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      A new twenty-first century science for effective epidemic response

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          Abstract

          With rapidly changing ecology, urbanization, climate change, increased travel and fragile public health systems, epidemics will become more frequent, more complex and harder to prevent and contain. Here we argue that our concept of epidemics must evolve from crisis response during discrete outbreaks to an integrated cycle of preparation, response and recovery. This is an opportunity to combine knowledge and skills from all over the world—especially at-risk and affected communities. Many disciplines need to be integrated, including not only epidemiology but also social sciences, research and development, diplomacy, logistics and crisis management. This requires a new approach to training tomorrow’s leaders in epidemic prevention and response.

          Abstract

          We need to integrate the knowledge and skills from different disciplines and from communities all over the world to enable effective responses to future epidemics.

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          Most cited references53

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          Global rise in human infectious disease outbreaks

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            Is Open Access

            National and Local Influenza Surveillance through Twitter: An Analysis of the 2012-2013 Influenza Epidemic

            Social media have been proposed as a data source for influenza surveillance because they have the potential to offer real-time access to millions of short, geographically localized messages containing information regarding personal well-being. However, accuracy of social media surveillance systems declines with media attention because media attention increases “chatter” – messages that are about influenza but that do not pertain to an actual infection – masking signs of true influenza prevalence. This paper summarizes our recently developed influenza infection detection algorithm that automatically distinguishes relevant tweets from other chatter, and we describe our current influenza surveillance system which was actively deployed during the full 2012-2013 influenza season. Our objective was to analyze the performance of this system during the most recent 2012–2013 influenza season and to analyze the performance at multiple levels of geographic granularity, unlike past studies that focused on national or regional surveillance. Our system’s influenza prevalence estimates were strongly correlated with surveillance data from the Centers for Disease Control and Prevention for the United States (r = 0.93, p < 0.001) as well as surveillance data from the Department of Health and Mental Hygiene of New York City (r = 0.88, p < 0.001). Our system detected the weekly change in direction (increasing or decreasing) of influenza prevalence with 85% accuracy, a nearly twofold increase over a simpler model, demonstrating the utility of explicitly distinguishing infection tweets from other chatter.
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              Understanding the link between malaria risk and climate.

              The incubation period for malaria parasites within the mosquito is exquisitely temperature-sensitive, so that temperature is a major determinant of malaria risk. Epidemiological models are increasingly used to guide allocation of disease control resources and to assess the likely impact of climate change on global malaria burdens. Temperature-based malaria transmission is generally incorporated into these models using mean monthly temperatures, yet temperatures fluctuate throughout the diurnal cycle. Here we use a thermodynamic malaria development model to demonstrate that temperature fluctuation can substantially alter the incubation period of the parasite, and hence malaria transmission rates. We find that, in general, temperature fluctuation reduces the impact of increases in mean temperature. Diurnal temperature fluctuation around means >21 degrees C slows parasite development compared with constant temperatures, whereas fluctuation around <21 degrees C speeds development. Consequently, models which ignore diurnal variation overestimate malaria risk in warmer environments and underestimate risk in cooler environments. To illustrate the implications further, we explore the influence of diurnal temperature fluctuation on malaria transmission at a site in the Kenyan Highlands. Based on local meteorological data, we find that the annual epidemics of malaria at this site cannot be explained without invoking the influence of diurnal temperature fluctuation. Moreover, while temperature fluctuation reduces the relative influence of a subtle warming trend apparent over the last 20 years, it nonetheless makes the effects biologically more significant. Such effects of short-term temperature fluctuations have not previously been considered but are central to understanding current malaria transmission and the consequences of climate change.
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                Author and article information

                Contributors
                j.farrar@wellcome.ac.uk
                Journal
                Nature
                Nature
                Nature
                Nature Publishing Group UK (London )
                0028-0836
                1476-4687
                6 November 2019
                2019
                : 575
                : 7781
                : 130-136
                Affiliations
                [1 ]Anthrologica, Oxford, UK
                [2 ]Wellcome, London, UK
                [3 ]Nigeria Centre for Disease Control, Abuja, Nigeria
                [4 ]ISNI 0000 0004 1763 2258, GRID grid.464764.3, Translational Health Science and Technology Institute, ; Faridabad, India
                [5 ]ISNI 000000040459992X, GRID grid.5645.2, Department of Viroscience, , Erasmus University Medical Center, ; Rotterdam, The Netherlands
                [6 ]ISNI 0000 0001 2189 9463, GRID grid.503447.1, Africa Centres for Disease Control and Prevention, , African Union, ; Addis Ababa, Ethiopia
                Article
                1717
                10.1038/s41586-019-1717-y
                7095334
                31695207
                1ed8d395-ad7f-414c-8d46-8096fa07812a
                © Springer Nature Limited 2019

                This article is made available via the PMC Open Access Subset for unrestricted research re-use and secondary analysis in any form or by any means with acknowledgement of the original source. These permissions are granted for the duration of the World Health Organization (WHO) declaration of COVID-19 as a global pandemic.

                History
                : 10 June 2019
                : 24 September 2019
                Categories
                Review
                Custom metadata
                © The Author(s), under exclusive licence to Springer Nature Limited 2019

                Uncategorized
                infectious diseases,medical research,epidemiology
                Uncategorized
                infectious diseases, medical research, epidemiology

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