Game changes how scientists study outbreaks

An international team of scientists have created an innovative tool for teaching the fundamentals of epidemiology—the science of how infectious diseases move through a population.

The team teaches a workshop annually in South Africa that helps epidemiologists improve the mathematical models they use to study outbreaks of diseases like cholera, AIDS and malaria. A team created a new game as a teaching aid for the workshop and which has proven effective in demonstrating concepts of epidemiology. The game was conceived by Steve Bellan of UC Berkeley and Juliet Pulliam of U. Florida, and implemented by a team of researchers, including Jonathan Dushoff, an associate professor of biology at McMaster and member of the M.G. DeGroote Institute for Infectious Disease Research, and James Scott of Colby College; all four co-authored the paper.

The exercise is presented in the April 3 edition of the online, open-access journal PLoS Biology. Click here to view the study.

In the game, players simulate a real-life epidemic by passing around pieces of paper that say, “You have been infected,” followed by instructions for propagating the disease.

"The exercise gave mathematically oriented participants a concrete feeling for some of the complexity that underlies data, and gave the epidemiologically oriented participants an appreciation of the meaning and practical value of mathematical models," says Dushoff, who has been involved with teaching and organizing the workshops in Africa for the last five years.

Collaborations between bio-mathematicians and classical epidemiologists have resulted in valuable lessons for tracking the spread of diseases, said Steve Bellan, one of the authors of the study from the University of California at Berkeley. For example, HIV interventions and efforts to eliminate trachoma, a bacterial infection that causes blindness, have successfully used the tag-team approach. In both cases, studies have shown that when practitioners employ the power of mathematical modeling to improve their intervention strategies, they are more likely to interrupt the progress of an epidemic.

“This is about the importance of collaboration,” said Bellan, an ecologist who specializes in epidemiology of wildlife diseases. “No one can be an expert in everything. We want to see more scientists working together from the start.”

Dushoff agrees. "Dealing with public health challenges effectively require collaboration between scientists from different fields of study, and different parts of the globe.  We found that this exercise has the ability to bridge gaps and draw people in."

Dushoff, Bellan and six other scientists from South Africa, Canada and the US, offer two-week clinics every year at the African Institute for Mathematical Sciences. The clinics immerse epidemiological number-crunchers more fully into the human aspects of how disease spreads. The addition of the new game has significantly changed how this is achieved.

In the game, an “infectious” piece of paper notifies people that they have been exposed and instructs them to email Bellan of their fate. They then use a random number generator to determine how many others should be infected, and then pass that number of “infections” to other participants. The rules serve to propagate the disease, but also to build a data set of who infected whom and when.

Clinic attendees typically spend the first week talking about where data sets come from, who collects them, and what the numbers refer to. The real benefit comes during the second week, when groups experiment with various epidemiological models using actual data sets – typically from HIV studies or other ongoing projects.

Photo caption: Jonathan Dushoff