title: Predictability and epidemic pathways in global outbreaks of infectious diseases: the SARS case study.
abstract: BACKGROUND
  The global spread of the severe acute respiratory syndrome (SARS) epidemic has clearly shown the importance of considering the long-range transportation networks in the understanding of emerging diseases outbreaks. The introduction of extensive transportation data sets is therefore an important step in order to develop epidemic models endowed with realism.
  
  
  METHODS
  We develop a general stochastic meta-population model that incorporates actual travel and census data among 3 100 urban areas in 220 countries. The model allows probabilistic predictions on the likelihood of country outbreaks and their magnitude. The level of predictability offered by the model can be quantitatively analyzed and related to the appearance of robust epidemic pathways that represent the most probable routes for the spread of the disease.
  
  
  RESULTS
  In order to assess the predictive power of the model, the case study of the global spread of SARS is considered. The disease parameter values and initial conditions used in the model are evaluated from empirical data for Hong Kong. The outbreak likelihood for specific countries is evaluated along with the emerging epidemic pathways. Simulation results are in agreement with the empirical data of the SARS worldwide epidemic.
  
  
  CONCLUSIONS
  The presented computational approach shows that the integration of long-range mobility and demographic data provides epidemic models with a predictive power that can be consistently tested and theoretically motivated. This computational strategy can be therefore considered as a general tool in the analysis and forecast of the global spreading of emerging diseases and in the definition of containment policies aimed at reducing the effects of potentially catastrophic outbreaks.
authors.affiliation: Complex Networks Lagrange Laboratory (CNLL), Institute for Scientific Interchange (ISI) Foundation, Turin, Italy. vcolizza@isi.it
authors.forename: Vittoria
authors.initials: V
authors.lastname: Colizza
authors.forename: Alain
authors.initials: A
authors.lastname: Barrat
authors.forename: Marc
authors.initials: M
authors.lastname: Barthélemy
authors.forename: Alessandro
authors.initials: A
authors.lastname: Vespignani
mesh_terms: D002170:Canada; D003141:Communicable Diseases / Q000453:epidemiology* / Q000635:transmission; D004196:Disease Outbreaks / Q000706:statistics & numerical data*; D005843:Geography; D006801:Humans; D045169:Severe Acute Respiratory Syndrome / Q000453:epidemiology* / Q000635:transmission; D013269:Stochastic Processes; D014505:Urban Population; D014944:World Health Organization