Stochastic epidemic models: A survey

This paper is a survey paper on stochastic epidemic models. A simple stochastic epidemic model is defined and exact and asymptotic (relying on a large community) properties are presented. The purpose of modelling is illustrated by studying effects of vaccination and also in terms of inference procedures for important parameters, such as the basic reproduction number and the critical vaccination coverage. Several generalizations towards realism, e.g. multitype and household epidemic models, are also presented, as is a model for endemic diseases.     

An epidemic model with infector and exposure dependent severity

A stochastic epidemic model allowing for both mildly and severely infectious individuals is defined, where an individual can become severely infectious directly upon infection or if additionally exposed to infection. It is shown that, assuming a large community, the initial phase of the epidemic may be approximated by a suitable branching process and that the main part of an epidemic that becomes established admits a law of large numbers and a central limit theorem, leading to a normal approximation for the final outcome of such an epidemic. Effects of vaccination prior to an outbreak are studied and the critical vaccination coverage, above which only small outbreaks can occur, is derived. The results are illustrated by simulations that demonstrate that the branching process and normal approximations work well for finite communities, and by numerical examples showing that the final outcome may be close to discontinuous in certain model parameters and that the fraction mildly infected may actually increase as an effect of vaccination.     

Population dynamics of live-attenuated virus vaccines

Viruses contained in live-attenuated virus vaccines (LAVV) can be transmitted between individuals, resulting in secondary or contact vaccinations. This fact has been exploited successfully in the use of the Oral Polio Vaccine (OPV) to better control wild-type polio viruses. In this work we analyze general LAVV vaccination models for infections that confer lifelong immunity. We consider both standard (continuous) vaccination strategies and pulse vaccination programs (where mass vaccination is carried out at regular intervals). For continuous vaccination, we provide a complete global analysis of a very general compartmental ordinary differential equation LAVV model. We find that the threshold vaccination level required for the eradication of wild-type virus depends on the basic reproduction numbers of both the wild-type and vaccine viruses, but is otherwise independent of the distributions of the durations in each of the sequence of stages of disease progression (e.g., latent, infectious, etc.). Furthermore, even for vaccine viruses with reproduction numbers below one, which would naturally fade from the population upon cessation of vaccination, there can be a significant reduction in the threshold vaccination level. The dependence of the threshold vaccination level on the virus reproduction numbers largely generalizes to the pulse vaccination model. For shorter pulsing periods there is negligible difference in threshold vaccination level as compared to continuous vaccination campaigns. Thus, we conclude that current policy in many countries to employ annual pulsed OPV vaccination does not significantly diminish the benefits of contact vaccination.     

Household Epidemics: Modelling Effects of Early Stage Vaccination

A Markovian susceptible → infectious → removed (SIR) epidemic model is considered in a community partitioned into households. A vaccination strategy, which is implemented during the early stages of the disease following the detection of infected individuals is proposed. In this strategy, the detection occurs while an individual is infectious and other susceptible household members are vaccinated without further delay. Expressions are derived for the influence on the reproduction numbers of this vaccination strategy for equal and unequal household sizes. We fit previously estimated parameters from influenza and use household distributions for Sweden and Tanzania census data. The results show that the reproduction number is much higher in Tanzania (6 compared with 2) due to larger households, and that infected individuals have to be detected (and household members vaccinated) after on average 5 days in Sweden and after 3.3 days in Tanzania, a much smaller difference.     

Reactive vaccination in the presence of disease hotspots

Reactive vaccination has recently been adopted as an outbreak response tool for cholera and other infectious diseases. Owing to the global shortage of oral cholera vaccine, health officials must quickly decide who and where to distribute limited vaccine. Targeted vaccination in transmission hotspots (i.e. areas with high transmission efficiency) may be a potential approach to efficiently allocate vaccine, however its effectiveness will likely be context-dependent. We compared strategies for allocating vaccine across multiple areas with heterogeneous transmission efficiency. We constructed metapopulation models of a cholera-like disease and compared simulated epidemics where: vaccine is targeted at areas of high or low transmission efficiency, where vaccine is distributed across the population, and where no vaccine is used. We find that connectivity between populations, transmission efficiency, vaccination timing and the amount of vaccine available all shape the performance of different allocation strategies. In highly connected settings (e.g. cities) when vaccinating early in the epidemic, targeting limited vaccine at transmission hotspots is often optimal. Once vaccination is delayed, targeting the hotspot is rarely optimal, and strategies that either spread vaccine between areas or those targeted at non-hotspots will avert more cases. Although hotspots may be an intuitive outbreak control target, we show that, in many situations, the hotspot-epidemic proceeds so fast that hotspot-targeted reactive vaccination will prevent relatively few cases, and vaccination shared across areas where transmission can be sustained is often best.     

