On the transmission of HIV with self-protective behavior and preferred mixing

An epidemic model of HIV transmission with self-protective behavior and preferred mixing is presented. Individuals in the model are assumed to choose their levels of risk behavior by comparing the costs and benefits of self-protective actions. Unlike in models which treat individual risk behavior as exogenously given and fixed, the condition under which an endemic steady state equilibrium exists does not depend on the extent of assortative mixing in the population. Specifically, a unique endemic equilibrium exists when the basic reproductive number of the disease, which is given in the model by the expected number of secondary infections caused by an infected individual in the absence of any self-protection, is strictly greater than one. Otherwise, the disease-free equilibrium is the only steady state equilibrium. With respect to changes in contact patterns, it is shown that, if the degree of preferred mixing is increased, the disease prevalence can decrease in the high-risk subpopulation consisting of individuals who are more likely to engage in unsafe practices. The situation is reversed for the low-risk subpopulation, which is composed of individuals who are less willing to engage in risky practices, so that increasing the likelihood of mixing with members of one's own group may increase the prevalence level within the low-risk subpopulation.     

Public avoidance and epidemics: insights from an economic model

In this paper, we present a mathematical model of infectious disease transmission in which people can engage in public avoidance behavior to minimize the likelihood of acquiring an infection. The framework employs the economist's theory of utility maximization to model people's decision regarding their level of public avoidance. We derive the reproductive number of a disease which determines whether an endemic equilibrium exists or not. We show that when the contact function exhibits saturation, an endemic equilibrium must be unique. Otherwise, multiple endemic equilibria that differ in disease prevalence can coexist, and which one the population gets to depends on initial conditions. Even when a unique endemic equilibrium exists, people's preferences and the initial conditions may determine whether the disease will eventually die out or become endemic. Public health policies that increase the recovery rate or encourage self-quarantine by infected people can be beneficial to the community by lowering disease prevalence. However, it is also possible for these policies to worsen the situation and cause prevalence to rise since these measures give people less incentive to engage in public avoidance behavior. We also show that implementing policies that result in a higher level of public avoidance behavior in equilibrium does not necessarily lower prevalence and can result in more infections.     

Global dynamics of an SEIR epidemic model with saturating contact rate

Heesterbeek and Metz [J. Math. Biol. 31 (1993) 529] derived an expression for the saturating contact rate of individual contacts in an epidemiological model. In this paper, the SEIR model with this saturating contact rate is studied. The basic reproduction number R0 is proved to be a sharp threshold which completely determines the global dynamics and the outcome of the disease. If R0 < or =1, the disease-free equilibrium is globally stable and the disease always dies out. If R0 > 1, there exists a unique endemic equilibrium which is globally stable and the disease persists at an endemic equilibrium state if it initially exists. The contribution of the saturating contact rate to the basic reproduction number and the level of the endemic equilibrium is also analyzed.     

Infection-age structured epidemic models with behavior change or treatment

We formulate infection-age structured susceptible-infective-removed (SIR) models with behavior change or treatment of infections. Individuals change their behavior or have treatment after they are infected. Using infection age as a continuous variable, and dividing infectives into discrete groups with different infection stages, respectively, we formulate a partial differential equation model and an ordinary differential equation model with behavior change or treatment. We derive explicit formulas for the reproductive number by linear stability analysis of the infection-free equilibrium, and explicit formulas for the unique endemic equilibrium, when it exists, for both models. These formulas provide mathematical theoretical frameworks for analysis of impact of behavior change or treatment of infection to the transmission dynamics of infectious diseases. We study several special cases and provide sensitivity analysis for the reproductive numbers with respect to model parameters based on those formulas.     

Infection-age structured epidemic models with behavior change or treatment

We formulate infection-age structured susceptible-infective-removed (SIR) models with behavior change or treatment of infections. Individuals change their behavior or have treatment after they are infected. Using infection age as a continuous variable, and dividing infectives into discrete groups with different infection stages, respectively, we formulate a partial differential equation model and an ordinary differential equation model with behavior change or treatment. We derive explicit formulas for the reproductive number by linear stability analysis of the infection-free equilibrium, and explicit formulas for the unique endemic equilibrium, when it exists, for both models. These formulas provide mathematical theoretical frameworks for analysis of impact of behavior change or treatment of infection to the transmission dynamics of infectious diseases. We study several special cases and provide sensitivity analysis for the reproductive numbers with respect to model parameters based on those formulas.     

