Epidemic Response and Emerging Infectious Diseases

Police woman

Raina MacIntyre is an international leader in emerging infections, and is involved in numerous face mask, vaccine, influenza and other infectious diseases research studies that directly inform national and international policy and practice in communicable disease control. Her research is underpinned by extensive field outbreak investigation experience. She is a graduate of the only Australian Field Epidemiology Training program, the MAE at ANU, and has extensive experience in shoe-leather epidemiology of infectious diseases outbreaks including influenza, meningococcal disease, clostridium perfringens, hepatitis A, legionella, mycoplasma, pertussis and gastroenteritis to name a few. Her in-depth understanding of the science of outbreak investigation draws from this experience combined with her academic training through a Masters and PhD in Epidemiology. Her passion for field epidemiology led her to co-found the ARM network for Australian outbreak response. She does research on the transmission dynamics and prevention of infectious diseases, particularly respiratory pathogens such as influenza, tuberculosis and other vaccine-preventable infections. She has also done research on using risk-analysis methods for analysing emerging infectious diseases outbreaks such as Ebola and MERS-CoV.

She leads a NHMRC Centre for Research Excellence in Epidemic Response which is international and multi-sectoral, and will address gaps in global systems for epidemic response. She won many career awards including the Sir Henry Wellcome Medal and Prize, from the Association of Military Surgeons of the United States in 2007 for her work on a risk-priority scoring system for category A bioterrorism agents; and the highest national award in infectious diseases, the Frank Fenner Award for Research in Infectious Diseases in 2003.


Selected Publications

MacIntyre CR; Costantino V; Kunasekaran MP, 2019, 'Health system capacity in Sydney, Australia in the event of a biological attack with smallpox', PLoS ONE, vol. 14, http://dx.doi.org/10.1371/journal.pone.0217704

Barnes CE; MacIntyre CR, 2019, 'Risk modelling the mortality impact of antimicrobial resistance in secondary pneumococcal pneumonia infections during the 2009 influenza pandemic', International Journal of Infectious Diseases, vol. 85, pp. 1 - 6, http://dx.doi.org/10.1016/j.ijid.2019.05.005

Sparks R; Jin B; Karimi S; Paris C; MacIntyre CR, 2019, 'Rejoinder', Quality Engineering, vol. 31, pp. 105 - 107, http://dx.doi.org/10.1080/08982112.2018.1547831

Sparks R; Jin B; Karimi S; Paris C; MacIntyre CR, 2019, 'Real-time monitoring of events applied to syndromic surveillance', Quality Engineering, vol. 31, pp. 73 - 90, http://dx.doi.org/10.1080/08982112.2018.1537443

Moa AM; Adam DC; MacIntyre CR, 2019, 'Inter-seasonality of influenza in Australia.', Influenza Other Respir Viruseshttp://dx.doi.org/10.1111/irv.12642

Joshi A; Karim S; Sparks R; Paris C; MacIntyre R, 2019, 'Survey of Text-based Epidemic Intelligence: A Computational Linguistic Perspective', ACM Computing Surveys

Jayasundara D; Hui BB; Regan DG; Heywood AE; MacIntyre CR; Wood JG, 2019, 'Modelling the decline and future of hepatitis A transmission in Australia', Journal of Viral Hepatitis, vol. 26, pp. 199 - 207, http://dx.doi.org/10.1111/jvh.13018

Hii A, Chughtai AA, Housen T, Saketa A, Kunasekaran MP, Sulaiman F, et al. Epidemic intelligence needs of stakeholders in the Asia–Pacific region. Western Pac Surveill Response J. 2018 Dec;9(4). doi:10.5365/wpsar.2018.9.2.009

Bui CM, Adam DC, Njoto E, Scotch M, MacIntyre CR. Characterising routes of H5N1 and H7N9 spread in China using Bayesian phylogeographical analysis. Emerging Microbes and Infections. 2018; 7(1):184

Chen X, Chughtai AA, MacIntyre CR. Recalibration of the Grunow-Finke Assessment Tool to improve performance in detecting unnatural epidemics. Risk Analysis. 2018 Dec 24

MacIntyre CR, Dyda A, Bui CM, Chughtai AA. Author Response to Comments on “Rolling epidemic of Legionnaires’ disease outbreaks in small geographic areas”. Emerging microbes & infections. 2018;7.

