ROLE OF MAPPING IN

DISEASE CONTROL
MASTER’S SEMINAR – VEP 691

M. S. SHEETAL
20-MVP-24
DEPT OF VETERINARY EPIDEMIOLOGY & PREVENTIVE MEDICINE
Introduction:
Mapping in general terms refers to the pictorial representation of geographical features.
Disease mapping is the visual representation of geographical distribution of disease in a
population. A common method of displaying the geographical (spatial) distribution of disease
and related factors is by drawing maps (cartography). Maps can also suggest possible causes
of diseases of unknown aetiology. At their simplest, maps may be qualitative, indicating
location without specifying the amount of disease. They can also be quantitative, displaying
the number of cases of disease. Sometimes the statistical methods alone are mind-boggling.
maps are commonly used in epidemiology to present complicated information succinctly and
clearly. Sometimes a picture can truly be worth a thousand words! Maps demonstrate with a
unique efficiency the distribution of phenomena in space.

History:
Mapping was used early in 1800s itself to demonstrate the distribution of diseases in several
American and British studies. Most of these maps portrayed infectious diseases like Plague,
Yellow fever in US and contagious fevers in Ireland. One of the most famous uses of
mapping in epidemiology were studies of cholera epidemics in London.
Spot Map by John Snow
• Severe Cholera outbreak of Broad Street 1854
• The disease had unknown nature and means of spread
• John snow observed the affected and the places where they lived
• He then plotted dot maps of cases in Golden square area by using black rectangles
• Distinct cluster of cases were observed around the Broad Street water pump
• Thus, Snow’s Dot map suggested contaminated water supply from the pump as the
source of disease
Construction of a Map:
Constructing a map mainly contains three major components. The Data, Area of study and
Choice of scale. The Data can be crude or raw data of disease distribution or results of
statistical processing, Area of Study is sometimes predefined and should be chosen on basis
of gathered information, Choice of Scale determines the extent of arial coverage and degree
to which spatial structures are observable on the map. Sometimes symbols, contours and
colours can be used for appropriate representations.
Types of Maps
Point maps are type of maps which shows the exact location of disease occurrence depicted
by points or dots. Distribution maps shows the area of disease occurrence in different shades.
Choroplethic maps display quantitative information about disease of interest based on
administrative regions. Isoplethic maps include isomorts and isomorbs where the true
boundary of disease distribution is shown.
Geographical Information System (GIS)
GIS are advanced form of mapping. These are computerized systems for collecting, storing,
interrogating and displaying spatial data. GIS also include graphical analysis, statistical
analysis and modelling based on spatial location data.
Application of GIS in Veterinary Epidemiology
In Veterinary Epidemiology GIS is used in many disciplines like Monitoring, recording and
forecasting of disease, Epidemic emergency system, Analysis of clustering of diseases in a
place, Modeling of spreading of disease, Planning of epidemic control programs.
Relevance of Disease Cartography
GIS and its streams can be relevant in many aspects of veterinary including understanding
weather and its role in spread of diseases, disease emergence and vector incursion,
identifying risk prone areas for better disease control and understanding the spatio - temporal
magnitude of a disease.
UNDERSTANDING WEATHER AND ITS ROLE IN DISEASE SPREAD
FMD EPIDEMIC – ENGLAND (1967-68)
An analysis was conducted on 1967-68 epidemic in England and Wales. During this period,
every outbreak was carefully investigated by the Government Veterinary Field Service
(V.F.S.). Infected or Incubating animals, Animal products and Fomites were considered to be
common means of spread. Even though aerosol transmission was suggested, long distance
transmission through wind was unknown. The possibility of dissemination of FMDV by wind
was suggested in many studies during the 1900s
Major studies which suggested the possibility of dissemination of FMDV by wind:
• Suggested FMDV was carried on particles and insects - Hardy et al. (1938)
• Experimental airborne infection over 10 m - Fogedby et al. (1960)
• Demonstrated that release of virus into the air occurred before the appearance of
clinical symptoms - Hyslop et al. (1965 a)
• Presence of aerosols of FMD virus in air - Hyslop et al. (1965 b)
Type of data collection used in this study include Interviews of farmers and veterinary
officers in selected areas, Information which was abstracted from the V.F.S. files of all
outbreaks, Meteorological data which included hourly weather records, Wind directions, rain,
proximity to the supposed source and Statistical analysis showing rate of spread
The first known outbreak and that with the longest history of clinical disease was Bryn Farm
5 miles to the south of Oswestry in Shropshire. The farms next affected in the area were two
neighbors within 0.5 km. and 2 km. Subsequently more farms were affected. The position of
all farms affected during this period was mapped. The weather data that include wind
direction, wind speed, precipitations were also recorded. 31 outbreaks lay within a limited
sector (between discontinuous lines), and 11 outbreaks were outside this sector but less than 2
km from Bryn Farm. During the period, the surface wind blew predominantly towards
bearings 360°-070°. This range of directions contains the sector in which the outbreaks
occurred. Frequent rain was also observed during this period and spread of disease was
confined to the directions in which the rainy winds blew. Mean 2000 ft. wind direction was
also recorded, but the direction of spread was closer to the surface wind than to the 2000 ft.
wind. Thus, from the disease map created during this period, suggestions were made to
conclude that most of the initial spread in the 1967-8 epidemic can be attributed to wind. And
disease cartography hence proved to be effective in predicting the spread of a disease.

