI developed the methods for generating synthesized households and personsassigning agents to schools and workplaces so that complex interactions among agents as they go about their daily activities can be taken into accountgenerating synthesized human agents who occupy group quarters (military bases, college dormitories, prisons, nursing homes).In this report, we describe both the methods used to generate the synthesized population database and the final data structure and data content of the database. This information will provide researchers with the information they need to use the database in developing agent-based models.Portions of the synthesized agent database are available to any user upon request. RTI will extract a portion (a county, region, or state) of the database for users who wish to use this database in their own agent-based models.