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Ebola: The Distribution of a Cure

Problem A
Abstract
The eradication of Ebola has become a central concern as the virus
quickly spreads, becoming an epidemic due to the failure of medical
staff using proper sanitation techniques and the lack of identifying a
large percentage of the people who have become infected by the disease.
Although Ebola has been around since 1976, a larger amount of attention
was brought to this epidemic in late 2014 when cases of Ebola were
confirmed outside of Africa. On average, 50% of the individuals that are
infected with Ebola do not survive the disease. Because of this, the major
effort of the eradication process is to help the infected survive the epidemic
and gain immunity towards Ebola.
If a medication was invented that had the potential to cure the infected
whose disease had not advanced to a critical state, the next step towards
eradication would be to find a model that predicts the future outcome
of the population as it is affected by Ebola, both with and without the
medication. After the population is predicted, it will need to be decided
how much medication will need to be produced and the most efficient route
to distribute the medication.
To determine the amount of the medication that will be needed to
be manufactured, we built a model formed from a system of equations
that will determine not only the number of infected individuals but also
the amount of individuals that have recovered and have gained immunity
and the individuals that remain susceptible to the disease. Through the
determination of the number of infected individuals, we can ascertain the
amount of medication that will need to be produced.
Along with this model, we proposed a strategy for distribution that
allows doctors to get to and from each distribution center in the swiftest way
possible. This employs Dijkstras algorithm on a variation of the Traveling
Salesman Problem. We recognized that disease spreads like wildfire in the
most recently infected areas and large population centers. The distribution
model takes this into account and allows a quick distribution of vaccine to
where it is most needed.
We believe with this model that Ebola can finally be eradicated. This
model provides a surplus of medication in the event that the disease spreads
faster than the rate of manufacture. Coupled with this, the model also
provide the fastest, most efficient way to distribute the medication.

CONTENTS

CONTENTS

Contents
1 Introduction

2 The
2.1
2.2
2.3

3
3
4
6

Model
Modeling the Spread of Ebola . . . . . . . . . . . . . . . . . . .
Determining Geographic Location . . . . . . . . . . . . . . . . .
Strengths and Weaknesses . . . . . . . . . . . . . . . . . . . . .

Non-Technical Letter

References

THE MODEL

Introduction

In 2014, news of an Ebola epidemic was broadcast across nations. Although


this disease has been around since 1976, this was the first case of Ebola appearing
outside of Africa.[4][5] Because a total of four cases were confirmed in the United
States, new efforts to eradicate Ebola have been initiated.[6] Since it is harder
to contract Ebola, such few cases would not be enough cause to warrant a
declaration of a global threat.[6][7] The reasoning for this declaration was not
found in the speed with which the disease is spread but in the way the disease
attacks its host.
Ebola, previously known as Ebola hemorrhagic fever, is a virus that is
spread through direct contact of another persons bodily fluids.[8] After a person
has become infected by the virus, flu-like symptoms will occur.[4] In more
advanced cases, the infected person will begin to bleed both internally and
externally.[4] Because this virus prevents the immune system from attacking it,
the mortality rate for those who have become infected with this virus is 50%.[9]
Due to the high death rate and the volatile process of death, this disease has
been classified as a global threat.[6]
In light of this recent occurrence, we, as mathematicians, have built models
that represent the population as it is affected by the Ebola virus. These models
also take into account the trend of the virus if proper sanitation and epidemic
procedures are properly utilized and if the detection of individuals who have been
infected by the virus are hospitalized quickly. In the event that a medication is
invented to cure the infected, so long as the virus has not become too advanced,
a secondary model was implemented to insure the quickest, most cost efficient
way to distribute the medication.

