A zero-inflated endemic-epidemic model with an application to measles time series in Germany

Count data with excessive zeros are often encountered when modelling infectious disease occurrence. The degree of zero inflation can vary over time due to non-epidemic periods as well as by age group or region. The existing endemic-epidemic modelling framework (aka HHH) lacks a proper treatment for surveillance data with excessive zeros as it is limited to Poisson and negative binomial distributions. In this paper, we propose a multivariate zero-inflated endemic-epidemic model with random effects to extend HHH. Parameters of the new zero-inflation and the HHH part of the model can be estimated jointly and efficiently via (penalized) maximum likelihood inference using analytical derivatives. A simulation study confirms proper convergence and coverage probabilities of confidence intervals. Applying the model to measles counts in the 16 German states, 2005--2018, shows that the added zero-inflation improves probabilistic forecasts.