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CASESTUDY:Monsters,MicrobiologyandMathematics:theepidemiologyofazombieapocalypseJ.Verran1*,M.Crossley2,K.Carolan1,N.Jacobs2,M.Amos2,

1SchoolofHealthcareScienceand2SchoolofComputing,MathematicsandDigital

Technology,ManchesterMetropolitanUniversity,ChesterSt.,ManchesterM15GD.

Runningheader:Epidemiologyofzombieapocalypse

Keywords:epidemiology–mathematicalmodelling–zombies

Correspondingauthor:ProfJoannaVerran,SchoolofHealthcareScience,Manchester

MetropolitanUniversity,ChesterSt.,ManchesterM15GD.

Tel:00-44-161–2471206

j.verran@mmu.ac.uk

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CASESTUDY:Monsters,MicrobiologyandMathematics:theepidemiologyofazombie

apocalypse

Abstract

Theaimofthislearningexercisewastoharnesscurrentinterestinzombiesinorderto

educateaudiencesabouttheepidemiologyofinfectiousdisease.Participantsintheactivity

wereprovidedwithanoutbreakscenario,whichtheythenusedasthebasisofplay-based

activities.Byconsideringthemodeandspeedoftransmission,sizeofoutbreak,and

prevention/controlstrategy,participantgroupswereabletodefineparametersoftheir

outbreakscenario.TheseweretheninputtoSimZombie,acomputersimulationprogram

developedbytheauthors,whichvisuallydemonstratedthespreadofinfectionthrougha

population.Theresultinganimationswerethenusedasthebasisofin-depthdiscussion,

which,inturn,enabledtheconsiderationofprinciplesofdiseasetransmissionandcontrol

strategies.

Theactivityprovidedanopportunitytoengagearangeofaudiencesthroughavarietyof

differentdeliverymechanisms,includingroleplay,workshopandinformaldrop-in.Learning

wasevidencedbyparticipationandfeedback.

Introduction

Giventheincreasinglyconnectednatureoftheglobalcommunity,thereisapressingneed

forabetterpublicunderstandingofdiseasedynamics(Hufnagel,etal.;2004).InUKschools

andcolleges,knowledgeofinfectiousdiseasesisindicatedintheschoolsciencecurriculum

(DepartmentforEducation,2013).Forthegeneralpublic,salientfactsaboutinfectious

diseaseincludeprinciplesofdiseasepreventionandcontrolandawarenessoftransmission

routes.Publicinformationisgenerallyprovidedthroughthemedia,leafletsin

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surgeries/pharmaciesandviatheinternet,butthesearetypically“one-way”modesof

communication,withnosubsequentevaluationoflearningacquisition(Bemelmans,2007).

Engagementcanthereforebeenhancedbymodifyingthedeliverysystemtouseanovel

vehicleorcontext,suchasmixingsciencewithart,literature(Verran2013a)orgames

(MichaelandChen,2005).

Vampires,andother‘monsters’suchaszombiesandwerewolves,potentiallyofferafocus

forengagementwithdiseasetransmissionandoutbreaks.Thus,aworkshopdeliveredfor

the2010ManchesterChildren’sBookFestival(MCBF:Verran,2010,2013b)usedthe

Twilightnovel(StephenieMeyer,2005;movie2008,directedbyCatherineHardwick)inthat

context.TheworkshopwassetinaBiologylaboratory,withmicroscopesandslidesofthe

cellcycleavailableforexamination.Usingreadingsfromthenovelandfacilitateddiscussion,

theparticipantsidentifiedroutesofvampirism/diseasetransmission,andconsidered

analogousmethodsofprevention(garlicasarepresentationofanantimicrobial;‘not

invitingthemin’representingbehaviourmodification).

Meanwhile,anagent-basedsimulationtoolhadbeendevelopedbythesecondauthor,as

partofhisundergraduatestudies(CrossleyandAmos2011;softwareavailableat

https://code.google.com/p/simzombie/).Theprogram(SimZombie)simulatesthespreadof

infectionthroughananimatedpopulationofindividuals,usinganindividual-basedversion

ofastandardsusceptible/infected/recoveredmodel(Munz,etal.;2009),andgraphically

depictsdifferentcategoriesofindividualovertime(Figure1).