The Model

2.1

Modeling the Spread of Ebola

Let . . .
N be the total population
S(t) be the number of healthy, unvaccinated people at time t
I(t) be the number of infected people at time t
D(t) be the number of people who have died at time t
V (t) be the total number of vaccines prepared at time t
R(t) be the number of people who have recovered or been vaccinated at
time t

2.2

Determining Geographic Location

THE MODEL

K be the death rate once infected (should be between 0 and 1)


be the shipping constant. Should be adjusted to make sin(t) produce a
period equal to the shipment frequency
A be the number of people initially infected
B be the rate at which the disease spreads (should be greater than 1)
is the mean time from infection until death
t is time in days
S(t) works off of all of the other equations. It is simply the number of people
who do not belong to any of the other groups. To account for the development
and deployment of the vaccine, a V (t ) term was added where V (t) is the
number of vaccines available and is the delay caused by the shipment of the
vaccines.
I(t) is the number of people who are infected. Infection occurs when two
people come into contact with each other. This was assumed to be an exponential
growth dependent upon the number of people who were initially infected. Thus
the term ABt . However, this exponential growth could not exceed the total
number of people. So the function was capped by use of the Heaviside function
translated by the term ln(SA)
, which is the point at which the exponential
B
growth of infected individuals meets the number of uninfected people. I(t) is also
two terms to account for the eventual outcome of the infection: D(t) and R(t).
To account for the development and deployment of the vaccine, a (V (t ))
term was added where V (t) is the number of vaccines available and is the
delay caused by the shipment of the vaccines.
D(t) is the total number of people claimed by the disease. This is the same
function as I(t), except the time component is translated by , the mean time
from infection till death. The function I(t) is also multiplied by K, which is the
rate at which the disease kills
R(t) is the total number of people that have recovered from the disease. These
people are now considered immune because they have developed the antibodies
to resist future infection (provided that there is no extreme mutation by the
Ebola virus). This term is identical to D(t) except it is multiplied by (1 K),
resulting in D(t) and R(t) equaling I(t) (for some past time t ).
V (t) is the function that represents the manufacturing of the vaccine. The
1.5 represents a constant (we made the assumption that doctors would want
to produce 1.5 times the number of vaccines when compared to the number of
patients). The dirac-delta function is representative of the shipping (the number
of vaccines produced at that point will ship). The integration from 0 to t is
representative of the total number of vaccines produced.

2.2

Determining Geographic Location

For determining geographic locations of where to deploy the cure for Ebola, we
decided to target concentrated population centers. The model demonstrates
4

2.2

Determining Geographic Location

THE MODEL

that diseases proliferate at large population centers and then tend to spread
towards other heavily populated areas. Afterwards, it eventually disperses into
the rural areas. This requires distributors to visit each large population center
in the most efficient way possible that saves on cost and on time. This leads us
to our example of Figure 1.
Figure 1: Graph of areas in Africa with recent Ebola cases
Conakry
Forecariah
Kono

Western Rural

Port Loko

Freetown

Kenema

Lola

Bomi
Monrovia
These are provinces/cities in Sierra Leone, Liberia, and Guinea that have had
a high amount of new Ebola cases during the week of January 26th to February
1st, 2015 [1] [3] [2]. The reason we chose only recent cases is because those cases
are ones that might still have a chance of being cured as a result of not having
an advanced version of the disease. The way we get through each city efficiently
is to view it as a variation on the Traveling Salesman Problem. That is, visit
every Ebola-stricken area once but do not carry the restriction that forces us to
return to our original location. We developed an algorithm to accomplish this,
which gave us Figure 2.
We took into account distances between each location on a physical map
using Google Maps and found the shortest path that hits all locations. Using
this idea, we can apply this method of vaccine distribution to speed up the rate
of vaccination.

2.3

Strengths and Weaknesses

THE MODEL

Figure 2: Shortest path through nodes in Figure 1


Conakry
Forecariah
Kono

Western Rural

Port Loko

Freetown

Kenema

Lola

Bomi
Monrovia

2.3

Strengths and Weaknesses

For the most part, we believe that the model is adequate, although by no means
extraordinary. We do think that an exponential growth would represent the
infection rate in a population well as each person has a relatively consistent
exposure to others. The kill rate also seems to be fairly consistent and as such,
it makes sense that it would be a constant. There are also no recorded cases of
people contracting Ebola after having it and surviving; therefore, we created the
R(t) function.
The weakest point of this model has to do with the vaccine development.
We had a hard time coming up with a function that would approximate the
development of a vaccine. We do think that logistic growth seems reasonable and
appropriate, but the distribution of the vaccine is a bit more complex. By making
the assumption that shipments would move out in bulk at regular intervals, we
were able to use the dirac delta function. However, it was difficult to visualize
how this equation would affect the rest of the population.