DISEASE EMERGENCE AND VECTOR INCURSION - BLUETONGUE IN EUROPE

Bluetongue is caused by orbivirus and Culicoides sp act as the vector for the disease. These
vectors were found to survive only at a temperature above 12°. Historically, the maps
suggested that bluetongue was restricted to 40° latitude, this was called the sonoral line.
Mapping of vectors also suggested this to be the north most boundary for the vectors. The
major vectors found to cause the disease include C. imicola, C. sonorensis, C. brevitarsis
found in Africa Middle East, southeast Asia, parts of Southern Europe, North America and
Australia respectively.
Post 1998 cetrain incidents occurred further north of sonoral line Towards central and
northern Europe. These occurences were attributed to C. obsoletus and C. pulicaris group.
These vectors could survive in the northern region due to overwintering and climatic change.
 The weather maps showing time series of global average temperature also showed the
increase in global temperature over years.

Distribution across the world was shown to Estimated global range of bluetongue virus
comprise a broad band between after 1998
approximately 40°N & 35°S - prior to 1998

The finding of BTV in the countries north of the Alps is considered to be associated with
recent global climatic changes and the related spread of BTV vector. In 2006 a sudden and
unexpected bluetongue outbreak occurred in Northern Europe. It was also the year the
country recorded an exceptionally warm autumn.
The Isotherm predictions, Meteorological maps on climate change, Mapping of new vectors
outside the conventional zone, Reports of outbreaks in areas thought to be free of virus,
Control of new vectors leading to control of outbreaks and Application of explicit dispersion
modelling on Culicoides survival and introduction showed the incursion of vectors and thus
emergence of diseases to new areas which was earlier thought to be free of the disease. Thus,
Mapping helped in finding out vector incursion and subsequent emergence of diseases.

IDENTIFYING RISK PRONE AREAS FOR DISEASE CONTROL – ONE HEALTH

APPROACH - EBOLA MAPPING

Ebola virus disease (EVD) is caused by Ebola virus belonging to filoviridae. It was originally
reported in Democratic Republic of Congo in 1976 and from 2000 onwards it is reported
from West African countries like Liberia. There have also been reports of several large
epidemics on wild primates. Old World fruit bats are suspected to be the most likely carriers
of the virus in the wild. Interaction between human and wild animals is considered to be a
factor causing the disease.
Based on predictions by Pigott et al.(2014) about where in Africa wild animals may harbor
the virus and where the transmission of the virus from these animals to humans is possible.
Combined mapping of human and animal outbreaks along with environmental factors and
location of possible reservoirs were attempted. These niche mapping do not enable
assessment of secondary transmission rates in human populations. But they act as an
evidenced-based indicator of locations with potential for future zoonotic transmission and
thus outbreaks. Mapping of zoonotic Niche can help in identifying risk areas –initiating
programs for better control.
The data incorporated include,
• A comprehensive dataset of the reported locations of index cases and human reports
• A dataset of the locations of Ebola virus infections in suspected reservoir and (non-
human)
• susceptible host species
• A suite of ecologically relevant environmental covariates for Africa, including
predicted distribution maps of suspected reservoir bat species
• Retrospective data representing locations where zoonotic Ebola virus has not been
reported.
For identifying index cases and reconstructing zoonotic transmission data was Initially
sourced from the scientific literature &health reporting organisations. Site/ supposed site was
geopositioned using Google Earth. If accurate region was not geopositioned - geographic area
(polygon) was defined covering the reported region. Assembling database of reported
infections in animals was done using the sampling site or location of the animal in the study
was identified and geopositioned using Google Maps. Predicted distribution maps of
reservoir bats were sourced from Global Biodiversity Information Facility, expert-opinion
range maps and regression tree species distribution models. Population living in areas of
environmental suitability for zoonotic transmission were assessed by Randomly sampling and
detection of 10,000 locations across Africa along with identifying population at risk by using
the Global Rural Urban Mapping Project, Meteorological analysis for environmental
suitability of zoonotic Ebola virus transmission and National level demographic and mobility
data with help of the International Air Transport Association.

