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Volume 23, Number 1—January 2017


Modeling Tool for Decision Support during Early Days of an Anthrax Event

Gabriel RainischComments to Author , Martin I. Meltzer1, Sean Shadomy, William A. Bower, and Nathaniel Hupert1
Author affiliations: Centers for Disease Control and Prevention, Atlanta, Georgia, USA (G. Rainisch, M.I. Meltzer, S. Shadomy, W.A. Bower, N. Hupert); Weill Cornell Medical College and New York–Presbyterian Hospital, New York, New York, USA (N. Hupert)

Main Article

Table 1

Anthrax Assist models and associated inputs, outputs, and public health decisions supported*

Model Inputs Outputs Decision informed
Epidemic Curve
1) Case counts by illness-onset date 1) Cumulative caseload How the event unfolds:
2) Incubation period distribution 2) Unmitigated epidemic curve 1) Size of event

2) How quickly people become ill
PEP Impact
1) Epidemic curve (output from Epidemic Curve model) 1) Cases prevented by PEP 1) Initiate a PEP campaign and when to begin
2) Dispensing plan 2) PEP-mitigated epidemic curve 2) How much PEP to dispense
3) Effectiveness
3) Dispensing resource requirements
4) Population needing prophylaxis
Healthcare Impact 1) Unmitigated epidemic curve (output from Epidemic Curve model) or PEP-mitigated epidemic curve (output from PEP Impact model) 1) Hospital demand curves: 1) Treatment guidance:
a) ED surge a) messaging to public
b) treatment load b) standards of care
2) Disease progression 2) Deaths curve 2) Set treatment priorities
3) Treatment-seeking behavior 3) Recovered curve 3) Mobilize medical care 
4) Treatment effectiveness and availability

*ED, emergency department; PEP, postexposure prophylaxis.

Main Article

1These senior authors contributed equally to this article.