Model of the evolution of a waterborne epidemic down a river system

An urban epidemic model is coupled with a transport and fate model in order to simulate the evolution of a waterborne disease down a river system. Rivers are ideal conduits for the transmission of waterborne pathogens. Controlling the progression of epidemics along such systems involves understanding and predicting the transport and fate of pathogens through both (1) the water distribution infrastructure ( pumps, wells, pipes, sewers, etc.) (2) environmental sinks (rivers, groundwater, etc.) and (3) the human population. Although models are available to simulate how diseases and organisms move through and evolve within each system, little work has been done to merge these perspectives into a single unified framework. In the present study, we develop such a framework to simulate the progression of an epidemic down an urbanized river system. The framework consists of two coupled models: (1) a river model simulating pathogen transport and fate, and (2) an urban epidemic model. A simulation of the progression of a cholera outbreak in Haiti is provided as an example of the model's utility for both simulation and decision support.