ArticleAmerican journal of epidemiology2021
A Quantitative Framework for Defining the End of an Infectious Disease Outbreak: Application to Ebola Virus Disease.
Article in American journal of epidemiology, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 21 papers.
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Who cites it
21 citing papers in PubMed.
- CDC Operational Guidance for Investigating Locally Acquired Mosquito-Transmitted Malaria - United States, 2026.MMWR. Recommendations and reports : Morbidity and mortality weekly report. Recommendations and reports · 2026Article
- Characterisation of Salmonella Typhimurium from a fatal equine nosocomial outbreak and retrospective analysis of equine clinic salmonellosis cases (2010-2025).Scientific reports · 2026Article
- Real-time inference of the end of an outbreak: Temporally aggregated disease incidence data and under-reporting.Infectious Disease Modelling · 2025Article
- A Primer on Inference and Prediction With Epidemic Renewal Models and Sequential Monte Carlo.Statistics in medicine · 2025Article
- Estimation of Incubation Period for Oropouche Virus Disease among Travel-Associated Cases, 2024-2025.Emerging infectious diseases · 2025Article
- Estimation of end-of-outbreak probabilities in the presence of delayed and incomplete case reporting.Proceedings. Biological sciences · 2025Article
- Article
- Time to control of anthrax outbreaks in Africa, 2014-2023: A systematic review and meta-analysis.PLOS global public health · 2025Article
- How mathematical modelling can inform outbreak response vaccination.BMC infectious diseases · 2024Review
- Using real-time modelling to inform the 2017 Ebola outbreak response in DR Congo.Nature communications · 2024Article
- Optimizing the timing of an end-of-outbreak declaration: Ebola virus disease in the Democratic Republic of the Congo.Science advances · 2024Article
- Exact calculation of end-of-outbreak probabilities using contact tracing data.Journal of the Royal Society, Interface · 2023Article
- A modelling analysis of a new multi-stage pathway for classifying achievement of public health milestones for leprosy.Philosophical transactions of the Royal Society of London. Series B, Biological sciences · 2023Article
- A quantitative method to project the probability of the end of an epidemic: Application to the COVID-19 outbreak in Wuhan, 2020.Journal of theoretical biology · 2022Article
- Real-time estimation of the epidemic reproduction number: Scoping review of the applications and challenges.PLOS digital health · 2022Article
- An Outbreak Investigation of Varicella Zoster among Male Military Personnel in a Military Training Centre.JNMA; journal of the Nepal Medical Association · 2022Article
- Inferring the reproduction number using the renewal equation in heterogeneous epidemics.Journal of the Royal Society, Interface · 2022Article
- Early intervention is the key to success in COVID-19 control.Royal Society open science · 2021Article
- Sub-spreading events limit the reliable elimination of heterogeneous epidemics.Journal of the Royal Society, Interface · 2021Article
- How epidemics end.Centaurus; international magazine of the history of science and medicine · 2021Article
Corrections and comments
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Authors and funding
6 authors.
Funding
Abstract
The end-of-outbreak declaration is an important step in controlling infectious disease outbreaks. Objective estimation of the confidence level that an outbreak is over is important to reduce the risk of postdeclaration flare-ups. We developed a simulation-based model with which to quantify that confidence and tested it on simulated Ebola virus disease data. We found that these confidence estimates were most sensitive to the instantaneous reproduction number, the reporting rate, and the time between the symptom onset and death or recovery of the last detected case. For Ebola virus disease, our results suggested that the current World Health Organization criterion of 42 days since the recovery or death of the last detected case is too short and too sensitive to underreporting. Therefore, we suggest a shift to a preliminary end-of-outbreak declaration after 63 days from the symptom onset day of the last detected case. This preliminary declaration should still be followed by 90 days of enhanced surveillance to capture potential flare-ups of cases, after which the official end of the outbreak can be declared. This sequence corresponds to more than 95% confidence that an outbreak is over in most of the scenarios examined. Our framework is generic and therefore could be adapted to estimate end-of-outbreak confidence for other infectious diseases.
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