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Systematic Review and Evaluation of Mathematical Attack Models of Human Inhalational Anthrax for Supporting Public Health Decision Making and Response

Published online by Cambridge University Press:  04 June 2020

Xin Chen Open the ORCID record for Xin Chen [Opens in a new window] ,
Prateek Bahl ,
Charitha de Silva ,
David Heslop ,
Con Doolan ,
Samsung Lim  and
C. Raina MacIntyre
Xin Chen*
Affiliation:
Biosecurity Program, The Kirby Institute, UNSW Sydney, NSW, Australia
Prateek Bahl
Affiliation:
School of Mechanical and Manufacturing Engineering, UNSW Sydney, NSW, Australia
Charitha de Silva
Affiliation:
School of Mechanical and Manufacturing Engineering, UNSW Sydney, NSW, Australia
David Heslop
Affiliation:
School of Public Health and Community Medicine, UNSW Sydney, NSW, Australia
Con Doolan
Affiliation:
School of Mechanical and Manufacturing Engineering, UNSW Sydney, NSW, Australia
Samsung Lim
Affiliation:
School of Civil and Environmental Engineering, UNSW Sydney, NSW, Australia
C. Raina MacIntyre
Affiliation:
Biosecurity Program, The Kirby Institute, UNSW Sydney, NSW, Australia College of Health Solutions and College of Public Service and Community Solutions, Arizona State University, Tempe, ArizonaUSA
*
Correspondence: Xin Chen, MPH, Biosecurity Program, Kirby Institute, Level 6, Wallace Wurth Building, UNSW Sydney, NSW, 2052, Australia, E-mail: xinjessiechen@protonmail.com
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Abstract

Background:

Anthrax is a potential biological weapon and can be used in an air-borne or mail attack, such as in the attack in the United States in 2001. Planning for such an event requires the best available science. Since large-scale experiments are not feasible, mathematical modelling is a crucial tool to inform planning. The aim of this study is to systematically review and evaluate the approaches to mathematical modelling of inhalational anthrax attack to support public health decision making and response.

Methods:

A systematic review of inhalational anthrax attack models was conducted using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) criteria. The models were reviewed based on a set of defined criteria, including the inclusion of atmospheric dispersion component and capacity for real-time decision support.

Results:

Of 13 mathematical modelling studies of human inhalational anthrax attacks, there were six studies that took atmospheric dispersion of anthrax spores into account. Further, only two modelling studies had potential utility for real-time decision support, and only one model was validated using real data.

Conclusion:

The limited modelling studies available use widely varying methods, assumptions, and data. Estimation of attack size using different models may be quite different, and is likely to be under-estimated by models which do not consider weather conditions. Validation with available data is crucial and may improve models. Further, there is a need for both complex models that can provide accurate atmospheric dispersion modelling, as well as for simpler modelling tools that provide real-time decision support for epidemic response.

Keywords

anthraxbiological warfare agentsbioterrorisminhalation anthraxmathematical models
Type
Systematic Review
Information
Prehospital and Disaster Medicine , Volume 35 , Issue 4 , August 2020 , pp. 412 - 419
Copyright
© World Association for Disaster and Emergency Medicine 2020

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