Development of a method for optimal detection of emerging disease incursions : a thesis presented in partial fulfilment of the requirements for the degree of Doctor of Philosophy at Massey University, Institute of Veterinary, Animal and Biomedical Sciences, Massey University, Palmerston North, New Zealand

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Massey University
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Emerging and re-emerging infectious diseases (ERID) are capable of generating sizable economic loss, and causing loss of life and social instability. To prevent and mitigate the negative impacts of ERID, it is imperative to have a sensitive surveillance system for early disease detection. Furthermore, from the economic perspective, resources are always scarce and have opportunity cost, so investment in surveillance programs has to demonstrate that it can maximize the utility of available resources. The thesis was focused on development and application of a software toolbox, Human and Animal Disease Response Program (HandiResponse), designed for (i) visualizing the disease risk landscape and representing spatial variation in the expected occurrence of a zoonotic disease both quantitatively and visually; (ii) evaluating economic benefit and costs of a single surveillance activity or a multi-component portfolio; (iii) identifying optimal use of resources for surveillance. It comprises four modules: (i) risk map development – HandiMap; (ii) surveillance portfolio development – HandiSurv; (iii) economic impact assessment – HandiEcon and (iv) surveillance optimization – OptiSurv. The modules developed were tested on a number of data sets from various countries. The experience demonstrated that using satellite-derived data in combination with national statistical data to produce a disease risk map improved spatial prediction of avian influenza H5N1 outbreaks in southern Vietnam. Development of a risk map from satellite data for Crimean Congo Haemorrhagic Fever for Mongolia guided a field surveillance program which provided the first evidence that this disease is present in both animals and people in Mongolia. Finally an invented disease affecting pigs and people was used to investigate the likely consequences of an incursion of such a novel disease into Australia, involving both domestic and feral pigs and transferring to people. Risk-based and classical disease surveillance options were then tested for disease detection, and modelling work confirmed that a portfolio consisting of different options was the most technically and economically appropriate. HandiResponse is a practical tool that could promote the implementation of risk-based surveillance approaches, and improve both technical and economic efficiency of surveillance programs for infectious diseases, particularly those affecting both people and animals.
Communicable diseases, Epidemiology, Methodology, Health risk assessment, Software, Avian influenza, Vietnam, Haemorrhagic fever, Mongolia, Research Subject Categories::MEDICINE