Jayasundara D, Hui BB, Regan DG, Heywood AE, MacIntyre CR, Wood JG. Modelling the decline and future of hepatitis A transmission in Australia. Journal of viral hepatitis. 2018 Oct 13.

Ajisegiri WS, Chughtai AA, MacIntyre CR. A Risk Analysis Approach to Prioritizing Epidemics: Ebola Virus Disease in West Africa as a Case Study. Risk Analysis. 2018 Mar;38(3):429-41

Adam, D.C., Jonnagaddala, J., Han-Chen, D., Batongbacal, S., Almeida, L., Zhu, J.Z., Yang, J.J., Mundekkat, J.M., Badman, S., Chughtai, A. and MacIntyre, C.R., 2017. ZikaHack 2016: A digital disease detection competition. In Proceedings of the International Workshop on Digital Disease Detection using Social Media 2017 (DDDSM-2017) (pp. 39-46).

Dillon C Adam, Matthew Scotch, C Raina MacIntyre; Bayesian phylogeography and pathogenic characterisation of smallpox based on HAATI and CrmB genes, Molecular Biology and Evolution, , msy153, https://doi.org/10.1093/molbev/msy153

MacIntyre CR, Valentina C, Xin C, et al. Influence of Population Immunosuppression and Past Vaccination on Smallpox Reemergence. Emerging Infectious Disease journal. 2018;24(4).

Raina MacIntyre, C., Engells, T.E., Scotch, M. et al. Converging and emerging threats to health security, Environ Syst Decis (2018) 38: 198. https://doi.org/10.1007/s10669-017-9667-0

Njoto EN;Scotch M;Bui CM;Adam DC;Chughtai AA;Macintyre CR, 2018, 'Phylogeography of H5N1 avian influenza virus in Indonesia', Transboundary and Emerging Diseases, http://dx.doi.org/10.1111/tbed.12883

Valentina Costantino, Mohana P Kunasekaran, Abrar A Chughtai, Chandini R MacIntyre; How Valid Are Assumptions About Re-emerging Smallpox? A Systematic Review of Parameters Used in Smallpox Mathematical Models, Military Medicinehttps://doi.org/10.1093/milmed/usx092

MacIntyre CR;Dyda A;Bui CM;Chughtai AA, 2018, 'Rolling epidemic of Legionnaires' disease outbreaks in small geographic areas article', Emerging Microbes and Infections, vol. 7, http://dx.doi.org/10.1038/s41426-018-0051-z

Pan Y, Q Wang, P Yang, L Zhang, S Wu, Y Zhang, Y Sun, W Duan, C Ma, M Zhang, X Zhang, and C R MacIntyre (2017) Influenza vaccination in preventing outbreaks in schools: A long-term ecological overview Vaccine

Ralf Itzwerth, Aye Moa, C. Raina MacIntyre. Australia’s influenza pandemic preparedness plans: an analysis J Public Health Pol (2017)

Narain JP, Dhariwal AC, MacIntyre CR, 2017, 'Acute encephalitis in india: An unfolding tragedy', Indian Journal of Medical Research, vol. 145, pp. 584 - 587, http://dx.doi.org/10.4103/ijmr.IJMR_409_17

MacIntyre CR, Bui CM. Pandemics, public health emergencies and antimicrobial resistance - putting the threat in an epidemiologic and risk analysis context. Archives of Public Health. 2017;75(1):54.

Ajisegiri W S, Chughtai A A,  and MacIntyre C R. (2017), A Risk Analysis Approach to Prioritizing Epidemics: Ebola Virus Disease in West Africa as a Case Study. Risk Analysis. doi:10.1111/risa.12876

Heslop DJ, Chughtai AA, Bui CM, MacIntyre CR. Publicly available software tools for decision-makers during an emergent epidemic—Systematic evaluation of utility and usability. June 2017, Epidemics. Full text

Ajisegiri W S, Chughtai A A,  and MacIntyre C R. (2017), A Risk Analysis Approach to Prioritizing Epidemics: Ebola Virus Disease in West Africa as a Case Study. Risk Analysis. doi:10.1111/risa.12876

