A Model Of Reporting And Controlling Outbreaks By Public Health Agencies

A model of reporting and controlling outbreaks by public health agencies

When an outbreak of an infectious disease is suspected, a local health agency may notify a state or federal agency and request additional resources to investigate and, if necessary, contain it. However, due to capacity constraints, state and federal health agencies may not be able to grant all such requests, which may give an incentive to local agencies to request help strategically. We study a model of detection and control of an infectious disease by local health agencies in the presence of imperfect information about the likelihood of an outbreak and limited diagnostic capacity. When diagnostic capacity is rationed based on reports of symptoms, the decision to report symptoms or not creates a trade-off. On the one hand, rigorous testing allows one to make an informed disease control decision. On the other hand, it also increases the probability that the disease will spread from an untested area where fewer precautionary measures are taken. Symptoms are overreported (respectively, reported truthfully, or underreported) when the cost of disease control is sufficiently small (respectively, in some intermediate range, or sufficiently large). If the disease incidence decreases or infectiousness increases, symptoms are reported less frequently. If the precision of private signals increases, the extent of overreporting of symptoms may increase. For different values of the parameters it can be socially optimal to subsidize or tax requests for additional investigations and confirmatory testing.

Public Health Systems and Emerging Infections

The Forum on Emerging Infections was created in 1996 in response to a request from the Centers for Disease Control and Prevention and the National Institutes of Health. The goal of the forum is to provide structured opportunities for representatives from academia, industry, professional and interest groups, and government to examine and discuss scientific and policy issues that relate to research, prevention, detection, and management of emerging infectious diseases. A critical part of this mission has been the convening of a series of workshops. Public Health Systems and Emerging Infections summarizes the fourth in a series of five workshops. With a focus on our knowledge and understanding of the role of private and public health sectors in emerging infectious disease surveillance and response, the participants explored the effects of privatization of public health laboratories and the modernization of public health care. The issues discussed included epidemiological investigation, surveillance, communication, coordination, resource allocations, and economic support.

Morbidity and Mortality Weekly Report