Ecological and immunological determinants of dengue epidemics
Ecological and immunological determinants of dengue epidemics
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DOI：
10.1073/pnas.0602960103
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发表时间：
2006-08-01
影响因子：
11.1
通讯作者：
Rohani, Pejman
中科院分区：
文献类型：
--
作者：
Wearing, Helen J.;Rohani, Pejman
传染病的管理是一个日益重要的公共卫生问题，由于难以区分影响传播的外在和内在因素的相对作用，这一问题的有效实施往往变得复杂。登革热是一种媒介传播的菌株多态性疾病，是一种传播动力学受环境变量以及免疫介导的血清型相互作用影响的感染。为了了解关于登革热感染和传播的替代假设如何解释观察到的疾病发病率的多年周期，我们采用了一种结合生态学和免疫学机制的理论方法。我们证明，与感知的智慧相反，仅由抗体依赖性增强或病毒毒力异质性产生的模式在重要方面与特定类型的通知数据不一致。此外，为了生成具有在数据中观察到的特征签名的流行病，我们发现，媒介人口统计学的季节性变化和至关重要的交叉免疫的短暂时期的组合是足够的。然后，我们将展示如何理解登革热血清型的持续存在和根除严重依赖于替代假设的机制。
The management of infectious diseases is an increasingly important public health issue, the effective implementation of which is often complicated by difficulties in teasing apart the relative roles of extrinsic and intrinsic factors influencing transmission. Dengue, a vector-borne strain polymorphic disease, is one such infection where transmission dynamics are affected by environmental variables as well as immune-mediated serotype interactions. To understand how alternative hypotheses concerning dengue infection and transmission may explain observed multiannual cycles in disease incidence, we adopt a theoretical approach that combines both ecological and immunological mechanisms. We demonstrate that, contrary to perceived wisdom, patterns generated solely by anti body-dependent enhancement or heterogeneity in virus virulence are not consistent with serotype-specific notification data in important ways. Furthermore, to generate epidemics with the characteristic signatures observed in data, we find that a combination of seasonal variation in vector demography and, crucially, a short-lived period of cross-immunity is sufficient. We then show how understanding the persistence and eradication of dengue serotypes critically depends on the alternative assumed mechanisms.