Heslop DJ, Chughtai AA, Bui CM, MacIntyre CR. Publicly available software tools for decision-makers during an emergent epidemic—Systematic evaluation of utility and usability. June 2017, Epidemics. Full text

Moa AM, Muscatello DJ, Turner RM, MacIntyre CR. Epidemiology of influenza B in Australia: 2001-2014 influenza seasons. Influenza Other Respir Viruses. 2017;11(2):102-9. https://www.ncbi.nlm.nih.gov/pubmed/27650482

Muscatello DJ, Chughtai AA, Heywood A, Gardner LM, Heslop DJ, MacIntyre CR. Translation of Real-Time Infectious Disease Modeling into Routine Public Health Practice. Emerg Infect Dis. 2017;23(5). https://www.ncbi.nlm.nih.gov/pubmed/28418309

Bui CM; Gardner L; MacIntyre R; Sarkar S, 2017, 'Influenza A H5N1 and H7N9 in China: A spatial risk analysis', PLoS ONE, vol. 12, http://dx.doi.org/10.1371/journal.pone.0174980

Bui C; Bethmont A; Chughtai AA; Gardner L; Sarkar S; Hassan S; Seale H; MacIntyre CR, 2016, 'A Systematic Review of the Comparative Epidemiology of Avian and Human Influenza A H5N1 and H7N9-Lessons and Unanswered Questions', TRANSBOUNDARY AND EMERGING DISEASES, vol. 63, pp. 602 - 620, http://dx.doi.org/10.1111/tbed.12327

Bui CM;Chughtai AA;Adam DC;MacIntyre CR, 2017, 'An overview of the epidemiology and emergence of influenza A infection in humans over time', Archives of Public Health, vol. 75, http://dx.doi.org/10.1186/s13690-017-0182-z

Narasimhan P, MacIntyre CR, Mathai D, Wood J. High rates of latent TB infection in contacts and the wider community in South India. Transactions of the Royal Society of Tropical Medicine and Hygiene. 2017:1-7. https://www.ncbi.nlm.nih.gov/pubmed/28407146

Awadh A, Chughtai AA, Dyda A, Sheikh M, Heslop DJ, MacIntyre CR. Does Zika Virus Cause Microcephaly – Applying the Bradford Hill Viewpoints. PLOS Currents Outbreaks. 2017 Feb 22 . Edition 1. doi: 10.1371/currents.outbreaks.2fced6e886074f6db162a00d4940133b.

Saha A, Rosewell A, Hayen A, MacIntyre CR, Qadri F, 2017, 'Improving immunization approaches to cholera', Expert Review of Vaccines, vol. 16, pp. 235 - 248, http://dx.doi.org/10.1080/14760584.2017.1249470, ROS ID: 853541

WONG ZS Y, BUI CM, CHUGHTAI AA, MACINTYRE CR, 2017, 'A systematic review of early modelling studies of Ebola virus disease in West Africa', Epidemiology and Infection, pp. 1 - 26, http://dx.doi.org/10.1017/S0950268817000164, ROS ID: 874683

Chughtai AA, Wang Q, Dung TC, Macintyre CR, 2017, 'The presence of fever in adults with influenza and other viral respiratory infections', Epidemiology and Infection, vol. 145, pp. 148 - 155, http://dx.doi.org/10.1017/S0950268816002181, ROS ID: 847567

Gardner, LM, Chughtai AA, MacIntyre CR. Risk of global spread of Middle East respiratory syndrome coronavirus (MERS-CoV) via the air transport network. Journal of Travel Medicine. DOI:http://dx.doi.org/10.1093/jtm/taw063 First published online: 5 September 2016

Bethmont A, Bui CM, Gardner L, Sarkar S, Chughtai AA, MacIntyre CR. Quantified degree of poultry exposure differs for human cases of avian influenza H5N1 and H7N9. Epidemiology and Infection 2016; 1-8.  [Epub ahead of print]

Chughtai AABarnes MMacIntyre CR. Persistence of Ebola virus in various body fluids during convalescence: evidence and implications for disease transmission and control. Epidemiol Infect.2016 Jan 25:1-9. [Epub ahead of print] 