Differentpatternsofdiseasespreademerge,dependingontheparametervaluesentered

intotheprogramme.Usingour‘monster’analogy,zombieinfectionsareslowtospread,but

inexorable;vampireoutbreaksspreadquickly,butarelessefficient;werewolvesareonly

activeonceinalunarmonth,thustheinfectiongoes‘latent’withclustersemergingin

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differentlocationovertime.Animationsofalloftheseoutbreaksareavailablefordownload

athttp://dx.doi.org/10.6084/m9.figshare.729232

Figure1:SamplescreenshotofSimZombieprogram.

TheMonsters,MicrobiologyandMaths(MoMiMa)groupatManchesterMetropolitan

Universitywasformedin2010,comprisingindividualswithacommoninterestin

‘monsters’.Thegroup’saimwastointegratethisexpertiseandenthusiasm,andSimZombie,

intopublicengagementactivities.Therestofthispaperdescribesthedevelopmentofthese

activities,inordertofacilitateengagementwitharangeofaudiences.Themainevents,

processes,deliverables,outcomesandandfeedbackmechanismsaresummarisedinFigure

2.Wenowpresentourworkinthecontextofthevariousstagesofitsevolution.

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Figure2:Flowchartdepictingtheevolutionoftheproject.

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Figure2:Flowchartdepictingtheevolutionoftheproject.

Stage1:DevelopmentofmaterialsaroundSimZombie

Additionalkeycharacteristicstodifferentiatethekineticsofoutbreaksofvampires,zombies

andwerewolveswereidentified.Forexample,vampiresmovequickly,butareonlyactiveat

night;victimsmaydie,orbecomevampires(orvampire‘food’);zombiesareactiveallthe

time,butmoveslowly(theexceptionbeingtherecentlyemerging‘zoombies’(Botting,

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2010)),andtransmissionis100%effectiveand100%‘lethal’,unlessthevictimisconsumed.

Thesefictionalcharacteristicscanbeusedtoparalleltruediseaseoutbreaks–forexample,

therelativetransmissionandinfectionratesofH5N1(birdflu–forman,lowtransmission

ratebuthighvirulence),ortherecentH1N1pandemic(swineflu–hightransmissionrate

butlowvirulence);thelatencyofherpesorHIV;thedurationofincubationperiodsand

impactonepidemiology(forexamplechronicdiseasessuchastuberculosis,oracute

infectionssuchasmeasles);thehighvirulenceofEbolabutlackofairbornetransmission;

andsoon(Verran,2013c).

Figure3:Activityworkmat.

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AnA1-sizeactivityworkmat(Figure3)wasdevelopedtoencourageexplorationofselected

diseaseparameters.Thematwasinitiallytrialledbyfocusgroups,comprisingstaffand

studentsfromarangeofdisciplinesacrosstheUniversity.Questionsonthematprompted

participantstoconsidertheparametersofazombie,vampireorwerewolfoutbreak

scenario,derivedfromliterature,imagination,filmorgame.Responsesweresubsequently

usedasparametervalues,whichwerefedintotheSimZombieprogram.Theresultant

outputpresentedavisualillustrationofthegivenoutbreak.Althoughthediscussionsand

subsequentsimulationvisualisationswereuseful,itwasclearthatparticipantsexperienced

difficultiesincontextualisingtheoutbreakswithoutanaccompanyingnarrative.Thus,

specific‘scene-settings’weredeveloped,withaparticularfocusonzombieoutbreaks,due

totheperceivedinterestofbothgendersinzombies(Higson,2013).

Stage2:Firstpublicdeliveryofmaterials

MoMiMaofferedaseriesofeventsatthe2011ManchesterScienceFestival(MSF),each

targetedatadifferentaudience.Atanevening‘pubquiz’(Kappa,2009),tenteamsof4–6

peopleweretaskedwithansweringquestionsonmonsters(includinga‘filmclips’round),

microbiology(includinga‘matchthediseasetothemicrobe’pictureround)andgeneral

scientificknowledge.Inbetweenrounds,eachteamusedanactivitymattoidentify

parametervaluesassociatedwithaparticularoutbreakscenario(ashortdescriptive

paragraphonacard).Duringthemarkingofthequizrounds,thesimulationsresultingfrom

theirparametervalueswerepresented,yieldingarichcollectionofvaried‘outbreaks’atthe

