Outside the continental United States international travel and contagion impact quick look tool

This paper describes a tool that will allow public health analysts to estimate infectious disease risk at the country level as a function of different international transportation modes. The prototype focuses on a cholera epidemic originating within Latin America or the Caribbean, but it can be expanded to consider other pathogens as well. This effort leverages previous work in collaboration with the Centers for Disease Control and Prevention to develop the International Travel to Community Impact (IT-CI) model, which analyzes and assesses potential international disease outbreaks then estimates the associated impacts to U.S. communities and the nation as a whole and orient it for use Outside the Continental United States (OCONUS). For brevity, we refer to this refined model as OIT-CI. First, we developed an operationalized meta-population spatial cholera model for Latin America and the Caribbean at the secondary administrative-level boundary. Secondly, we developed a robust function of human airline critical to approximating mixing patterns in the meta-population model. In the prototype version currently presented here, OIT-CI models a cholera epidemic originating in a Latin American or Caribbean country and spreading via airline transportation routes. Disease spread is modeled at the country level using a patch model with a connectivity function based on demographic, geospatial, and human transportation data. We have also identified data to estimate the water and health-related infrastructure capabilities of each country to include this potential impact on disease transmission. OIT-CI utilizes these data and modeling constructs to estimate the cholera risk, as a function of attack rate, for each country consistent [1]. This estimation will be completed by providing an order of magnitude risk estimate (e.g., 1 percent, 10 percent, 50 percent, 100 percent) for a cholera outbreak originating within and spreading to Latin American and Caribbean countries at secondary level boundaries (i.e., states or administrative districts). To create a product that is both useful and desirable, feedback from end users of OIT-CI will be incorporated into the model software and visualization design.