Delays in Epidemic Outbreak Control Cost Disproportionately Large Treatment Footprints to Offset

Pathogens. 2022 Mar 24;11(4):393. doi: 10.3390/pathogens11040393.

Abstract

Epidemic outbreak control often involves a spatially explicit treatment area (quarantine, inoculation, ring cull) that covers the outbreak area and adjacent regions where hosts are thought to be latently infected. Emphasis on space however neglects the influence of treatment timing on outbreak control. We conducted field and in silico experiments with wheat stripe rust (WSR), a long-distance dispersed plant disease, to understand interactions between treatment timing and area interact to suppress an outbreak. Full-factorial field experiments with three different ring culls (outbreak area only to a 25-fold increase in treatment area) at three different disease control timings (1.125, 1.25, and 1.5 latent periods after initial disease expression) indicated that earlier treatment timing had a conspicuously greater suppressive effect than the area treated. Disease spread computer simulations over a broad range of influential epidemic parameter values (R0, outbreak disease prevalence, epidemic duration) suggested that potentially unrealistically large increases in treatment area would be required to compensate for even small delays in treatment timing. Although disease surveillance programs are costly, our results suggest that treatments early in an epidemic disease outbreak require smaller areas to be effective, which may ultimately compensate for the upfront costs of proactive disease surveillance programs.

Keywords: disease management; epidemic control; outbreak control; quarantine area; rapid outbreak response; ring cull.