NON-TECHNICAL LETTER

Non-Technical Letter

In response to your announcement of a medication that could cure patients


with Ebola, we have constructed models to represent the future of the population
with the addition of your medication. Although the medication will only cure
those in which the virus has not become too advanced and under the assumption
that proper sanitation and epidemic procedures are utilized, we have provided
two models to aid in the manufacturing and distribution of your breakthrough
medication.
If we were to produce exactly as much medication as there were infected,
then the virus would continue to infect those who are susceptible to the disease,
creating a shortage in the amount of medication we are able to provide. To
prevent an incident where we would have an insufficient amount of medication
for the infected, we assumed that medical professionals would want to produce a
surplus of medication and factored this into our model. In order to determine
the amount of medication we will need to produce, we will take the number of
infected and run it through our first model. This would effectively provide the
manufacturers of the medication with a figure that is 1.5 times the size of the
infected portion of the population.
After the medication has been manufactured, we look to our second model
for the quickest, most cost efficient way to distribute the medication to the
infected. In order to eradicate the disease, we considered the regions of the most
current cases and the regions in which there has been confirmed cases of Ebola.
Although there were a few confirmed cases outside of Africa, the individuals in
these cases had traveled from Africa where, it is presumed, they contracted the
disease. Because all other cases are in Africa, we decided to focus on the region
of Africa where the most cases of Ebola were found, namely Guinea, Liberia, and
Sierra Leone. Notably, a large aggregation of the cases were found around areas
that had concentrated population centers. We assumed that these cases were
the most likely to be cured, preventing further infection within these densely
populated areas. We also assumed that if these individuals were cured, they
would be immune to the disease, and of those that were not able to be cured, the
corpses of the diseased will be properly disposed of so as not to infect another
person.
If our models were to be implemented, there would be a surplus of medication to cure those who are in the early stages of the infection, and there would
be fast and cost efficient way to ship and distribute the medication. As a result
of proper sanitation procedures and the use of our models, the spread of Ebola
will be greatly reduced if not eradicated.

REFERENCES

REFERENCES

References
[1] Data Published on 04 February 2015-Data on New Cases by Epi Week
and District. Ebola Data and Statistics. N.p., 4 Feb. 2015. Web. 08 Feb.
2015. http://apps.who.int/gho/data/view.ebola-sitrep.ebola-country-GINnew-conf-prob -districs-20150204-data?lang=en
[2] Data Published on 04 February 2015-Data on New Cases by Epi
Week and District. Ebola Data and Statistics. N.p., n.d. Web. 08 Feb.
2015. http://apps.who.int/gho/data/view.ebola-sitrep.ebola-country-LBRnew-conf-prob -districs-20150204-data?lang=en
[3] Data Published on 04 February 2015-Data on New Cases by Epi
Week and District. Ebola Data and Statistics. N.p., n.d. Web. 08 Feb.
2015. http://apps.who.int/gho/data/view.ebola-sitrep.ebola-country-SLEnew-conf-prob -districs-20150204-data?lang=en
[4] Ebola Virus Disease. WHO. Web. 8 Feb. 2015.
http://www.who.int/mediacentre/factsheets/fs103/en.
[5] Cases of Ebola Diagnosed in the United States. Centers for Disease Control and Prevention. Centers for Disease Control and Prevention, 16 Dec.
2014. Web. 8 Feb. 2015. http://www.cdc.gov/vhf/ebola/outbreaks/2014-westafrica/united-states-imported-case.html.
[6] The U.S. Government Response to the Ebola Outbreak. U.S. Department of State. U.S. Department of State, 12 Nov. 2014. Web. 8 Feb. 2015.
http://www.state.gov/s/dmr/remarks/2014/233996.htm.
[7] How Quickly Ebola Spreads Compared to Other Diseases. Washington
Post. The Washington Post. Web. 8 Feb. 2015.
http://www.washingtonpost.com/wp-srv/special/health/how-ebolaspreads.
[8] Ebola Virus. Web. 8 Feb. 2015. https://www.bcm.edu/departments/molecularvirology-and-microbiology/emerging-i nfections-and-biodefense/ebola-virus.
[9] Chan, Amanda. What Actually Happens When A Person Is Infected With
The Ebola Virus. The Huffington Post. TheHuffingtonPost.com. Web. 8
Feb. 2015. http://www.huffingtonpost.com/2014/08/02/ebola-symptomsinfection-virus n 56 39456.html.