Transmission is the driving force in the dynamics of any infectious disease. A crucial element in understanding disease dynamics, therefore, is the ‘transmission term’ describing the rate at which susceptible hosts are ‘converted’ into infected hosts by their contact with infectious material. Recently, the conventional form of this term has been increasingly questioned, and new terminologies and conventions have been proposed. Here, therefore, we review the derivation of transmission terms, explain the basis of confusion, and provide clarification. The root of the problem has been a failure to include explicit consideration of the area occupied by a host population, alongside both the number of infectious hosts and their density within the population. We argue that the terms ‘density-dependent transmission’ and ‘frequency-dependent transmission’ remain valid and useful (though a ‘fuller’ transmission term for the former is identified), but that the terms ‘mass action’, ‘true mass action’ and ‘pseudo mass action’ are all unhelpful and should be dropped. Also, contrary to what has often been assumed, the distinction between homogeneous and heterogeneous mixing in a host population is orthogonal to the distinction between density- and frequency-dependent transmission modes.
21 September 2005 in American Journal of Epidemiology
Simulation studies using susceptible-infectious-recovered models were conducted to estimate individuals' risk of infection and time to infection in small-world and randomly mixing networks. Infection transmitted more rapidly but ultimately resulted in fewer infected individuals in the small-world, compared with the random, network. The ability of measures of network centrality to identify high-risk individuals was also assessed. “Centrality” describes an individual's position in a population; numerous parameters are available to assess this attribute. Here, the authors use the centrality measures degree (number of contacts), random-walk betweenness (a measure of the proportion of times an individual lies on the path between other individuals), shortest-path betweenness (the proportion of times an individual lies on the shortest path between other individuals), and farness (the sum of the number of steps between an individual and all other individuals). Each was associated with time to infection and risk of infection in the simulated outbreaks. In the networks examined, degree (which is the most readily measured) was at least as good as other network parameters in predicting risk of infection. Identification of more central individuals in populations may be used to inform surveillance and infection control strategies.
The number of microbes on Earth may be 10 30 , exceeding all other diversity. A small number of these can infect people and cause disease. The diversity of parasitic organisms likely correlates with the hosts they live in and the number mammal hosts for zoonotic infections increases with species richness among mammalian orders. Thus, while habitat loss and fragmentation may reduce species diversity, the habitat encroachment by people into species-rich areas may increase the exposure of people to novel infectious agents from wildlife. Here, we present a theoretical framework that exploits the species–area relationship to link the exposure of people to novel infections with habitat biodiversity. We model changes in human exposure to microbes through defined classes of habitat fragmentation and predict that increased habitat division intrinsically increases the hazard from microbes for all modelled biological systems. We apply our model to African tropical forests as an example. Our results suggest that it is possible to identify high-risk areas for the mitigation and surveillance of novel disease emergence and that mitigation measures may reduce this risk while conserving biodiversity.