Measles outbreak risk in Pakistan: exploring the potential of combining vaccination coverage and incidence data with novel data-streams to strengthen control.

摘要: Although measles incidence has reached historic lows in many parts of the world, disease still causes substantial morbidity globally. Even where control programs have succeeded driving locally extinct, unless vaccination coverage is maintained at extremely high levels, susceptible numbers may increase sufficiently to spark large outbreaks. Human mobility will drive potentially infectious contacts and interact with landscape susceptibility determine pattern These interactions proved difficult characterise empirically. We explore degree which new sources data combined existing public health can be used evaluate immunity role spatial movement for introductions by retrospectively evaluating our ability predict outbreaks vaccinated populations. Using inferred patterns accumulation individuals travel data, we predicted timing epidemics each district Pakistan during a outbreak 2012-2013 over 30 000 reported cases. these extracted from 40 million mobile phone subscribers same time frame country quantify connectivity spread measles. investigate how different approaches could contribute targeting efforts reach districts before started. While some prediction was possible, accuracy low discuss key uncertainties linked streams that impede such inference detail what might necessary robustly infer epidemics.