Differential susceptibility epidemic models

We formulate compartmental differential susceptibility (DS) susceptible-infective-removed (SIR) models by dividing the susceptible population into multiple subgroups according to the susceptibility of individuals in each group. We analyze the impact of disease-induced mortality in the situations where the number of contacts per individual is either constant or proportional to the total population. We derive an explicit formula for the reproductive number of infection for each model by investigating the local stability of the infection-free equilibrium. We further prove that the infection-free equilibrium of each model is globally asymptotically stable by qualitative analysis of the dynamics of the model system and by utilizing an appropriately chosen Liapunov function. We show that if the reproductive number is greater than one, then there exists a unique endemic equilibrium for all of the DS models studied in this paper. We prove that the endemic equilibrium is locally asymptotically stable for the models with no disease-induced mortality and the models with contact numbers proportional to the total population. We also provide sufficient conditions for the stability of the endemic equilibrium for other situations. We briefly discuss applications of the DS models to optimal vaccine strategies and the connections between the DS models and predator-prey models with multiple prey populations or host-parasitic interaction models with multiple hosts are also given.This research was partially supported by the Department of Energy under contracts W-7405-ENG-36 and the Applied Mathematical Sciences Program KC-07-01-01.     

A Susceptible-infected Epidemic Model with Voluntary Vaccinations

An susceptible-infected epidemic model with endogenous behavioral changes is presented to analyze the impact of a prophylactic vaccine on disease prevalence. It is shown that, with voluntary vaccination, whether an endemic equilibrium exists or not does not depend on vaccine efficacy or the distribution of agent-types. Although an endemic equilibrium is unique in the absence of a vaccine, the availability of a vaccine can lead to multiple endemic equilibria that differ in disease prevalence and vaccine coverage. Depending on the distribution of agent-types, the introduction of a vaccine or, if one is available, a subsidy for vaccination can increase disease prevalence by inducing more risky behavior.I would like to thank one of the editors of the journal, Alan Hastings, for his comments and suggestions.     

Global stability of an SIR epidemic model with time delays

An SIR disease transmission model is formulated under the assumption that the force of infection at the present time depends on the number of infectives at the past. It is shown that a disease free equilibrium point is globally stable if no endemic equilibrium point exists. Further the endemic point (if it exists) is globally stable with respect to the whole state space except the neighborhood of the disease free state.Research partly supported by the Ministry of Education, Science and Culture, Japan, Grant 05640256     

A mathematical model for Chagas disease with infection-age-dependent infectivity

In this paper we develop a mathematical model for Chagas disease with infection-age-dependent infectivity. The effects of vector and blood transfusion transmission are considered, and the infected population is structured by the infection age (the time elapsed from infection). The authors identify the basic reproduction ratio R0 and show that the disease can invade into the susceptible population and unique endemic steady state exists if R0 > 1, whereas the disease dies out if R0 is small enough. We show that depending on parameters, backward bifurcation of endemic steady state can occur, so even if R0 < 1, there could exist endemic steady states. We also discuss local and global stability of steady states.     

具有一般形式饱和接触率SEIS模型渐近分析

研究具有一般形式饱和接触率SEIS模型渐近性态,得到决定疾病绝灭和持续的阈值-基本再生数R0。当R0 ≤ 1时,仅存在无病平衡点P^0;当R0＞1时,除存在无病平衡点P^0外,还存在惟一的地方病平衡点P^＊。当R0＜1时,无病平衡点P^0全局渐近稳定;当R0＞1时,地方病平衡点P^＊局部渐近稳定。特别地,无因病死亡时,极限方程地方病平衡点P^-＊全局渐近稳定。     

若干具有非线性传染力的传染病模型的稳定性分析

讨论了具有常数迁入和非线性传染力的三类传染病模型,即SIRI模型,SIRI框架下的DS模型及SIR框架下的DI模型。给出了它们基本再生数R0的表达式,证明了R0≤1时无病平衡点是全局稳定的,同时证明了如果地方病平衡点存在,则必是全局稳定的结果（从而必唯一）对第一和第三个模型还给出了R0＞1时地方病平衡点的存在唯一性。     

一个具非单调传染率的SEIR传染病模型的全局稳定性

本文研究一类描述某种严重疾病的传染数目变大时在心理上产生影响的非单调传染率的SEIR传染病模型.研究表明模型的动力行为和疾病的爆发完全由基本再生数R0决定.当R0≤1时,无病平衡点是全局稳定的,疾病消亡;当R0〉1时,地方病平衡点是全局稳定的,疾病持续且发展成地方病.     

一类具有垂直传染和预防接种的传染病模型的稳定性

考虑了垂直传染和预防接种因素对传染病流行影响的SEIRS模型,主要研究了系统的平衡点及其稳定性,得出当预防接种水平超过某一个阈值时疾病可以根除,若接种水平低于阈值时疾病将流行.     

Global dynamics of an epidemiological model with age of infection and disease relapse

In this paper, an epidemiological model with age of infection and disease relapse is investigated. The basic reproduction number for the model is identified, and it is shown to be a sharp threshold to completely determine the global dynamics of the model. By analysing the corresponding characteristic equations, the local stability of a disease-free steady state and an endemic steady state of the model is established. By means of suitable Lyapunov functionals and LaSalle's invariance principle, it is verified that if the basic reproduction number is less than unity, the disease-free steady state is globally asymptotically stable, and hence the disease dies out; if the basic reproduction number is greater than unity, the endemic steady state is globally asymptotically stable and the disease becomes endemic.     