endoftheevening.Theseenableddiscussionscentredontheprogressionofvarious

outbreaks.Feedbackwasacquiredviaashortquestionnaire,inwhichparticipantswere

askedtorankenjoyment,organisation,learningofscienceandlikelihoodofattendinga

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repeatevent,ona1–5scale.Freetextcommentswerealsosought.From24respondents,

theaveragescoresforenjoyment,organisation,learningandrepeatattendancewere4.5,

4.1,3.5and4.5respectively.Textcommentswerepositiveoverall;negativecomments

alludedtovenue-specificissuessuchasnoiseandlackofspace,thedifficultyofthemicrobe

quiz(twocomments),andarequestformoreinformationonthesimulations(two

comments).Therelativeperceivedlackof‘sciencelearning’incomparisontootherscores

wasslightlydisappointing:moreovertemphasisonepidemiologyprinciplesmightbemade

infuture.

Stage3:Usingfictiontoenhanceengagement

AtMSF2011,theBadBugsBookclub(Verran,2013c)hostedcomplementaryeventswhere

WorldWarZ(MaxBrooks,2006),andIamLegend(RichardMatheson,1954)–both

apocalypticzombie/vampirenovels-werediscussed.Liketheactivityworkmat,thebooks

(andmoviescreeningsofthreeversionsofIamLegend)stimulateddiscussionondisease

epidemiology.

Wellover200individualswerereachedbytheseactivities.Thecombinationofliterature,

computerprogramanddiseaseepidemiologywasthendevelopedforthe2012

ManchesterChildren’sBookFestival.Theaimofthisfestivalistoencouragethe

engagementofchildrenwithliterature.Thus,four‘zombienovels’aimedatateenage

audience(BoneshakerbyCheriePriest[2009],WarmBodiesbyIsaacMarion[2011],Rotand

RuinbyJonathonMaberry[2010],andTheDeadbyCharlieHigson[2010])wereselectedfor

incorporationintoaworkshopheldattheFestivalFamilyFunDay.Participantssignedupto

theworkshopatareceptiondeskwheremediamake-upartists‘zombified’visitors

throughouttheday.

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Shortsummariesofeachbookwereprovidedto(four)facilitators,alongwithabrief

outbreakscenario.Thefacilitatorswererole-playingasepidemiologists,andparticipants

becamescientistsworkinginanepidemiologylaboratory.Thepresentedscenariowasthat

ofaragingpandemic,andparticipantsurgentlyneededtoidentifytheparametersofthe

outbreakwithaviewtopreventionandcontrol.SimulatednewsbroadcastsandTwitter

feedscontributedtotheatmosphere.Participants(predominantlyfamiliesorteenagers)

weregroupedatoneoffourtables,eachfocusingonadifferentnovel.Facilitatorsread

excerptsfromthenovels,andthegroupsidentifiedparametersoftheiroutbreaksusinga

simplifiedworkmatdesign(fullversionsofallworkmatsaredownloadablefrom

http://dx.doi.org/10.6084/m9.figshare.729232).

Inallofthenovels,itbecameapparentthatthestrategyforcontrolwastoisolatethe

uninfected(analogoustotheuseofimmunisationtoprotectpopulations)ortheinfected

(quarantine).SimZombiewasmodifiedtodepicttheseresponsestrategiesofpopulation

enclosure,andlimitationsoftheisolationoftheuninfectedstrategyweregraphically

demonstrated,wherethezombieswereabletoenterthe‘safe’enclavethroughabreakin

theperimeterwalls.Thiswasextrapolatedtodiscussionontheimportanceofhighvaccine

uptakelevelstoensureherdimmunity.Quarantineoftheinfectedwassuccessfulifthe

boundarywallswerestrong,andifnumbersofuninfectedindividualswerehigh.

