Integrating Surveillance and Stakeholder Insights to Predict Influenza Epidemics: A Bayesian Network Study in Queensland, Australia

Seasonal influenza continues to pose a substantial and recurrent public health challenge in Queensland, driven by annual variability in transmission and uncertainty in climatic, demographic, and behavioural determinants. Predictive modelling is constrained by data limitations and parameter uncertainty. In response, this study developed a Bayesian network (BN) model to estimate the probability of influenza epidemics in Queensland, Australia. The model integrated diverse inputs, including international and local influenza surveillance data, demographic health statistics, and expert and stakeholder insights to capture the complex multifactorial causal relationships underlying epidemic risk. Scenario-based simulations revealed that Southeast Asian viral origin, severe global influenza seasons, peak season timing, increasing international travel, absence of control measures, and low immunisation rates substantially elevate the likelihood of influenza epidemics. Southeast Queensland was identified as particularly vulnerable under high-risk conditions. Model evaluation demonstrated good discriminative performance (AUC = 0.6974, accuracy = 70%) with appropriate uncertainty quantification through credible intervals and sensitivity analysis. Its modular design and capacity for integrating various data sources make it a practical decision-making support tool for public health preparedness and responding to evolving climatic and epidemiological conditions.