Giuseppe
Emeritus
[Source: Proceedings of the National Academy of the Sciences of the United States of America, full text: (LINK). Abstract, edited.]
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House-to-house human movement drives dengue virus transmission
Steven T. Stoddard<SUP>a</SUP>,<SUP>b</SUP>,<SUP>1</SUP>, Brett M. Forshey<SUP>c</SUP>,<SUP>d</SUP>,<SUP>e</SUP>, Amy C. Morrison<SUP>a</SUP>,<SUP>c</SUP>,<SUP>d</SUP>, Valerie A. Paz-Soldan<SUP>f</SUP>, Gonzalo M. Vazquez-Prokopec<SUP>b</SUP>,<SUP>g</SUP>, Helvio Astete<SUP>c</SUP>,<SUP>d</SUP>, Robert C. Reiner, Jr<SUP>a</SUP>,<SUP>b</SUP>, Stalin Vilcarromero<SUP>c</SUP>,<SUP>d</SUP>, John P. Elder<SUP>h</SUP>, Eric S. Halsey<SUP>c</SUP>,<SUP>d</SUP>, Tadeusz J. Kochel<SUP>c</SUP>,<SUP>d</SUP>,<SUP>2</SUP>, Uriel Kitron<SUP>b</SUP>,<SUP>g</SUP>, and Thomas W. Scott<SUP>a</SUP>,<SUP>b</SUP>
<SUP></SUP>
Author Affiliations: <SUP>a</SUP>Department of Entomology, University of California, Davis, CA 95616; <SUP>b</SUP>Fogarty International Center, National Institutes of Health, Bethesda, MD 20892; <SUP>c</SUP>Virology Department, US Naval Medical Research Unit No. 6, Hospital Centro Medico Naval, Lima, Peru; <SUP>d</SUP>Virology Department, US Naval Medical Research Unit No. 6, Clinica Naval de Iquitos, Iquitos, Peru; <SUP>e</SUP>Department of Biostatistics, College of Public Health, University of Iowa, Iowa City, IA 52242; <SUP>f</SUP>Global Health Systems and Development, School of Public Health and Tropical Medicine, Tulane University, New Orleans, LA 70112; <SUP>g</SUP>Department of Environmental Studies, Emory University, Atlanta, GA 30322; and <SUP>h</SUP>Division of Health Promotion and Behavioral Sciences, Graduate School of Public Health, San Diego State University, San Diego, CA 92182
Edited by Simon A. Levin, Princeton University, Princeton, NJ, and approved November 27, 2012 (received for review August 6, 2012)
Abstract
Dengue is a mosquito-borne disease of growing global health importance. Prevention efforts focus on mosquito control, with limited success. New insights into the spatiotemporal drivers of dengue dynamics are needed to design improved disease-prevention strategies. Given the restricted range of movement of the primary mosquito vector, Aedes aegypti, local human movements may be an important driver of dengue virus (DENV) amplification and spread. Using contact-site cluster investigations in a case-control design, we demonstrate that, at an individual level, risk for human infection is defined by visits to places where contact with infected mosquitoes is likely, independent of distance from the home. Our data indicate that house-to-house human movements underlie spatial patterns of DENV incidence, causing marked heterogeneity in transmission rates. At a collective level, transmission appears to be shaped by social connections because routine movements among the same places, such as the homes of family and friends, are often similar for the infected individual and their contacts. Thus, routine, house-to-house human movements do play a key role in spread of this vector-borne pathogen at fine spatial scales. This finding has important implications for dengue prevention, challenging the appropriateness of current approaches to vector control. We argue that reexamination of existing paradigms regarding the spatiotemporal dynamics of DENV and other vector-borne pathogens, especially the importance of human movement, will lead to improvements in disease prevention.
infectious disease - spatial epidemiology - arthropod-borne virus - emerging infections - disease ecology
Footnotes
<SUP>1</SUP>To whom correspondence should be addressed. E-mail: ststoddard@gmail.com.
<SUP>2</SUP>Present address: Viral and Rickettsial Diseases Department, Naval Medical Research Center, Silver Spring, MD 20910.
Author contributions: S.T.S., B.M.F., A.C.M., V.A.P.-S., G.M.V.-P., J.P.E., T.J.K., U.K., and T.W.S. designed research; S.T.S., B.M.F., A.C.M., H.A., S.V., and T.J.K. performed research; S.T.S., B.M.F., V.A.P.-S., G.M.V.-P., R.C.R., J.P.E., E.S.H., and T.J.K. contributed new reagents/analytic tools; S.T.S. and R.C.R. analyzed data; and S.T.S., B.M.F., A.C.M., and T.W.S. wrote the paper.
The authors declare no conflict of interest.
This article is a PNAS Direct Submission.
This article contains supporting information online at www.pnas.org/lookup/suppl/doi:10.1073/pnas.1213349110/-/DCSupplemental.
