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The effect of missing data was assessed in sensitivity analyses for all outbreaks for which we had an estimated outbreak start date (17 of 20).
The simulation modelling approach also permits the use of sensitivity analyses to explore the influence of uncertainty in estimated outbreak parameters and other data characteristics on algorithm detection performance.
The median time from estimated outbreak start to initial public communication was 10 days shorter for nongovernmental sources (23 days, 95% CI 20 32) than for governmental sources (33 days, 95% CI 30 45), although this difference was not significant according to the Wilcoxon rank-sum test (p = 0.200) (Table 1).
Of all initial outbreak reports identified, 137 were excluded from analysis for ≥1 of the following reasons: 117 (85%) of the excluded reports were missing information on the estimated outbreak start date; 20 (15%) were not found in the ProMED-mail archives; and 1 (1%) outbreak estimated start date occurred after the date of public communication of the outbreak.
Based on the estimated outbreak length (70+days) on the 'Trevelyan' and 'Duntrune' and estimated mean serial interval of 12.3 days, it is likely that there were five to six generations of measles infections during these outbreaks.
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Understanding these household contacts helps estimate outbreak size.
R0 is a useful metric for estimating outbreak thresholds and is therefore of relevance in estimating risk of epidemic strains introduced into fully susceptible (disease-free) populations.
It estimated the outbreak could sap billions of dollars from economies in the region by the end of next year if it is not contained.
Parameters for the transmission probability were estimated using outbreak data for northern Europe in 2006.
Applying these data to our results, the estimated total outbreak costs would be ≈$0.9 million higher.
Pairwise differences were estimated among outbreak and reference population isolates to discriminate clusters against a background population.
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Justyna Jupowicz-Kozak
CEO of Professional Science Editing for Scientists @ prosciediting.com