A game dynamic model for delayer strategies in vaccinating behaviour for pediatric infectious diseases

Several studies have found that some parents delay the age at which their children receive pediatric vaccines due to perception of higher vaccine risk at the recommended age of vaccination. This has been particularly apparently during the Measles-Mumps-Rubella scare in the United Kingdom. Under a voluntary vaccination policy, vaccine coverage in certain age groups is a potentially complex interplay between vaccinating behaviour, disease dynamics, and age-specific risk factors. Here, we construct an age-structured game dynamic model, where individuals decide whether to vaccinate according to imitation dynamics depending on age-dependent disease prevalence and perceived risk of vaccination. Individuals may be timely vaccinators, delayers, or non-vaccinators. The model exhibits multiple equilibria and a broad range of possible dynamics. For certain parameter regimes, the proportion of timely vaccinators and delayers oscillate in an anti-phase fashion in response to oscillations in infection prevalence. Under an exogenous change to the perceived risk of vaccination as might occur during a vaccine scare, the model can also capture an increase in delayer strategists similar in magnitude to that observed during the Measles-Mumps-Rubella vaccine scare in the United Kingdom. Our model also shows that number of delayers steadily increases with increasing severity of the scare, whereas it saturates to specific value with increases in duration of the scare. Finally, by comparing the model dynamics with and without the option of a delayer strategy, we show that adding a third delayer strategy can have a stabilizing effect on model dynamics. In an era where individual choice—rather than accessibility—is becoming an increasingly important determinant of vaccine uptake, more infectious disease models may need to use game theory or related techniques to determine vaccine uptake.     

Deterministic epidemic models with explicit household structure

For a wide range of airborne infectious diseases, transmission within the family or household is a key mechanism for the spread and persistence of infection. In general, household-based transmission is relatively strong but only involves a limited number of individuals in contact with each infectious person. In contrast, transmission outside the household can be characterised by many contacts but a lower probability of transmission. Here we develop a relatively simple dynamical model that captures these two transmission regimes. We compare the dynamics of such models for a range of household sizes, whilst constraining all models to have equal early growth rate so that all models fit to the same early incidence observations of an epidemic. Finally we consider the use of prophylactic vaccination, responsive vaccination, or antivirals to combat epidemic spread and focus on whether it is optimal to target controls at entire households or to treat individuals independently.     

Optimal rates of dispersal II. Diploid populations

The problem of how an individual should divide its progeny into dispersed and non-dispersed descendants is investigated for a number of haploid models. In each model, a unique optimal ratio of dispersed to non-dispersed has been found, where the type with this optimal strategy has a selective advantage over all other types. Although the survival ability of a dispersed offspring is reduced (compared to that of a non-dispersed offspring), the optimal strategy implies that a substantial part of the progeny will be dispersed.     

Optimal rates of dispersal I. Haploid populations

The problem of how an individual should divide its progeny into dispersed and non-dispersed descendants is investigated for a number of haploid models. In each model, a unique optimal ratio of dispersed to non-dispersed has been found, where the type with this optimal strategy has a selective advantage over all other types. Although the survival ability of a dispersed offspring is reduced (compared to that of a non-dispersed offspring), the optimal strategy implies that a substantial part of the progeny will be dispersed.     

Impulsive Vaccination of an SEIRS Model with Time Delay and Varying Total Population Size

Pulse vaccination is an effective and important strategy for the elimination of infectious diseases. A delayed SEIRS epidemic model with pulse vaccination and varying total population size is proposed in this paper. We point out, if R* < 1, the infectious population disappear so the disease dies out, while if R _*; > 1, the infectious population persist. Our results indicate that a long period of pulsing or a small pulse vaccination rate is sufficient condition for the permanence of the model.     