Freely available online through the PNAS open access option.
-Steven T. Stoddard<SUP>a</SUP>,<SUP>b</SUP>,<SUP>1</SUP>, Brett M. Forshey<SUP>c</SUP>,<SUP>d</SUP>,<SUP>e</SUP>, Amy C. Morrison<SUP>a</SUP>,<SUP>c</SUP>,<SUP>d</SUP>, Valerie A. Paz-Soldan<SUP>f</SUP>, Gonzalo M. Vazquez-Prokopec<SUP>b</SUP>,<SUP>g</SUP>, Helvio Astete<SUP>c</SUP>,<SUP>d</SUP>, Robert C. Reiner, Jr<SUP>a</SUP>,<SUP>b</SUP>, Stalin Vilcarromero<SUP>c</SUP>,<SUP>d</SUP>, John P. Elder<SUP>h</SUP>, Eric S. Halsey<SUP>c</SUP>,<SUP>d</SUP>, Tadeusz J. Kochel<SUP>c</SUP>,<SUP>d</SUP>,<SUP>2</SUP>, Uriel Kitron<SUP>b</SUP>,<SUP>g</SUP>, and Thomas W. Scott<SUP>a</SUP>,<SUP>b</SUP>
<SUP></SUP>
Author Affiliations: <SUP>a</SUP>Department of Entomology, University of California, Davis, CA 95616; <SUP>b</SUP>Fogarty International Center, National Institutes of Health, Bethesda, MD 20892; <SUP>c</SUP>Virology Department, US Naval Medical Research Unit No. 6, Hospital Centro Medico Naval, Lima, Peru; <SUP>d</SUP>Virology Department, US Naval Medical Research Unit No. 6, Clinica Naval de Iquitos, Iquitos, Peru; <SUP>e</SUP>Department of Biostatistics, College of Public Health, University of Iowa, Iowa City, IA 52242; <SUP>f</SUP>Global Health Systems and Development, School of Public Health and Tropical Medicine, Tulane University, New Orleans, LA 70112; <SUP>g</SUP>Department of Environmental Studies, Emory University, Atlanta, GA 30322; and <SUP>h</SUP>Division of Health Promotion and Behavioral Sciences, Graduate School of Public Health, San Diego State University, San Diego, CA 92182
Edited by Simon A. Levin, Princeton University, Princeton, NJ, and approved November 27, 2012 (received for review August 6, 2012)
Abstract
Dengue is a mosquito-borne disease of growing global health importance. Prevention efforts focus on mosquito control, with limited success. New insights into the spatiotemporal drivers of dengue dynamics are needed to design improved disease-prevention strategies. Given the restricted range of movement of the primary mosquito vector, Aedes aegypti, local human movements may be an important driver of dengue virus (DENV) amplification and spread. Using contact-site cluster investigations in a case-control design, we demonstrate that, at an individual level, risk for human infection is defined by visits to places where contact with infected mosquitoes is likely, independent of distance from the home. Our data indicate that house-to-house human movements underlie spatial patterns of DENV incidence, causing marked heterogeneity in transmission rates. At a collective level, transmission appears to be shaped by social connections because routine movements among the same places, such as the homes of family and friends, are often similar for the infected individual and their contacts. Thus, routine, house-to-house human movements do play a key role in spread of this vector-borne pathogen at fine spatial scales. This finding has important implications for dengue prevention, challenging the appropriateness of current approaches to vector control. We argue that reexamination of existing paradigms regarding the spatiotemporal dynamics of DENV and other vector-borne pathogens, especially the importance of human movement, will lead to improvements in disease prevention.
infectious disease - spatial epidemiology - arthropod-borne virus - emerging infections - disease ecology
Footnotes
<SUP>1</SUP>To whom correspondence should be addressed. E-mail: ststoddard@gmail.com.
<SUP>2</SUP>Present address: Viral and Rickettsial Diseases Department, Naval Medical Research Center, Silver Spring, MD 20910.
Author contributions: S.T.S., B.M.F., A.C.M., V.A.P.-S., G.M.V.-P., J.P.E., T.J.K., U.K., and T.W.S. designed research; S.T.S., B.M.F., A.C.M., H.A., S.V., and T.J.K. performed research; S.T.S., B.M.F., V.A.P.-S., G.M.V.-P., R.C.R., J.P.E., E.S.H., and T.J.K. contributed new reagents/analytic tools; S.T.S. and R.C.R. analyzed data; and S.T.S., B.M.F., A.C.M., and T.W.S. wrote the paper.
The authors declare no conflict of interest.
This article is a PNAS Direct Submission.
This article contains supporting information online at www.pnas.org/lookup/suppl/doi:10.1073/pnas.1213349110/-/DCSupplemental.
Freely available online through the PNAS open access option.
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