PubMed Health⌕ Search

Biomedical subjects

Matt J Keeling

Publications and source records attributed to Matt J Keeling.

15 recordsLinked to original sources

Spatially extended host-parasite interactions: the role of recovery and immunity.

Techniques for determining the long-term dynamics of host-parasite systems are well established for mixed populations. The field of spatial modelling in ecology is more recent but a number of key advances have been made. In this paper, we use state-of-the-art approximation techniques, supported by simulations, in order to investigate the role of recovery and immunity in spatially structured populations. Our approach is to use correlation models, namely pair-wise models, to capture the spatial relationships of contacts and interactions between individuals. We use the pair-wise framework to address a number of key ecological questions; including, the persistence of endemic limit cycles and regions of parasite-driven extinction--features which differentiate spatial from non-spatial models--and the effects on invasion fitness. We demonstrate a loss of limit cycle behaviour, in addition to an increase in the critical transmissibility and extinction thresholds, when recovery is included. This approach allows for a better analytical understanding of the dynamics of host-parasite interactions and demonstrates the importance of recovery and immunity in local interactions.

Animals↗

Coexistence and specialization of pathogen strains on contact networks.

The coexistence of different pathogen strains has implications for pathogen variability and disease control and has been explained in a number of different ways. We use contact networks, which represent interactions between individuals through which infection could be transmitted, to investigate strain coexistence. For sexually transmitted diseases the structure of contact networks has received detailed study and has been shown to be a vital determinant of the epidemiological dynamics. By using analytical pairwise models and stochastic simulations, we demonstrate that network structure also has a profound influence on the interaction between pathogen strains. In particular, when the population is serially monogamous, fully cross-reactive strains can coexist, with different strains dominating in network regions with different characteristics. Furthermore, we observe specialization of different strains in different risk groups within the network, suggesting the existence of diverging evolutionary pressures.

Biological Evolution↗

Disease evolution across a range of spatio-temporal scales.

Traditional explorations of infectious disease evolution have considered the competition between two cross-reactive strains within the standard framework of disease models. Such techniques predict that diseases should evolve to be highly transmissible, benign to the host and possess a long infectious period: in general, diseases do not conform to this ideal. Here we consider a more holistic approach, suggesting that evolution is a trade-off between adaptive pressures at different scales: within host, between hosts and at the population level. We present a model combining within-host pathogen dynamics and transmission between individuals governed by an explicit contact network, where transmission dynamics between hosts are a function of the interaction between the pathogen and the hosts' immune system, though ultimately constrained by the contacts each infected host possesses. Our results show how each of the scales places constraints on the evolutionary behavior, and that complex dynamics may emerge due to the feedbacks between epidemiological and evolutionary dynamics. In particular, multiple stable states can occur with switching between them stochastically driven.

Communicable Diseases↗

Optimal reactive vaccination strategies for a foot-and-mouth outbreak in the UK.

Foot-and-mouth disease (FMD) in the UK provides an ideal opportunity to explore optimal control measures for an infectious disease. The presence of fine-scale spatio-temporal data for the 2001 epidemic has allowed the development of epidemiological models that are more accurate than those generally created for other epidemics and provide the opportunity to explore a variety of alternative control measures. Vaccination was not used during the 2001 epidemic; however, the recent DEFRA (Department for Environment Food and Rural Affairs) contingency plan details how reactive vaccination would be considered in future. Here, using the data from the 2001 epidemic, we consider the optimal deployment of limited vaccination capacity in a complex heterogeneous environment. We use a model of FMD spread to investigate the optimal deployment of reactive ring vaccination of cattle constrained by logistical resources. The predicted optimal ring size is highly dependent upon logistical constraints but is more robust to epidemiological parameters. Other ways of targeting reactive vaccination can significantly reduce the epidemic size; in particular, ignoring the order in which infections are reported and vaccinating those farms closest to any previously reported case can substantially reduce the epidemic. This strategy has the advantage that it rapidly targets new foci of infection and that determining an optimal ring size is unnecessary.

Animals↗

Networks and epidemic models.

