Estimating pathogen introduction rates from serological data to characterize past and future patterns of transmission

AlexanderMeyer

University of Notre Dame

"Estimating pathogen introduction rates from serological data to characterize past and future patterns of transmission"

The unpredictable timing of infectious disease outbreaks poses significant challenges for public health preparedness. For many pathogens, this unpredictability is due to uncertainty regarding introduction rates—the frequency with which the pathogen is introduced into at-risk populations. We present three model-driven advances toward quantifying pathogen introduction rates and their effects on outbreak timing and size. Our method relies on the assumption that pathogen introductions can only cause large outbreaks when population immunity is sufficiently low (i.e., the reproduction number R(t) > 1). First, we demonstrate that, for pathogens that cause lifelong immunity, introduction rates can be estimated from age-structured serological data. Second, we estimate annual rates of chikungunya virus (CHIKV, a mosquito-borne pathogen) introductions into 17 populations in Africa and Asia using serological data collected between 1973 and 2015. Our median estimates ranged from 1 to 70 CHIKV introductions per 10 million people per year. Finally, we used simulations to show how the introduction rate of a pathogen can shape its transmission patterns over time in affected populations. A lower introduction rate allows population immunity to wane between introductions, leading to large but infrequent outbreaks. In contrast, a higher introduction rate causes frequent low-level transmission, resulting in elevated population immunity that precludes large outbreaks. Together, these results illustrate how age-structured serology, a common type of epidemiological data, can be leveraged to better understand both historical and future transmission patterns in different populations.
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