Incentives Increase Participation in Mass Dog Rabies Vaccination Clinics and Methods of Coverage Estimation Are Assessed to Be Accurate

In this study we show that incentives (dog collars and owner wristbands) are effective at increasing owner participation in mass dog rabies vaccination clinics and we conclude that household questionnaire surveys and the mark-re-sight (transect survey) method for estimating post-vaccination coverage are accurate when all dogs, including puppies, are included. Incentives were distributed during central-point rabies vaccination clinics in northern Tanzania to quantify their effect on owner participation. In villages where incentives were handed out participation increased, with an average of 34 more dogs being vaccinated. Through economies of scale, this represents a reduction in the cost-per-dog of $0.47. This represents the price-threshold under which the cost of the incentive used must fall to be economically viable. Additionally, vaccination coverage levels were determined in ten villages through the gold-standard village-wide census technique, as well as through two cheaper and quicker methods (randomized household questionnaire and the transect survey). Cost data were also collected. Both non-gold standard methods were found to be accurate when puppies were included in the calculations, although the transect survey and the household questionnaire survey over- and under-estimated the coverage respectively. Given that additional demographic data can be collected through the household questionnaire survey, and that its estimate of coverage is more conservative, we recommend this method. Despite the use of incentives the average vaccination coverage was below the 70% threshold for eliminating rabies. We discuss the reasons and suggest solutions to improve coverage. Given recent international targets to eliminate rabies, this study provides valuable and timely data to help improve mass dog vaccination programs in Africa and elsewhere.     

A two-age-classes dengue transmission model

In this paper, we discuss a two-age-classes dengue transmission model with vaccination. The reason to divide the human population into two age classes is for practical purpose, as vaccination is usually concentrated in one age class. We assume that a constant rate of individuals in the child-class is vaccinated. We analyze a threshold number which is equivalent to the basic reproduction number. If there is an undeliberate vaccination to infectious children, which worsens their condition as the time span of being infectious increases, then paradoxically, vaccination can be counter productive. The paradox, stating that vaccination makes the basic reproduction number even bigger, can occur if the worsening effect is greater than a certain threshold, a function of the human demographic and epidemiological parameters, which is independent of the level of vaccination. However, if the worsening effect is to increase virulence so that one will develop symptoms, then the vaccination is always productive. In both situations, screening should take place before vaccination. In general, the presence of class division has obscured the known rule of thumb for vaccination.     

Epidemiological and evolutionary consequences of targeted vaccination

Recent theory has examined the way in which vaccination strategies are expected to influence the evolution of parasite virulence. Most of this work has assumed that vaccination is imposed on a homogeneous host population. However, host populations are typically composed of different types of individuals, with each type responding differently to infection. Moreover, actual interventions often focus treatment on those hosts that are likely to suffer the most ill effects of a particular disease. Here we consider the epidemiological and evolutionary consequences of interventions that focus vaccination on individuals expressing the greatest susceptibility to infection and/or the greatest vulnerability to mortality once infected. Our results indicate that predictions are very sensitive to the nature and degree of heterogeneity in susceptibility and vulnerability. They further suggest that accounting for realistic kinds of heterogeneity when contemplating targeted treatment plans and policies might provide a new tool in the design of more effective virulence management strategies.     

Dynamic vaccination games and variational inequalities on time-dependent sets

This paper presents a model of a dynamic vaccination game in a population consisting of a collection of groups, each of which holds distinct perceptions of vaccinating versus non-vaccinating risks. Vaccination is regarded here as a game due to the fact that the payoff to each population group depends on the so-called perceived probability of getting infected given a certain level of the vaccine coverage in the population, a level that is generally obtained by the vaccinating decisions of other members of a population. The novelty of this model resides in the fact that it describes a repeated vaccination game (over a finite time horizon) of population groups whose sizes vary with time. In particular, the dynamic game is proven to have solutions using a parametric variational inequality approach often employed in optimization and network equilibrium problems. Moreover, the model does not make any assumptions upon the level of the vaccine coverage in the population, but rather computes this level as a final result. This model could then be used to compute possible vaccine coverage scenarios in a population, given information about its heterogeneity with respect to perceived vaccine risks. In support of the model, some theoretical results were advanced (presented in the appendix) to ensure that computation of optimal vaccination strategies can take place; this means, the theory states the existence, uniqueness and regularity (in our case piecewise continuity) of the solution curves representing the evolution of optimal vaccination strategies of each population group.     

