A Bayesian approach for estimating bioterror attacks from patient data

• Published in: Statistics in medicine Vol. 30; no. 2; pp. 101 - 126
• Main Authors: Ray, J., Marzouk, Y. M., Najm, H. N.
• Format: Journal Article
• Language: English
• Published: Chichester, UK John Wiley & Sons, Ltd 30.01.2011; Wiley Subscription Services, Inc
• Subjects: Anthrax; Anthrax - diagnosis; Anthrax - epidemiology; Bacillus anthracis; Bayes Theorem; Bayesian analysis; Bayesian inference; Bias; Biological & chemical terrorism; Bioterrorism; Disease Outbreaks; Dose-Response Relationship, Drug; Epidemics; Humans; Medical statistics; Models, Statistical; Pathogens; Patients - statistics & numerical data; Russia - epidemiology; Simulation; Sverdlovsk outbreak
• ISSN: 0277-6715; 1097-0258
• DOI: 10.1002/sim.4090

Terrorist attacks using an aerosolized pathogen have gained credibility as a national security concern after the anthrax attacks of 2001. Inferring some important details of the attack quickly, for example, the number of people infected, the time of infection, and a representative dose received can be crucial to planning a medical response. We use a Bayesian approach, based on a short time series of diagnosed patients, to estimate a joint probability density for these parameters. We first test the formulation with idealized cases and then apply it to realistic scenarios, including the Sverdlovsk anthrax outbreak of 1979. We also use simulated outbreaks to explore the impact of model error, as when the model used for generating simulated epidemic curves does not match the model subsequently used to characterize the attack. We find that in all cases except for the smallest attacks (fewer than 100 infected people), 3–5 days of data are sufficient to characterize the outbreak to a specificity that is useful for directing an emergency response. Copyright © 2010 John Wiley & Sons, Ltd.