Networks and the epidemiology of directly transmitted infectious diseases are fundamentally linked. The foundations of epidemiology and early epidemiological models were based on population wide random-mixing, but in practice each individual has a finite set of contacts to whom they can pass infection; the ensemble of all such contacts forms a 'mixing network'. Knowledge of the structure of the network allows models to compute the epidemic dynamics at the population scale from the individual-level behaviour of infections. Therefore, characteristics of mixing networks-and how these deviate from the random-mixing norm-have become important applied concerns that may enhance the understanding and prediction of epidemic patterns and intervention measures. Here, we review the basis of epidemiological theory (based on random-mixing models) and network theory (based on work from the social sciences and graph theory). We then describe a variety of methods that allow the mixing network, or an approximation to the network, to be ascertained. It is often the case that time and resources limit our ability to accurately find all connections within a network, and hence a generic understanding of the relationship between network structure and disease dynamics is needed. Therefore, we review some of the variety of idealized network types and approximation techniques that have been utilized to elucidate this link. Finally, we look to the future to suggest how the two fields of network theory and epidemiological modelling can deliver an improved understanding of disease dynamics and better public health through effective disease control.

Animals↗

Appropriate models for the management of infectious diseases.

BACKGROUND: Mathematical models have become invaluable management tools for epidemiologists, both shedding light on the mechanisms underlying observed dynamics as well as making quantitative predictions on the effectiveness of different control measures. Here, we explain how substantial biases are introduced by two important, yet largely ignored, assumptions at the core of the vast majority of such models. METHODS AND FINDINGS: First, we use analytical methods to show that (i) ignoring the latent period or (ii) making the common assumption of exponentially distributed latent and infectious periods (when including the latent period) always results in underestimating the basic reproductive ratio of an infection from outbreak data. We then proceed to illustrate these points by fitting epidemic models to data from an influenza outbreak. Finally, we document how such unrealistic a priori assumptions concerning model structure give rise to systematically overoptimistic predictions on the outcome of potential management options. CONCLUSION: This work aims to highlight that, when developing models for public health use, we need to pay careful attention to the intrinsic assumptions embedded within classical frameworks.

Communicable Diseases↗

Models of foot-and-mouth disease.

During the 2001 foot-and-mouth disease outbreak in the UK, three very different models were used in an attempt to predict the disease dynamics and inform control measures. This was one of the first times that models had been used during an epidemic to support the decision-making process. It is probable that models will play a pivotal role in any future livestock epidemics, and it is therefore important that decision makers, veterinarians and farmers understand the uses and limitations of models. This review describes the utility of models in general before focusing on the three foot-and-mouth disease models used in 2001. Finally, the future of modelling is discussed, analysing the advances needed if models are to be successfully applied during any subsequent epidemics.

Animals↗

Using conservation of pattern to estimate spatial parameters from a single snapshot.

Rapid reaction in the face of an epidemic is a key element in effective and efficient control; this is especially important when the disease has severe public health or economic consequences. Determining an appropriate level of response requires rapid estimation of the rate of spread of infection from limited disease distribution data. Generally, the techniques used to estimate such spatial parameters require detailed spatial data at multiple time points; such data are often time-consuming and expensive to collect. Here we present an alternative approach that is computationally efficient and only requires spatial data from a single time point, hence saving valuable time at the start of the epidemic. By assuming that fundamental spatial statistics are near equilibrium, parameters can be estimated by minimizing the expected rate of change of these statistics, hence conserving the general spatial pattern. Although applicable to both ecological and epidemiological data, here we focus on disease data from computer simulations and real epidemics to show that this method produces reliable results that could be used in practical situations.

Animals↗

Monogamous networks and the spread of sexually transmitted diseases.

Patterns of sexual mixing and heterogeneity in the number of sexual partners can have a huge effect on the spread of a sexually transmitted disease (STD). The sexual mixing network identifies all partnerships within a population over a given period and is a powerful tool in the study of such infections. Previous models assumed all links within the network to be concurrent active partnerships. We present a novel modelling approach in which we adapt the notion of a sexual contact network to a monogamous population by allowing the nature of the links to change. We use the underlying network to represent potential sexual partnerships, only some of which are active at any one time. Thus serial monogamy can be modelled while maintaining the patterns of mixing displayed by the population.

Contact Tracing↗

The colour of noise in short ecological time series data.

