From: Cholera Epidemic in Haiti, 2010: Using a Transmission Model to Explain Spatial Spread of Disease and Identify Optimal Control Interventions Ann Intern.

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From: Cholera Epidemic in Haiti, 2010: Using a Transmission Model to Explain Spatial Spread of Disease and Identify Optimal Control Interventions Ann Intern Med. 2011;154(9):593-601. doi:10.7326/0003-4819-154-9-201105030-00334 Figure Legend: Model overview.For each of the 10 departments in Haiti, the population is divided into “susceptible,” “infectious,” and “recovered.” Infection spreads through contact of susceptible with infectious persons both within a given department and in other departments, as well as through contamination of water sources. Additional model details are provided in the Appendix. Date of download: 12/27/2017 Copyright © American College of Physicians. All rights reserved.

From: Cholera Epidemic in Haiti, 2010: Using a Transmission Model to Explain Spatial Spread of Disease and Identify Optimal Control Interventions Ann Intern Med. 2011;154(9):593-601. doi:10.7326/0003-4819-154-9-201105030-00334 Figure Legend: Map of Haiti, showing the 10 departments and locations of capital cities. Date of download: 12/27/2017 Copyright © American College of Physicians. All rights reserved.

From: Cholera Epidemic in Haiti, 2010: Using a Transmission Model to Explain Spatial Spread of Disease and Identify Optimal Control Interventions Ann Intern Med. 2011;154(9):593-601. doi:10.7326/0003-4819-154-9-201105030-00334 Figure Legend: Correlation between model projections and MSPP reports on initial case dates (top) and ordering of outbreaks (bottom).Close correlation is observed between model projections and reported dates of epidemic onset by region. MSPP = Ministère de la Santé Publique et de la Population. Date of download: 12/27/2017 Copyright © American College of Physicians. All rights reserved.

From: Cholera Epidemic in Haiti, 2010: Using a Transmission Model to Explain Spatial Spread of Disease and Identify Optimal Control Interventions Ann Intern Med. 2011;154(9):593-601. doi:10.7326/0003-4819-154-9-201105030-00334 Figure Legend: Model projections of overall hospitalized cases in Haiti and reported cumulative hospitalizations from MSPP data.The model was well-calibrated to reported cumulative hospitalizations. MSPP = Ministère de la Santé Publique et de la Population. Date of download: 12/27/2017 Copyright © American College of Physicians. All rights reserved.

From: Cholera Epidemic in Haiti, 2010: Using a Transmission Model to Explain Spatial Spread of Disease and Identify Optimal Control Interventions Ann Intern Med. 2011;154(9):593-601. doi:10.7326/0003-4819-154-9-201105030-00334 Figure Legend: Heat map showing the timing of epidemic peak in Haiti, by department.Timing is based on 1000 stochastic simulations, as described in the text. An increasing intensity of color denotes more simulations projecting that region's epidemic to peak at a given time. The epidemic in Artibonite, home of the initial outbreak, is projected to peak first; epidemics in Grand'Anse, Nippes, and Sud are projected to peak last. Date of download: 12/27/2017 Copyright © American College of Physicians. All rights reserved.

From: Cholera Epidemic in Haiti, 2010: Using a Transmission Model to Explain Spatial Spread of Disease and Identify Optimal Control Interventions Ann Intern Med. 2011;154(9):593-601. doi:10.7326/0003-4819-154-9-201105030-00334 Figure Legend: Projected relative benefit of competing vaccination strategies and of vaccination versus allocation of clean water.Top. Optimized allocation was always more effective than either equal or proportional allocation of vaccine, although the difference between strategies increased with delay in vaccination. Bottom. Compared with allocation of clean water, vaccination was projected to reduce far more cases of cholera. Date of download: 12/27/2017 Copyright © American College of Physicians. All rights reserved.

From: Cholera Epidemic in Haiti, 2010: Using a Transmission Model to Explain Spatial Spread of Disease and Identify Optimal Control Interventions Ann Intern Med. 2011;154(9):593-601. doi:10.7326/0003-4819-154-9-201105030-00334 Figure Legend: Projected effect of equal allocation of clean water to all departments, optimized allocation of vaccine, and a combination of these strategies.The combination strategy demonstrates a superadditive effect. Date of download: 12/27/2017 Copyright © American College of Physicians. All rights reserved.

From: Cholera Epidemic in Haiti, 2010: Using a Transmission Model to Explain Spatial Spread of Disease and Identify Optimal Control Interventions Ann Intern Med. 2011;154(9):593-601. doi:10.7326/0003-4819-154-9-201105030-00334 Figure Legend: Optimized allocation of limited vaccine resources, by department, according to time to complete vaccination.Optimized allocation of vaccine focuses largely on Ouest department, because of its large population, and Centre department, which serves as a “crossroads” for cholera spread. As vaccination is increasingly delayed, larger shares are allocated to peripheral regions where epidemics occurred later. Numbers in parentheses represent the ordering of outbreaks. Date of download: 12/27/2017 Copyright © American College of Physicians. All rights reserved.

From: Cholera Epidemic in Haiti, 2010: Using a Transmission Model to Explain Spatial Spread of Disease and Identify Optimal Control Interventions Ann Intern Med. 2011;154(9):593-601. doi:10.7326/0003-4819-154-9-201105030-00334 Figure Legend: Recalibration of the model to incorporate reduction in effective reproductive number over time.A best-fit model (dotted line) incorporating an R0 of 2.90 and discounted at a rate of 1.8% per day reproduces reported cumulative hospitalizations well. Estimated values for the reproductive number by time are plotted. The reproductive number may have fallen below 1.0 in mid-December; <1.0 is no longer associated with exponential growth (11). The gap between case counts with the discounted model, and models in which the reproductive number (2.78 [base case] and 2.90) is reduced only through depletion of susceptible persons through infection provides an index of the effect of disease-control interventions in Haiti to date. MSPP = Ministère de la Santé Publique et de la Population; R0 = basic reproductive number. Date of download: 12/27/2017 Copyright © American College of Physicians. All rights reserved.

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