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Please use this identifier to cite or link to this item: http://dspace.dsto.defence.gov.au/dspace/handle/dsto/10506

Title: Critical Factors for Parameterisation of Disease Diagnosis Modelling for Anthrax, Plaque and Smallpox.
Report number: DSTO-GD-0699
AR number: AR-015-390
Classification: Unclassified
Report type: General Document
Authors: Aubron, C.
Cheng, A.
Lau, W.M.
Dawson, P.
Gaillis, R.
Issue Date: 2012-09
Division: Human Protection and Performance Division
Abbreviation: HPPD
Release authority: Chief, Human Protection and Performance Division
Task sponsor: CDS
Task number: 07/301
File number: 201281060754/1
Pages or format: 23
References: 36
DSTORL/DEFTEST terms: Anthrax
Other descriptors: Bioterrorism
Disease diagnosis modelling
Abstract: This paper undertakes a technical review of the properties of three diseases often associated with the threat of bioterrorism: anthrax, plague and smallpox. While the literature on these agents is extensive, the information is not generally available in a concise form for the purpose of modelling the course of spread of disease through a population, including the emergence of observable indicators of community infection. The focus here is to extract from the literature information describing these agents for the purpose of developing models of symptoms emergence and disease progression in individual people, as well as parameters describing how the diseases may spread in a community and be observable. This information can be used to parameterise models of disease diagnosis in a community, for the purpose of analysing candidate syndromic surveillance systems. Information is also provided on common diseases that may be misdiagnosed in the early stages of an outbreak due to an act of bioterrorism, namely, influenza, chickenpox, and community acquired pneumonia. Where information is not available in precise quantitative form, semi-quantitative graphs are provided, which provide a useful summary for developers of probabilistic models of disease diagnosis.
Executive summary: The threat from terrorist groups using biological agents has been the subject of intense debate since the Amerithrax incident in 2001. The Australian Government shares similar concerns and has directed relevant Departments to develop a ‘Whole-of Government’ (WoG) strategy to prepare the nation against biological attacks. The Defence Science and Technology Organisation (DSTO) has initiated the development of a ‘detect-to-treat’ capability so that appropriate countermeasures can be deployed in a timely manner. A key element of this strategy is to leverage on the JeHDI system to be commissioned by Joint Health Command (JHC) at the end of 2012. It was hoped that the system will allow for an early indication of a disease outbreak.
Prompt and accurate reporting of disease symptoms from hospitals, GP and other health care providers are the backbone of an effective syndromic surveillance system. Individual reports may not contain sufficient information to raise an alarm, but when large data sources are pooled together, the analysis possesses significant statistical power for indication of a biological attack. As such they can potentially be used to raise an alert earlier than the medical community would have done.
Many different approaches have been adopted to track the propagation of an infectious disease. The major objective of this review is to describe the epidemiological and clinical parameters for three biological agents, namely anthrax (caused by Bacillus anthracis), plague (caused by Yersinia pestis) and smallpox (caused by variola virus) that are often considered as potential bioterrorism agents. The results have been used to parameterise the critical functions of a disease diagnosis model that will be a part of the syndromic surveillance system.
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