IEEE TRANSACTIONS ON KNOWLEDGE AND DATA

ENGINEERING
VOL. 22, NO. 4, APRL 2010

PROSPECTIVE INFECTIOUS DISEASE OUTBREAK
DETECTION USING MARKOV SWITCHING MODELS

ABSTRACT
Accurate and timely detection of infectious disease outbreaks
provides valuable information whi ch can enable public health
officials to respond to major public health threats in a timely fashion.
However, disease outbreaks are often not directly observable. For
surveillance systems used to detect outbreaks, noises caused by
routine behavioral patterns and by special events can further
complicate the detection task.
Most existing detection methods combine a time series filtering
procedure followed by a statistical surveillance method. The
performance of this "two-step detection method is hampered by the
unrealistic assumption that the training data are outbreak-free.
Moreover, existing approaches are sensitive to extreme values,
which are common in real-world data sets. We considered the
problem of identifying outbreak patterns in a syndrome count time
series using Markov switching models. The disease outbreak states
are modeled as hidden state variables which control the observed
time series.
A jump component is introduced to absorb sporadic extreme values
that may otherwise weaken the ability to detect slow-moving disease
outbreaks. Our approach outperformed several state-of-the-art
detection methods in terms of detection sensitivity using both
simulated and real-world data.

INDEX TERMS
Markov switching models, syndromic surveillance, Gi bbs sampling,
outbreak detection.