Bui CM, Gardner L, MacIntyre CR. Highly pathogenic avian influenza virus, Midwestern United States [letter]. Emerg Infect Dis. 2016 Jan.  Vol. 22, number 1, 138-139. http://dx.doi.org/10.3201/eid2201.151053

Bui CRahman BHeywood AEMacIntyre CR. A Meta-Analysis of the Prevalence of Influenza A H5N1 and H7N9 Infection in Birds. Transbound Emerg Dis.2016 Jan 10. doi: 10.1111/tbed.12466. [Epub ahead of print]

MacIntyre CR, Chughtai AA. Recurrence and reinfection– a new paradigm for management of Ebola virus disease (EVD).Int J Infect Dis 2015; 43:58-61.

Zhang D, WuS, ZhangY, Yang P, MacIntyreCR, SealeH  and *WangQ. Health literacy in Beijing: an assessment of adults’ knowledge and skills regarding communicable diseases. BMC Public Health2015, 15:799. doi:10.1186/s12889-015-2151-1

Heywood AE, Forssman BL, Seale H, MacIntyre CR, Zwar N. General Practitioners' Perception of Risk for Travelers Visiting Friends and Relatives. Journal of Travel Medicine, 2015.First published online: 15 JUL 2015. doi: 10.1111/jtm.12229

Chughtai AA, Rehman B, MacIntyre CR. Commentary on: Arriola et al. Antivirals and Effect Modification in Influenza Studies. Journal of Infectious Diseases, 2015. First published online: 14 JUL 2015. doi: 10.1093/infdis/jiv384

Ma THeywood AMacIntyreCR. Chinese travellers visiting friends and relatives - A review of infectious risks. Travel Med Infect Dis.2015 May 14. pii: S1477-8939(15)00083-6. doi: 10.1016/j.tmaid.2015.05.004. [Epub ahead of print] 

Zhang Y, Sun W, Svendsen ER, Tang S, MacIntyre CR, Yang P, Zhang D, *Wang Q. Do corticosteroids reduce the mortality of influenza A (H1N1) infection? A meta-analysis. Crit Care 2015;19(46):1-11. doi: 10.1186/s13054-015-0764-5. Epub 2015 Feb 20.

Wang X, Wu S, MacIntyre CR, Zhang H, Shi W, Peng X, et al. Using an Adjusted Serfling Regression Model to Improve the Early Warning at the Arrival of Peak Timing of Influenza in Beijing. PLoS ONE. 2015;10(3):e0119923.doi: 10.1371/journal.pone.0119923

*MacIntyre, CR, Travaglia, J. Heightened vulnerability, reduced oversight and ethical breaches on the Internet in the in West African Ebola epidemic. The American Journal of Bioethics, 2015.

Bui, C., A. Bethmont, A. A. Chughtai, L. Gardner, S. Sarkar, S. Hassan, H. Seale and C. R. MacIntyre, 2015: A Systematic Review of the Comparative Epidemiology of Avian and Human Influenza A H5N1 and H7N9 – Lessons and Unanswered Questions. Transboundary and Emerging Diseases, Jan 29, 2015. [Epub ahead of print]

Wood JG, Heywood AE, Menzies RI, McIntyre PB, MacIntyre CR. Predicting localised measles outbreak potential in Australia. Vaccine. 2015 Jan 22. [Epub ahead of print]

Hassan S, Kirk M, Stewart T, MacIntyre CR*. The ARM Network--a model for infectious disease surge response capacity in the Western Pacific Region. Western Pac Surveill Response J. 2014 Jun 16;5(2):5-8. doi: 10.5365/WPSAR.2014.5.2.011.

*MacIntyre CR. The discrepant epidemiology of Middle East respiratory syndrome coronavirus (MERS-CoV). Environ Syst Decis. 2014:1-8.