Mapping Human Outbreaks

Mapping Animal Disease Reports

Mapping Possible Geographical Distribution of Reservoirs

Result: Map of Possible Risk Prone Areas
Mapping of human and animal outbreaks, distribution of reservoirs and climatic factors in a
one health approach thus helped in obtaining a map showing risk prone areas which further
assisted in response impact.
The response impact of this Ebola mapping includes, improvements in public health in the
risk prone areas of west Africa as a result of the Ebola response in 4 key areas Emergency
response, Laboratory capacity, Surveillance and Workforce development.

UNDERSTANDING SPATIO TEMPORAL MAGNITUDE OF A DISEASE

HIGHLY PATHOGENIC AVIAN INFLUENZA - BANGLADESH (2007-09)
Bangladesh was one among the countries with highest no of HPAI outbreaks during 2007-
2009. Being a resource limited country, needed an epidemiological knowledge-based
approach to target the control of disease. Temporal distribution, Descriptive analysis,
Exploratory mapping and Geostatistical analysis was used to understand the spread. Maps
were created using data including date and time of occurrence, regions affected and species
affected.

Temporal distribution revealed Clusters during winter and spring. Exploratory mapping
showed an oblique line that connects south-east to north-west through the central part of the
country. The line follows the Brahmaputra-Meghna River system, the junction between
Central Asian and East Asian flyways, and the major poultry trading route in Bangladesh.
Several important migratory bird areas were identified along the line. Geostatistical analysis
revealed significant latitudinal directions of outbreak. A consistent pattern emerges
suggesting risk to be associated with duck abundance & rice cropping intensity. The line of
magnitude and direction understood from mapping of this disease indicate the necessity of
mobilizing maximum resources on this line to strengthen the existing surveillance. Countries
with similar geographical features, farming practices and bird population can also analyze the
risk in a similar way.
Response impact of mapping: In 2008, a global project of the United States Agency for
International Development, Stamping Out Pandemic and Avian Influenza (STOP AI), was
initiated in Bangladesh, Biosecurity training for veterinarians and livestock science graduates
on some large-scale commercial farms, Distribution of cleaning and disinfection equipment,
Training staff members on the use of the web-based Livestock Disease Information System
enabling them to initiate disease reporting.
21st CENTURY GIS TECHNOLOGIES SUPPORTING THE GLOBAL FIGHT AGAINST
OUTBREAKS
Online real- or near-real time mapping of disease cases, social media reactions to disease
spread, Predictive risk mapping using population travel data, Tracing and mapping super
spreader trajectories and contacts across space and time. Help in understanding disease
source, dynamics and epidemiology, thus shaping effective response.
Practical online/mobile GIS and mapping dashboards during the COVID-19 outbreak
JHU’s Science and Engineering dashboard
Interactive map locates and tallies confirmed infections, fatalities and recoveries, timeline
charts of total confirmed cases and total recovered cases virus progress over time.
The World Health Organization dashboard
ArcGIS Operations Dashboard for COVID-19. Includes an epidemic curve up front, showing
cases by date of reporting. Automatically updated data using GIS and Satellites along with
health data from officials reported to WHO.
Mapping the worldwide spread of misinformation about coronavirus
Social media play an important role in communicating verified facts along with ‘virally’
spreading misinformation, confusion and fear among the general public. Animated map
showing the worldwide propagation of the hashtag #coronavirus on Twitter and the actual
cases of coronavirus helped in identifying the extent of spread of misinformation.
FUTURE PERSPECTIVES
The future of disease mapping is extravagant. It can be expanded to different fields like
Expansion of advanced mapping possibilities to the animal sector, Availability of affordable
software, Maps which are made more user-friendly and understood by common people,
Artificial Intelligence in the field of Mapping and Neural Networking.
CONCLUSION
Disease Cartography is becoming extremely useful for One Health based disease control. GIS
analyses are now used in prioritizing health goals. Health organizations are now able to
visualize, analyze, interpret and display multifaceted geo-location data through the use of GIS
tools, mapping applications and Big Data. With the advancement of technologies Mapping
has been developed in a way which was previously thought impossible. It will be interesting
to witness how new technologies, analytical techniques, and data sources will shape the
future of the discipline
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