The Role of Immunity and Seasonality in Cholera Epidemics |
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| Authors: | Rosângela P Sanches Claudia P Ferreira Roberto A Kraenkel |
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| Institution: | (1) Enteric Diseases Epidemiology Branch, Division of Foodborne, Bacterial and Mycotic Diseases, National Center for Zoonotic, Vectorborne, and Enteric Diseases, Centers for Disease Control and Prevention, 30333 Atlanta, Georgia, USA;(2) Diarrheal Diseases Section, Enteric Diseases, Epidemiology Branch, Division of Foodborne, Bacterial and Mycotic Diseases, National Center for Zoonotic, Vectorborne, and Enteric Diseases, Centers for Disease Control and Prevention, 30333 Atlanta, Georgia, USA;(3) Division of Foodborne, Bacterial and Mycotic Diseases, National Center for Zoonotic, Vectorborne, and Enteric Diseases, Centers for Disease Control and Prevention, 30333 Atlanta, Georgia, USA |
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| Abstract: | This paper presents a mathematical model for cholera epidemics which comprises seasonality, loss of host immunity, and control
mechanisms acting to reduce cholera transmission. A collection of data related to cholera disease allows us to show that outbreaks
in endemic areas are subject to a resonant behavior, since the intrinsic oscillation period of the disease (∼1 year) is synchronized
with the annual contact rate variation. Moreover, we argue that the short period of the host immunity may be associated to
secondary peaks of incidence observed in some regions (a bimodal pattern). Finally, we explore some possible mechanisms of
cholera control, and analyze their efficiency. We conclude that, besides mass vaccination—which may be impracticable—improvements
in sanitation system and food/personal hygiene are the most effective ways to prevent an epidemic. |
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