*Gardner LM and MacIntyreCR. Unanswered questions about the Middle East respiratory syndrome coronavirus (MERS-CoV). BMC Research Notes2014, 7:358 doi:10.1186/1756-0500-7-358 

*Lauren M. GardnerDavid ReyAnita E. HeywoodRenin TomsJames WoodS. Travis WallerMohamud SheikhC. Raina MacIntyreA scenario-based evaluation of the Middle East respiratory syndrome coronavirus and the Hajj. Risk Analysis 2014;34(8):1391-400. doi: 10.1111/risa.12253 

*Muscatello DJ, Amin J, MacIntyre CR, Newall AT, Rawlinson WD, et al. (2014) Inaccurate Ascertainment of Morbidity and Mortality due to Influenza in Administrative Databases: A Population-Based Record Linkage Study. PLoS ONE 9(5): e98446.

*Muscatello DJ, Newall AT, Dwyer DE, MacIntyre CR. Mortality Attributable to Seasonal and Pandemic Influenza, Australia, 2003 to 2009, Using a Novel Time Series Smoothing Approach. PLoS ONE 2013; 8(6): e64734.

*Macintyre CR, Ridda I, Seale H, Gao Z, Ratnamohan VM, Donovan L, Zeng F, Dwyer DE. Respiratory viruses transmission from children to adults within a household. Vaccine. 30(19):3009-14, 2012 Apr 19.

*Macintyre CR, Burgess M, Isaacs D, McIntyre PB, Menzies R, Hull B. Epidemiology of severe hepatitis A in Indigenous Australian children. J Paediatr Child Health. 2007 May;43(5):383-387.

*Itzwerth RL, Macintyre CR, Shah S, Plant AJ. Pandemic influenza and critical infrastructure dependencies: possible impact on hospitals. Med J Aust. 2006 Nov 20;185(10):S70-S72.

*MacIntyre, CR; Goebel, K; Brown, GV. Patient knows best: blinded assessment of non-adherence with anti-tuberculous therapy by physicians, nurses and patients compared with urine drug levels. Preventive Medicine. 40(1):41-5, 2005.

*MacIntyre CR, McIntyre PB, Cagney M. Community based incidence and risk factors for all-cause childhood pneumonia in Western Sydney, Australia. Epi & Infection 2003;131:1091-6.

*MacIntyre CR, Hull B, Burgess MA, Gay NJ. Measles control in NSW Divisions of General Practice. NSW Public Health Bulletin. 2003; 14:13-17

*MacIntyre CR, Goebel K, Brown GV, Skull SA, Starr M, Fulinfaw RO. A randomised, controlled clinical trial of the efficacy of family based direct observation of anti-tuberculous therapy in an urban, developed-country setting. Int J Tuberc Lung Dis. 2003; 7(9):848-54

*MacIntyre CR, Gay NJ, Gidding H, Hull B, Gilbert GL, McIntyre P. A mathematical model to measure the impact of the Measles Control Campaign on the potential for measles transmission in Australia. Int J Infect Dis. 2002 Dec;6(4):277-81.

*MacIntyre CR. Empson M. Boardman C. Sindhusake D. Lokan J. Brown GV. Risk factors for colonization with vancomycin-resistant enterococci in a Melbourne hospital. Infection Control & Hospital Epidemiology. 22(10):624-9, 2001 October.

*MacIntyre CR. A case of uveitis associated with rifabutin in an HIV-negative patient with pulmonary Mycobacterium avium-intracellulare complex. Infectious Diseases In Clinical Practice 2000; Vol 9(8):pp 330-331.

 *MacIntyre CR, Ansari MZ, Carnie J, Hart WG. No evidence for multiple drug prophylaxis for tuberculosis compared to isoniazid alone in South-East Asian refugees and migrants - completion and compliance are major determinants of effectiveness.  Preventive Medicine. 2000; 30:425-432

*MacIntyre CR, Carnie J, Randall M.  Risk of transmission of tuberculosis among inmates of an Australian prison. Epidemiology & Infection 1999;123:437-443.

*MacIntyre CR, Kendig N, Kummer L, Birago S, Plant AJ.  Unrecognised transmission of tuberculosis in prisons.  European Journal of Epidemiology 1999; 15:705-709.

*MacIntyre CR, Plant, AJ.Longitudinal incidence of tuberculosis in South-East Asian refugees after re-settlement.  Int J Tuberc Lung Dis. 1999; 3:1-7.

*MacIntyre CR, Plant, AJ. Impact of policy and practice on the effectiveness of contact screening for tuberculosis.  Preventive Medicine. 1998; 27: 830-837.

