Forecasting the 2017/2018 seasonal influenza epidemic in England using multiple dynamic transmission models: a case study
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Published version
Author(s)
Type
Journal Article
Abstract
BACKGROUND: Since the 2009 A/H1N1 pandemic, Public Health England have developed a suite of real-time statistical models utilising enhanced pandemic surveillance data to nowcast and forecast a future pandemic. Their ability to track seasonal influenza and predict heightened winter healthcare burden in the light of high activity in Australia in 2017 was untested. METHODS: Four transmission models were used in forecasting the 2017/2018 seasonal influenza epidemic in England: a stratified primary care model using daily, region-specific, counts and virological swab positivity of influenza-like illness consultations in general practice (GP); a strain-specific (SS) model using weekly, national GP ILI and virological data; an intensive care model (ICU) using reports of ICU influenza admissions; and a synthesis model that included all data sources. For the first 12 weeks of 2018, each model was applied to the latest data to provide estimates of epidemic parameters and short-term influenza forecasts. The added value of pre-season population susceptibility data was explored. RESULTS: The combined results provided valuable nowcasts of the state of the epidemic. Short-term predictions of burden on primary and secondary health services were initially highly variable before reaching consensus beyond the observed peaks in activity between weeks 3-4 of 2018. Estimates for R0 were consistent over time for three of the four models until week 12 of 2018, and there was consistency in the estimation of R0 across the SPC and SS models, and in the ICU attack rates estimated by the ICU and the synthesis model. Estimation and predictions varied according to the assumed levels of pre-season immunity. CONCLUSIONS: This exercise successfully applied a range of pandemic models to seasonal influenza. Forecasting early in the season remains challenging but represents a crucially important activity to inform planning. Improved knowledge of pre-existing levels of immunity would be valuable.
Date Issued
2020-04-15
Date Acceptance
2020-03-04
Citation
BMC Public Health, 2020, 20 (1)
ISSN
1471-2458
Publisher
BioMed Central
Journal / Book Title
BMC Public Health
Volume
20
Issue
1
Copyright Statement
© The Author(s). 2020. This article is licensed under a Creative Commons Attribution 4.0 International License,which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriatecredit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes weremade. The images or other third party material in this article are included in the article’s Creative Commons licence, unlessindicated otherwise in a credit line to the material. If material is not included in the article’s Creative Commons licence and yourintended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directlyfrom the copyright holder. To view a copy of this licence, visithttp://creativecommons.org/licenses/by/4.0/. The CreativeCommons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/)appliestothedatamadeavailable in this article, unless otherwise stated in a credit line to the data.
Identifier
https://www.ncbi.nlm.nih.gov/pubmed/32293372
PII: 10.1186/s12889-020-8455-9
Subjects
Forecasting
GP consultations
Intensive care admissions
Nowcasting
Seasonal influenza
Transmission models
Publication Status
Published
Coverage Spatial
England
Article Number
ARTN 486