title: Spatial methods for infectious disease outbreak investigations: systematic literature review.
abstract: Investigations of infectious disease outbreaks are conventionally framed in terms of person, time and place. Although geographic information systems have increased the range of tools available, spatial analyses are used relatively infrequently. We conducted a systematic review of published reports of outbreak investigations worldwide to estimate the prevalence of spatial methods, describe the techniques applied and explore their utility. We identified 80 reports using spatial methods published between 1979 and 2013, ca 0.4% of the total number of published outbreaks. Environmental or waterborne infections were the most commonly investigated, and most reports were from the United Kingdom. A range of techniques were used, including simple dot maps, cluster analyses and modelling approaches. Spatial tools were usefully applied throughout investigations, from initial confirmation of the outbreak to describing and analysing cases and communicating findings. They provided valuable insights that led to public health actions, but there is scope for much wider implementation and development of new methods.
authors.affiliation: UCL Department of Infectious Disease Informatics, Farr Institute of Health Informatics Research, University College London, London, United Kingdom.
authors.forename: Catherine M
authors.initials: CM
authors.lastname: Smith
authors.forename: Steven C
authors.initials: SC
authors.lastname: Le Comber
authors.forename: Hannah
authors.initials: H
authors.lastname: Fry
authors.forename: Matthew
authors.initials: M
authors.lastname: Bull
authors.forename: Steve
authors.initials: S
authors.lastname: Leach
authors.forename: Andrew C
authors.initials: AC
authors.lastname: Hayward
mesh_terms: D016000:Cluster Analysis; D003140:Communicable Disease Control / Q000379:methods*; D003141:Communicable Diseases / Q000453:epidemiology*; D004196:Disease Outbreaks; D040362:Geographic Information Systems; D006801:Humans; D011159:Population Surveillance; D062206:Spatial Analysis
keywords: geographic information system - GIS; outbreaks