 *MacIntyre CR, Plant, AJ. Preventability of incident cases of tuberculosis in recently exposed contacts. Int J Tuberc Lung Dis. 1998; 2:56-61.

 *MacIntyre CR, Plant AJ.  Tuberculosis in South-East Asian refugees - can prevention be improved by better policy and practice? Preventive Medicine. 1998; 27:815-820.

*MacIntyre CR, Plant AJ, Yung A, Streeton JA.Int J Tuberc Lung Dis  Missed opportunities for prevention of tuberculosis (letter). 1998; 2:346-7.

 *MacIntyre CR, Plant AJ, Yung A, Streeton JA.Int J Tuberc Lung Dis Missed opportunities for prevention of tuberculosis in Victoria, Australia.  1997; 1:135-41.

*MacIntyre CR, Kendig N, Kummer L, Birago S, Graham N. Impact of tuberculosis control measures and crowding on the incidence of tuberculosis infection in Maryland prisons. Clin Infect Dis 1997; 24:1060-1067.  (Cited in Mandell, Douglas and Bennett's textbook of infectious diseases “Principles and Practice of Infectious Diseases, 5th edition, 2000)

*MacIntyre CR, Kendig N, Kummer L, Birago S, Graham NHM. Exposure to infectious tuberculosis in PPD skin test converters in Maryland prisons. Am J Respir Crit Care Med 1997; 155:A564.

*MacIntyre CR, Plant AJ, Hulls J, Streeton JA, Graham NMH, Rouch GJ.  High rate of tuberculosis transmission in an office setting - impact of delayed diagnosis. Clinical Infectious Diseases. 1995; 21: 1170-4.

*MacIntyre R, Lehmann N, Leydon J. An outbreak of Mycoplasma pneumoniae infection in Victoria, 1992. Communicable Diseases Intelligence 1993; 17:32-5.

*MacIntyre R, Wilby R, Alter M, Brown R. An outbreak of gastroenteritis at a Melbourne Metropolitan Lifesaving Club. Communicable Diseases Intelligence 1993; 17:90-1.

*MacIntyre R, Murphy A, Taylor K. Meningococcal meningitis at a retirement village, Melbourne 1992 - Neisseria meningitidis carriage survey and prophylaxis of contacts. Communicable Diseases Intelligence 1993;17:287-288.

*MacIntyre R, Wilby R. An outbreak of Clostridium perfringens gastroenteritis at a Melbourne hospital, 1993. Communicable Diseases Intelligence 1993;17:257-259. 

*MacIntyre R, Mansell C, Lynch P, Rich J. An outbreak of influenza A at a Victorian nursing home. Communicable Diseases Intelligence 1993;18:32-34.

 *MacIntyre CR, Dwyer B, Streeton JA. The epidemiology of tuberculosis in Victoria. Medical Journal of Australia 1993;159: 672-677.


Selected news

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ARM training workshop for Ebola responders

Scholarship in Bioterrorism and Health Intelligence – apply now! 

Weaponized Smallpox Virus Could Infect Thousands in Major Cities

Smallpox re-emergence is real possibility world must prepare for, disease expert warns

Biodefense Headlines – Lassa Fever in Nigeria, Vaccine Pills, Novichok Poisoning

Planning for smallpox outbreak must consider immunosuppression

Immune-suppression must while planning for smallpox outbreak

Smallpox Re-emergence can be a Threat to Immunosuppressed People

Researchers pinpoint where smallpox outbreak would hit hardest

New publication: How Valid Are Assumptions About Re-emerging Smallpox?

Smallpox lessons from the field, Prof MacIntyre interviewed Dr J Michael lane

SPHCM academics successful in winning NHMRC Fellowships

Research Excellence in Epidemic Control

Epi-watch stakeholders workshop

UNSW study on antibiotic resistance finds concern, but no 'epidemic'

Australia’s worst flu outbreak: What’s the difference between a cold and the flu? 

How long are you contagious when you have a cold?

Phylogeny workshop

Students find early signals of the Zika virus outbreak

Building knowledge of biosecurity and bioterrorism threats

First Responder

The number of new flu viruses is increasing, and could lead to a pandemic

Number of new flu viruses emerging globally heightens pandemic threat