The statistical properties of ecological time series data and general trends therein have historically been of great interest to ecologists. In recent years, there has been a focus on establishing the relative importance of 'memory' in these data. The classic study by Pimm & Redfearn (1988 Nature, 334, 613-614) has been extremely important in establishing within the ecological community the idea that population time series are generally 'red-shifted' (dominated by long-term trends). This conclusion was reached by exploring the relationship between observed variability and census length in ecological data and comparing them with those for artificially generated data. Here, we highlight some subtle problems with this approach and suggest possible alternative methods of analysis, especially when the time series of interest are short.

Censuses↗

Contact tracing and disease control.

Contact tracing, followed by treatment or isolation, is a key control measure in the battle against infectious diseases. It is an extreme form of locally targeted control, and as such has the potential to be highly efficient when dealing with low numbers of cases. For this reason it is frequently used to combat sexually transmitted diseases and new invading pathogens. Accurate modelling of contact tracing requires explicit information about the disease-transmission pathways from each individual, and hence the network of contacts. Here, pairwise-approximation methods and full stochastic simulations are used to investigate the utility of contact tracing. A simple relationship is found between the efficiency of contact tracing necessary for eradication and the basic reproductive ratio of the disease. This holds for a wide variety of realistic situations including heterogeneous networks containing core-groups or super-spreaders, and asymptomatic individuals. Clustering (transitivity) within the transmission network is found to destroy the relationship, requiring lower efficiency than predicted.

Communicable Disease Control↗

Planning for smallpox outbreaks.

Mathematical models of viral transmission and control are important tools for assessing the threat posed by deliberate release of the smallpox virus and the best means of containing an outbreak. Models must balance biological realism against limitations of knowledge, and uncertainties need to be accurately communicated to policy-makers. Smallpox poses the particular challenge that key biological, social and spatial factors affecting disease spread in contemporary populations must be elucidated largely from historical studies undertaken before disease eradication in 1979. We review the use of models in smallpox planning within the broader epidemiological context set by recent outbreaks of both novel and re-emerging pathogens.

Bioterrorism↗

Disease evolution on networks: the role of contact structure.

Owing to their rapid reproductive rate and the severe penalties for reduced fitness, diseases are under immense evolutionary pressure. Understanding the evolutionary response of diseases in new situations has clear public-health consequences, given the changes in social and movement patterns over recent decades and the increased use of antibiotics. This paper investigates how a disease may adapt in response to the routes of transmission available between infected and susceptible individuals. The potential transmission routes are defined by a computer-generated contact network, which we describe as either local (highly clustered networks where connected individuals are likely to share common contacts) or global (unclustered networks with a high proportion of long-range connections). Evolution towards stable strategies operates through the gradual random mutation of disease traits (transmission rate and infectious period) whenever new infections occur. In contrast to mean-field models, the use of contact networks greatly constrains the evolutionary dynamics. In the local networks, high transmission rates are selected for, as there is intense competition for susceptible hosts between disease progeny. By contrast, global networks select for moderate transmission rates because direct competition between progeny is minimal and a premium is placed upon persistence. All networks show a very slow but steady rise in the infectious period.

Biological Evolution↗

Modeling dynamic and network heterogeneities in the spread of sexually transmitted diseases.

A wide range of communicable human diseases can be considered as spreading through a network of possible transmission routes. The implied network structure is vital in determining disease dynamics, especially when the average number of connections per individual is small as is the case for many sexually transmitted diseases (STDs). Here we develop an intuitive mathematical framework to deal with the heterogeneities implicit within contact networks and those that arise because of the infection process. These models are compared with full stochastic simulations and show excellent agreement across a wide range of parameters. We show how such models can be used to estimate parameters of epidemiological importance, and how they can be extended to examine the effectiveness of various control strategies, in particular screening programs and contact tracing.

Algorithms↗

Understanding the persistence of measles: reconciling theory, simulation and observation.

Ever since the pattern of localized extinction associated with measles was discovered by Bartlett in 1957, many models have been developed in an attempt to reproduce this phenomenon. Recently, the use of constant infectious and incubation periods, rather than the more convenient exponential forms, has been presented as a simple means of obtaining realistic persistence levels. However, this result appears at odds with rigorous mathematical theory; here we reconcile these differences. Using a deterministic approach, we parameterize a variety of models to fit the observed biennial attractor, thus determining the level of seasonality by the choice of model. We can then compare fairly the persistence of the stochastic versions of these models, using the 'best-fit' parameters. Finally, we consider the differences between the observed fade-out pattern and the more theoretically appealing 'first passage time'.

Cities↗