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BACKGROUND: In 2015, the Zika arbovirus (ZIKV) began circulating in the Americas, rapidly expanding its global geographic range in explosive outbreaks. Unusual among mosquito-borne diseases, ZIKV has been shown to also be sexually transmitted, although sustained autochthonous transmission due to sexual transmission alone has not been observed, indicating the reproduction number (R0) for sexual transmission alone is less than 1. Critical to the assessment of outbreak risk, estimation of the potential attack rates, and assessment of control measures, are estimates of the basic reproduction number, R0. METHODS: We estimated the R0 of the 2015 ZIKV outbreak in Barranquilla, Colombia, through an analysis of the exponential rise in clinically identified ZIKV cases (n=359 to the end of November, 2015). FINDINGS: The rate of exponential rise in cases was ρ=0.076days-1, with 95% CI [0.066,0.087] days-1. We used a vector-borne disease model with additional direct transmission to estimate the R0; assuming the R0 of sexual transmission alone is less than 1, we estimated the total R0=3.8 [2.4,5.6], and that the fraction of cases due to sexual transmission was 0.23 [0.01,0.47] with 95% confidence. INTERPRETATION: This is among the first estimates of R0 for a ZIKV outbreak in the Americas, and also among the first quantifications of the relative impact of sexual transmission.

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Influenza outbreaks have been of relatively limited historical interest in Mexico. The 2009 influenza pandemic not only changed Mexico's health priorities but also brought to the forefront some of the strengths and weaknesses of Mexico's epidemiological surveillance and public health system. A year later, Mexico's data show an epidemic pattern characterized by three "waves''. The reasons this three-wave patterns are theoretically investigated via models that incorporate Mexico's general trends of land transportation, public health measures, and the regular opening and closing of schools during 2009. The role of vaccination is also studied taking into account delays in access and limitations in the total and daily numbers of vaccines available. The research in this article supports the view that the three epidemic "waves" are the result of the synergistic interactions of three factors: regional movement patterns of Mexicans, the impact and effectiveness of dramatic social distancing measures imposed during the first outbreak, and the summer release of school children followed by their subsequent return to classes in the fall. The three "waves" cannot be explained by the transportation patterns alone but only through the combination of transport patterns and changes in contact rates due to the use of explicit or scheduled social distancing measures. The research identifies possible vaccination schemes that account for the school calendar and whose effectiveness are enhanced by social distancing measures. The limited impact of the late arrival of the vaccine is also analyzed.

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In this work we consider every individual of a population to be a server whose state can be either busy (infected) or idle (susceptible). This server approach allows to consider a general distribution for the duration of the infectious state, instead of being restricted to exponential distributions. In order to achieve this we first derive new approximations to quasistationary distribution (QSD) of SIS (Susceptible- Infected- Susceptible) and SEIS (Susceptible- Latent- Infected- Susceptible) stochastic epidemic models. We give an expression that relates the basic reproductive number, R0 and the server utilization,p.

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The strengths and limitations of using homogeneous mixing and heterogeneous mixing epidemic models are explored in the context of the transmission dynamics of tuberculosis. The focus is on three types of models: a standard incidence homogeneous mixing model, a non-homogeneous mixing model that incorporates 'household' contacts, and an age-structured model. The models are parameterized using demographic and epidemiological data and the patterns generated from these models are compared. Furthermore, the effects of population growth, stochasticity, clustering of contacts, and age structure on disease dynamics are explored. This framework is used to asses the possible causes for the observed historical decline of tuberculosis notifications.

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OBJECTIVE: To explore whether early analysis of spatial data may result in identification of variables associated with epidemic spread of foot and mouth disease. SAMPLE POPULATION: 37 farms with infected cattle (ie, case farms) reported within the first 6 days of the 2001 Uruguayan foot-and-mouth disease epidemic. PROCEDURE: A georeferenced database was created and retrospective analysis was performed on case farm location in relation to farm density, cattle density, farm type (ie, beef vs dairy cattle production), road density, case farm distance to the nearest road, farm size, farm ownership, and day of infection. Mean or median results of 1 to 3 day versus 4 to 6 day spatial data were compared. Spatial-temporal associations were investigated by correlation analysis. RESULTS: Comparison of mean or median values between the first 3 days and days 4 to 6 of the epidemic and results of correlation analysis indicated a significant increase in road density, cattle density, and dairy cattle production and a significant decrease in farm size and case farm distance to the nearest road that developed over time. A route that linked most case farms by the shortest possible distance and also considered significantly associated variables was created. It included 86.1% of all case farms reported by 60 days into the epidemic. CONCLUSIONS AND CLINICAL RELEVANCE: Epidemic direction can be assessed on the basis of road density and other spatial variables as early as 6 days into an epidemic. Epidemic control areas may be more effectively identified if local and regional georeferenced data are considered.

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