The45-minuteworkshopwasrunthreetimes,with20participantsineachworkshop.For

feedback,beforetheyleft,participantswereaskedtonote(onpost-itnotes)whatthey

enjoyed,and/orwhattheyhadlearned.Oftwenty-sevenresponses,25werepositive,with

specificreferencesmadetomicrobiology(9responses)andzombies(11responses),suchas

‘Ilearnthowdifficultitwouldbetocontrolaveryseriousdisease’,‘howathletescanbe

morepronetodisease’and‘Ilearnthowdiseasespreads’.Themake-upsessionswere

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especiallypopular,butsomewhatdistracting.Theactivitywouldalsohavebeenenhanced

ifparticipantshadreadthebooksinadvanceoftheevent.

Stages4-6:Timeconstraineddeliveryofkeymessages

Theresponsestrategysimulationsprovedvaluablefordemonstratingprinciplesof

epidemiology,andencouragingdiscussion.Thesekeymessageswerecarriedforwardtothe

2012ManchesterScienceFestivalanddeliveredviaanarmy-style’bootcamp’event,

focusingonhowtodealwithazombieoutbreak.Thesessionsbeganwithastructured

(Powerpoint)presentation,whichincludedbackgroundinformationontheworkshop

followedbyaninteractivesession.Eachparticipantwasissuedwithahandbookguide,

whichwasusedasatriggerfordiscussion(epidemiology,diseasetransmission,prevention

andcontrol)aroundpreviouslypreparedoutbreaksimulations.Thisformatensured

deliveryofkeyscientificmessagestotheentiregroup,andreducedthenumberof

facilitatorsrequired.Participantswereawardedacertificateattheendoftheevent.

Thethree45-minuteworkshopseachattractedaround20participants,andagainfeedback

waspositive(22positiveresponsesof23),withcommentsdemonstratingimproved

acquisitionofunderstanding.Forexample:‘simulationswereexcellentforshowinghow

infectionscanspread’;‘likethesimulations.Thedifferencebetweenquarantineand

isolationwasreallystriking’;‘(name)isstudyingtheplague,soreallygoodatshowing

infectionpreventionandsurvival’;‘greatwaytoexplaininfectiontokids.Wellpresented.

Clearandfun’.

Despitethesuccessoftheseactivities,theyweretime-consumingintermsofaudience

numbers,andhigherthroughputdeliverywouldbedesirableforafutureevent.

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SaturdayScienceeventsaredeliveredmonthlybyvisitingscientistsattheManchester

MuseumofScienceandIndustry(http://www.mosi.org.uk/),andthezombieactivitywas

modifiedagaintoenablea‘drop-in’styledeliveryoftheoutbreaksimulationatoneofthese

eventsin2013.OnlySimZombiepre-preparedsimulationswereusedatthisevent,andthe

workmatwasalteredtoa‘keyquestions’format–eachquestionbecominga‘station’for

visitorstoattend(inanysequence).Thequestionsaddressed(i)Movement:howfasta

diseaseisabletospreadgeographically,(ii)Survival:whichresponsestrategiesthe

participantsmightconsider,andwhy,(iii)Transmission:howdopeoplebecomezombies,

andwhatothertransmissionmethodsexistforotherdiseases?Astationforyounger

childrenasked‘Whatdoviruseslooklike?’Participantslookedatimagesofviruses,and

thendrewtheirownzombievirus.Olderchildrentookpartintargetpractice(onalifesize

zombiedummy)usingtoyweaponry.Theeffectoftheir‘hit’wasnoted–forexample,

congratulationswereofferedtothosemanagingtohitthehead(inactivateszombies).An

accompanyingbookletposedkeyquestionstobeansweredateachstageoftheactivity.

Visitorswerethengiventheopportunitytopresentacompletedbooklettothebootcamp

’corporals’,inordertobecomecertified‘zombiesurvivalexperts’.

Thisactivityreachedalargeraudience(anestimatednumberofvisitorstotalledaround150

overa4hourperiod),butwasnotwithoutdrawbacks.Alargerworkforcewasrequired

(STEMambassadors),becauseeachstationneededtobemannedbyanexpert.Duetothe

drop-innatureoftheevent,itwasnoteasytoobtainfeedback:nineteenresponsesnoted

enjoyment,butlackedspecificcommentsrelatedtothesubject.Aquestionandanswer

sessionwithSTEMambassadorsandeventorganisersyieldedmoreconstructivecomments

regardingeventorganisation.Itwasnoteasytoencouragevisitorstoparticipateinallof

thestationactivities-perhapsastricter‘followthepath’layoutmayhaveencouragedthis.

