Reproduction numbers estimated from disease incidence data can give public health authorities valuable information about the progression and likely size of a disease outbreak. Here, we show that methods for estimating effective reproduction numbers commonly give overestimates early in an outbreak. This is due to many factors including the nature of outbreaks that are used for estimation, incorrectly accounting for imported cases and outbreaks arising in subpopulations with higher transmission rates. Awareness of this bias is necessary to correctly interpret estimates from early disease outbreak data. Copyright © 2011 John Wiley & Sons, Ltd.
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