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Abrupt events and population synchrony in the dynamics of Bovine Tuberculosis.

ABSTRACT: Disease control strategies can have both intended and unintended effects on the dynamics of infectious diseases. Routine testing for the harmful pathogen Bovine Tuberculosis (bTB) was suspended briefly during the foot and mouth disease epidemic of 2001 in Great Britain. Here we utilize bTB incidence data and mathematical models to demonstrate how a lapse in management can alter epidemiological parameters, including the rate of new infections and duration of infection cycles. Testing interruption shifted the dynamics from annual to 4-year cycles, and created long-lasting shifts in the spatial synchrony of new infections among regions of Great Britain. After annual testing was introduced in some GB regions, new infections have become more de-synchronised, a result also confirmed by a stochastic model. These results demonstrate that abrupt events can synchronise disease dynamics and that changes in the epidemiological parameters can lead to chaotic patterns, which are hard to be quantified, predicted, and controlled.

SUBMITTER: Moustakas A

PROVIDER: S-EPMC6053421 | biostudies-literature | 2018 Jul

REPOSITORIES: biostudies-literature

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Abrupt events and population synchrony in the dynamics of Bovine Tuberculosis.

Moustakas Aristides A Evans Matthew R MR Daliakopoulos Ioannis N IN Markonis Yannis Y

Nature communications 20180719 1

Disease control strategies can have both intended and unintended effects on the dynamics of infectious diseases. Routine testing for the harmful pathogen Bovine Tuberculosis (bTB) was suspended briefly during the foot and mouth disease epidemic of 2001 in Great Britain. Here we utilize bTB incidence data and mathematical models to demonstrate how a lapse in management can alter epidemiological parameters, including the rate of new infections and duration of infection cycles. Testing interruption ...[more]

PMID: 30026483

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Project description:BackgroundGuidelines recommend treatment of latent tuberculosis in patients at increased risk for active tuberculosis. Studies investigating the association of therapy with serious adverse events have not included the entire treated population nor accounted for comorbidities or occurrence of similar events in the untreated general population. Our objective was to estimate the risk of adverse events requiring hospital admission that were associated with therapy for latent tuberculosis infection in the general population.MethodsUsing administrative health data from the province of Quebec, we created a historical cohort of all residents dispensed therapy for latent tuberculosis between 1998 and 2003. Each patient was matched on age, sex and postal region with two untreated residents. The observation period was 18 months (from 6 months before to 12 months after initiation of therapy). The primary outcome was hospital admission for therapy-associated adverse events.ResultsDuring the period of observation, therapy for latent tuberculosis was dispensed to 9145 residents, of whom 95% started isoniazid and 5% started rifampin. Pretreatment comorbid illness was significantly more common among patients receiving such therapy compared with the matched untreated cohort. Of all patients dispensed therapy, 45 (0.5%) were admitted to hospital for a hepatic event compared with 15 (0.1%) of the untreated patients. For people over age 65 years, the odds of hospital admission for a hepatic event among patients treated for latent tuberculosis infection was significantly greater than among matched untreated people after adjustment for comorbidities (odds ratio [OR] 6.4, 95% CI 2.2-18.3). Excluding patients with comorbid illness, there were two excess admissions to hospital for hepatic events per 100 patients initiating therapy compared with the rate among untreated people over 65 years (95% CI 0.1-3.87).InterpretationThe risk of adverse events requiring hospital admission increased significantly among patients over 65 years receiving treatment for latent tuberculosis infection. The decision to treat latent tuberculosis infection in elderly patients should be made after careful consideration of risks and benefits.

Project description:Bovine tuberculosis (bTB) poses a challenge to animal health and welfare worldwide. Presence of genetic variation in host resistance to Mycobacterium bovis infection makes the trait amenable to improvement with genetic selection. Genetic evaluations for resistance to infection in dairy cattle are currently available in the United Kingdom (UK), enabling genetic selection of more resistant animals. However, the extent to which genetic selection could contribute to bTB eradication is unknown. The objective of this study was to quantify the impact of genetic selection for bTB resistance on cattle-to-cattle disease transmission dynamics and prevalence by developing a stochastic genetic epidemiological model. The model was used to implement genetic selection in a simulated cattle population. The model considered various levels of selection intensity over 20 generations assuming genetic heterogeneity in host resistance to infection. Our model attempted to represent the dairy cattle population structure and current bTB control strategies in the UK, and was informed by genetic and epidemiological parameters inferred from data collected from UK bTB infected dairy herds. The risk of a bTB breakdown was modeled as the percentage of herds where initially infected cows (index cases) generated secondary cases by infecting herd-mates. The model predicted that this risk would be reduced by half after 4, 6, 9, and 15 generations for selection intensities corresponding to genetic selection of the 10, 25, 50, and 70% most resistant sires, respectively. In herds undergoing bTB breakdowns, genetic selection reduced the severity of breakdowns over generations by reducing both the percentage of secondary cases and the duration over which new secondary cases were detected. Selection of the 10, 25, 50, and 70% most resistant sires reduced the percentage of secondary cases to <1% in 4, 5, 7, and 11 generations, respectively. Similarly, the proportion of long breakdowns (breakdowns in which secondary cases were detected for more than 365 days) was reduced by half in 2, 2, 3, and 4 generations, respectively. Collectively, results suggest that genetic selection could be a viable tool that can complement existing management and surveillance methods to control and ultimately eradicate bTB.

Dataset Information

Abrupt events and population synchrony in the dynamics of Bovine Tuberculosis.

Publications

Abrupt events and population synchrony in the dynamics of Bovine Tuberculosis.

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