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Itwasalsolessapparentthatsignificantlearninghadtakenplace–althoughengagement

wasevident.

Finally,‘Deadinburgh’wasanimmersiveeventdeliveredbyLAStheatregroupinApril2013.

TheoldRoyalEdinburghVeterinaryHospitalprovidedthelocationfora‘safezone’where

scientistswereworkingonacureforthe‘LazarusPathogen’(LP)outbreakwhichhadcaused

Edinburghtobeisolated.Overfournights,1000membersofthepublicenteredthesafe

zone,chasedbyinfected“PALPs”(personsaffectedwiththeLazarusPathogen)(actors)and

herdedbysoldiers(alsoactors)intothelaboratories.Scientists(notactors)wereunableto

agreeonastrategyfromthethreechoicesavailable:tocontinuethequarantineandwait

foracure;culltheinfected;sacrificethecitybyannihilationwithanexplosiveagent.The

audiencewasthereforerequiredtolistentothescientistsandmakethedecision

themselves.Theresultofavotewoulddeterminethefateofthecity.Asoneofthesix

scientistgroups,theMoMiMateam(oftwo)usedtheepidemiologylaboratoryscenario,

deliveredtothreegroupsof40adultswithina20minuteperiod,forfournights.Thehighly

structuredactivityinvolvedanoverviewofthesciencebehindtheoutbreakandthe

simulation,followedbyfiveminutegroupdiscussionsonthechoicesavailable,and

identificationofappropriateoutbreakparameters.Allsimulationswerepresentedinorder

tohelpparticipantstomaketheirfinaldecisionbasedonallofthescientificinformation

availabletothem.Dataanddiscussionderivedfromtheexercisesemphasisedthe

importanceof:maintainingastrongboundarywhenseparatingtheinfectedfromthe

uninfected(immunisation);knowingtheincubationperiodoftheinfection;thecarrierstate;

diagnosinginfectionswithaccuracyandprecision;ensuringthatthecontrolorprevention

strategyiseffective.ThisprojectwassupportedbytheUKBBSRC,andprojectevaluationis

ongoing.Afour-starreviewoftheeventinTheScotsman(April22,2013)statedthat

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“…whilethere’splentyoftalkaboutbridgingthegapbetweenartsandscience,thisisa

showthatactuallydoesit;andprovidesagood,exhausting,thought-provokingnightout

intothebargain.”

Conclusionsandfuturework

SimZombieanditsassociatedactivitieshaveengagedawiderangeofaudiencesthrougha

numberofdifferentdeliveryevents:Universitystaffandstudents,adults,familiesand

youngpeople.AnoverviewoftheactivitieswasdeliveredatateacherCPDsession,andwas

verywellreceived.Theversatilityoftheactivitywascommended,particularlythepotential

forcross-subjectwork(literature,microbiology,mathematics).Ayear8classweresimilarly

enthused.Forschools,keylearningoutcomesregardingdiseaseepidemiology,using

zombiesasthevehicleofinfection,canbedemonstratedandexploredinanengagingand

unusualcontext.IssuesofinfectionandbehaviourcanbeconsideredinPSHE(personal,

social,healthandeconomicstudies)-relatedactivities.Inbiologycourses,SimZombiecan

beusedtodemonstratetheepidemiologyofrealdiseaseoutbreaks.Inadditiontothe

materialsmadeavailablethroughthispublication,wearecurrentlydevelopingaschool

resourcepack,toincludeinformationondiseaseepidemiology,copies(paperand

electronic)ofworkmats,andanaccessibleandinteractiveversionofSimZombie.Thiswill

removetheneedfordirectcoordinationbyMoMiMa,andincreasethereachandimpactof

activities.

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Acknowledgements

MoMiMawishtoacknowledgethesupportoftheEPSRCBridgingtheGaps:NanoInfoBio

project(EP/H000291/1)andtheSocietyforAppliedMicrobiology(www.sfam.org.uk)for

providingfinancialsupportforsomeoftheevents.HEANationalTeachingFellowship

fundingawardedtoJVwasalsousedtoprovidesupport.

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