The evolution of density-dependent dispersal in a noisy spatial population model

It is well-known that dispersal is advantageous in many different ecological situations, e.g. to survive local catastrophes where populations live in spatially and temporally heterogeneous habitats. However, the key question, what kind of dispersal strategy is optimal in a particular situation, has remained unanswered. We studied the evolution of density-dependent dispersal in a coupled map lattice model, where the population dynamics are perturbed by external environmental noise. We used a very flexible dispersal function to enable evolution to select from practically all possible types of monotonous density-dependent dispersal functions. We treated the parameters of the dispersal function as continuously changing phenotypic traits. The evolutionary stable dispersal strategies were investigated by numerical simulations. We pointed out that irrespective of the cost of dispersal and the strength of environmental noise, this strategy leads to a very weak dispersal below a threshold density, and dispersal rate increases in an accelerating manner above this threshold. Decreasing the cost of dispersal increases the skewness of the population density distribution, while increasing the environmental noise causes more pronounced bimodality in this distribution. In case of positive temporal autocorrelation of the environmental noise, there is no dispersal below the threshold, and only low dispersal below it, on the other hand with negative autocorrelation practically all individual disperses above the threshold. We found our results to be in good concordance with empirical observations.     

Finding optimal vaccination strategies under parameter uncertainty using stochastic programming

We present a stochastic programming framework for finding the optimal vaccination policy for controlling infectious disease epidemics under parameter uncertainty. Stochastic programming is a popular framework for including the effects of parameter uncertainty in a mathematical optimization model. The problem is initially formulated to find the minimum cost vaccination policy under a chance-constraint. The chance-constraint requires that the probability that R(*) 相似文献   

An energy-based model of optimal feeding-territory size

An energy-based model of feeding territoriality is described. The model predicts an optimal territory size where the territory holder's net energy intake is maximized, on a daily or seasonal time scale. Simulated effects on optimal territory size of animal size, food availability, and competitor density are in general agreement with observed relationships in a wide variety of animals. When salmonid data are used to estimate the model parameter values, predicted territory sizes are similar to those actually observed. When emigration is allowed, the model predicts that territoriality, through individual selection alone, can regulate population size, but that this regulation breaks down when initial densities exceed some threshold value. Sensitivity analysis shows optimal territory size to be most affected by those parameters influencing food intake and energy expenditure. Some alternative criteria for optimization are also discussed. An animal maximizing net foraging efficiency has a smaller territory than one maximizing net energy, but the effects of animal size, food availability, and competitor density on territory size are the same in either case.     

Control of transmission with two types of infection

The effectiveness of a vaccination strategy to control transmission of an infectious disease depends on the way vaccine doses are distributed to individuals in a community of households. Here we show that this dependence is more complicated when acquisition and severity of illness are determined by the size of the infecting dose, as is thought to be the case for measles and varicella. Two alternative formulations for the way vaccination changes an individual's susceptibility and infectivity show that vaccination coverage, the nature of the vaccine response and the distribution of household size also have a big impact on which strategy is more effective. These judgements are made by comparing the post-vaccination reproduction numbers corresponding to different vaccination strategies.     

Optimal intervention for an epidemic model under parameter uncertainty

We will be concerned with optimal intervention policies for a continuous-time stochastic SIR (susceptible-->infective-->removed) model for the spread of infection through a closed population. In previous work on such optimal policies, it is common to assume that model parameter values are known; in reality, uncertainty over parameter values exists. We shall consider the effect upon the optimal policy of changes in parameter estimates, and of explicitly taking into account parameter uncertainty via a Bayesian decision-theoretic framework. We consider policies allowing for (i) the isolation of any number of infectives, or (ii) the immunisation of all susceptibles (total immunisation). Numerical examples are given to illustrate our results.     

Stochastic and deterministic models for SIS epidemics among a population partitioned into households

Models for the spread of an SIS epidemic among a population consisting of m households, each containing n individuals, are considered and their behaviour is analysed under the practically relevant situation when m is large and n small. A threshold parameter R* is determined. For the stochastic model it is shown that the epidemic has a non-zero probability of taking off if and only if R* > 1, and the extension to unequal household sizes is also considered. For the deterministic model, with households of size 2, it is shown that if R* < or = 1 then the epidemic dies out, whilst if R* > 1 the epidemic settles down to an endemic equilibrium. The usual basic reproductive ratio R0 does not provide a good indicator for the behaviour of these household epidemic models unless the household size n is large.