Spread of disease with transport-related infection and entry screening

An SIQS model is proposed to study the effect of transport-related infection and entry screening. If the basic reproduction number is below unity, the disease free equilibrium is locally asymptotically stable. There exists an endemic equilibrium which is locally asymptotically stable if the reproduction number is larger than unity. It is shown that the disease is endemic in the sense of permanence if and only if the endemic equilibrium exists. Entry screening is shown to be helpful for disease eradication since it can always have the possibility to eradicate the disease led by transport-related infection and furthermore have the possibility to eradicate disease even when the disease is endemic in both isolated cities.     

Analysis of SIR epidemic models with nonlinear incidence rate and treatment

This paper deals with the nonlinear dynamics of a susceptible-infectious-recovered (SIR) epidemic model with nonlinear incidence rate, vertical transmission, vaccination for the newborns of susceptible and recovered individuals, and the capacity of treatment. It is assumed that the treatment rate is proportional to the number of infectives when it is below the capacity and constant when the number of infectives reaches the capacity. Under some conditions, it is shown that there exists a backward bifurcation from an endemic equilibrium, which implies that the disease-free equilibrium coexists with an endemic equilibrium. In such a case, reducing the basic reproduction number less than unity is not enough to control and eradicate the disease, extra measures are needed to ensure that the solutions approach the disease-free equilibrium. When the basic reproduction number is greater than unity, the model can have multiple endemic equilibria due to the effect of treatment, vaccination and other parameters. The existence and stability of the endemic equilibria of the model are analyzed and sufficient conditions on the existence and stability of a limit cycle are obtained. Numerical simulations are presented to illustrate the analytical results.     

A time since onset of injection model for hepatitis C spread amongst injecting drug users

Studies of hepatitis C virus (HCV) infection amongst injecting drug users (IDUs) have suggested that this population can be separated into two risk groups (naive and experienced) with different injecting risk behaviours. Understanding the differences between these two groups and how they interact could lead to a better allocation of prevention measures designed to reduce the burden of HCV in this population. In this paper we develop a deterministic, compartmental mathematical model for the spread of HCV in an IDU population that has been separated into two groups (naive and experienced) by time since onset of injection. We will first describe the model. After deriving the system of governing equations, we will examine the basic reproductive number $R_0$ , the existence and uniqueness of equilibrium solutions and the global stability of the disease free equilibrium (DFE) solution. The model behaviour is determined by the basic reproductive number, with $R_0=1$ a critical threshold for endemic HCV prevalence. We will show that when $R_0\le 1$ , and HCV is initially present in the population, the system will tend towards the globally asymptotically stable DFE where HCV has been eliminated from the population. We also show that when $R_0>1$ there exists a unique non-zero equilibrium solution. Then we estimate the value of $R_0$ from epidemiological data for Glasgow and verify our theoretical results using simulations with realistic parameter values. The numerical results suggest that if $R_0>1$ and the disease is initially present then the system will tend to the unique endemic equilibrium.     

具有周期传染率的SIR传染病模型的周期解

考虑了具有周期传染率的SIR流行病模型,定义了基本再生数^-R0=β／（μ＋γ）,分析了该模型的动力学性态,证明了当^-R0〈1时无病平衡点是全局稳定的;^-R0〉1时,无病平衡点是不稳定的,模型至少存在一个周期解。对小振幅的周期传染率模型,给出了模型周期解的近似表达式,证明了该周期解的稳定性,最后做了数值模拟,结果显示周期解可能是全局稳定的。     

Epidemiological models with prevalence dependent endogenous self-protection measure

A simple mathematical model for human disease epidemics that takes the human learning behaviour and self-protective measures into account is proposed and investigated. We have analysed the effect of endogenous self-protective measures with respect to the prevalence level of the disease and conversely. In the model it is assumed that people start reacting against contracting a disease with self-protective measures whenever they are informed about the disease and when the burden of the disease is in a recognizable stage. It is shown that increasing the average effectiveness of self-protective measures is more important in decreasing the prevalence of a disease than increasing the proportion of individuals in a population into which awareness is created.     

The general mixing of addicts and needles in a variable-infectivity needle-sharing environment

 In this paper we develop and analyse a model for the spread of HIV/AIDS amongst a population of injecting drug users. The model we discuss focuses on the transmission of HIV through the sharing of contaminated drug injection equipment and in particular we examine the mixing of addicts and needles when the AIDS incubation period is divided into three distinct infectious stages. The impact of this assumption is to greatly increase the complexity of the HIV transmission mechanism. We begin the paper with a brief literature review followed by the derivation of a model which incorporates three classes of infectious addicts and three classes of infectious needles and where a general probability structure is used to represent the interaction of addicts and needles of varying levels of infectivity. We find that if the basic reproductive number is less than or equal to unity then there exists a globally stable disease free equilibrium. The model possesses an endemic equilibrium solution if the basic reproductive number exceeds unity. We then conduct a brief simulation study of our model. We find that the spread of disease is heavily influenced by the way addicts and needles of different levels of infectivity interact. Received: 20 September 2001 / Revised version: 21 December 2001 / Published online: 17 May 2002