# Estimating the reproductive number, total outbreak size, and reporting rates for Zika epidemics in South and Central America

## TL;DR

This study develops a mathematical model to estimate key outbreak parameters of Zika in South and Central America, providing insights into reproduction rates, total cases, and reporting accuracy, aiding future mitigation efforts.

## Contribution

The paper introduces a region-specific modeling approach for Zika outbreaks using Bayesian methods, accounting for variable susceptible populations and providing uncertainty quantification.

## Key findings

- Reproduction number estimates between 4 and 6 for El Salvador and Suriname.
- Reporting rates around 16-18%, indicating underreporting.
- Estimated total outbreak sizes of approximately 73,395 in El Salvador and 21,647 in Suriname.

## Abstract

As South and Central American countries prepare for increased birth defects from Zika virus outbreaks and plan for mitigation strategies to minimize ongoing and future outbreaks, understanding important characteristics of Zika outbreaks and how they vary across regions is a challenging and important problem. We developed a mathematical model for the 2015 Zika virus outbreak dynamics in Colombia, El Salvador, and Suriname. We fit the model to publicly available data provided by the Pan American Health Organization, using Approximate Bayesian Computation to estimate parameter distributions and provide uncertainty quantification. An important model input is the at-risk susceptible population, which can vary with a number of factors including climate, elevation, population density, and socio-economic status. We informed this initial condition using the highest historically reported dengue incidence modified by the probable dengue reporting rates in the chosen countries. The model indicated that a country-level analysis was not appropriate for Colombia. We then estimated the basic reproduction number, or the expected number of new human infections arising from a single infected human, to range between 4 and 6 for El Salvador and Suriname with a median of 4.3 and 5.3, respectively. We estimated the reporting rate to be around 16% in El Salvador and 18% in Suriname with estimated total outbreak sizes of 73,395 and 21,647 people, respectively. The uncertainty in parameter estimates highlights a need for research and data collection that will better constrain parameter ranges.