Seasonality and the dynamics of infectious diseases

Towards a mechanistic understanding of competence: a missing link in diversity-disease research

Biodiversity loss may increase the risk of infectious disease in a phenomenon known as the dilution effect. Circumstances that increase the likelihood of disease dilution are: (i) when hosts vary in their competence, and (ii) when communities disassemble predictably, such that the least competent hosts are the most likely to go extinct. Despite the central role of competence in diversity-disease theory, we lack a clear understanding of the factors underlying competence, as well as the drivers and extent of its variation. Our perspective piece encourages a mechanistic understanding of competence and a deeper consideration of its role in diversity-disease relationships. We outline current evidence, emerging questions and future directions regarding the basis of competence, its definition and measurement, the roots of its variation and its role in the community ecology of infectious disease.

Contrasting the seasonal and elevational prevalence of generalist avian haemosporidia in co-occurring host species

Understanding the ecology and evolution of parasites is contingent on identifying the selection pressures they face across their infection landscape. Such a task is made challenging by the fact that these pressures will likely vary across time and space, as a result of seasonal and geographical differences in host susceptibility or transmission opportunities. Avian haemosporidian blood parasites are capable of infecting multiple co-occurring hosts within their ranges, yet whether their distribution across time and space varies similarly in their different host species remains unclear. Here, we applied a new PCR method to detect avian haemosporidia (genera Haemoproteus, Leucocytozoon, and Plasmodium) and to determine parasite prevalence in two closely related and co-occurring host species, blue tits (Cyanistes caeruleus, N = 529) and great tits (Parus major, N = 443). Our samples were collected between autumn and spring, along an elevational gradient in the French Pyrenees and over a three-year period. Most parasites were found to infect both host species, and while these generalist parasites displayed similar elevational patterns of prevalence in the two host species, this was not always the case for seasonal prevalence patterns. For example, Leucocytozoon group A parasites showed inverse seasonal prevalence when comparing between the two host species, being highest in winter and spring in blue tits but higher in autumn in great tits. While Plasmodium relictum prevalence was overall lower in spring relative to winter or autumn in both species, spring prevalence was also lower in blue tits than in great tits. Together, these results reveal how generalist parasites can exhibit host-specific epidemiology, which is likely to complicate predictions of host-parasite co-evolution.

A Decade of Treatment of Canine Parvovirus in an Animal Shelter: A Retrospective Study

Here, we present 11.5 years of monthly treatment statistics showing an overall intake of 5127 infected dogs between June 2008 and December 2019, as well as more detailed datasets from more recent, less protracted time periods for the examination of mortality risk, seasonality, and resource requirements in the mass treatment of canine parvovirus (CPV) in a private animal shelter. The total survival rate of animals during the study period was 86.6% (n = 4438/5127 dogs survived) with the probability of survival increasing to 96.7% after five days of treatment (with 80% of fatalities occurring in that period). A distinct parvovirus season peaking in May and June and troughing in August, September, December, and January was observed, which could have contributed as much as 41 animals peak-to-trough in the monthly population (with a potential, smaller season occurring in October). Low-weight and male animals were at higher risk for death, whereas age was not a significant contributing factor. Treatment time averaged 9.03 h of total care during a seven-day median treatment duration. These findings, taken together, demonstrate that canine parvovirus can be successfully treated in a sustainable manner within a shelter setting using a largely volunteer workforce.

The evolution of host resistance and parasite infectivity is highest in seasonal resource environments that oscillate at intermediate amplitudes

Seasonal environments vary in their amplitude of oscillation but the effects of this temporal heterogeneity for host-parasite coevolution are poorly understood. Here, we combined mathematical modelling and experimental evolution of a coevolving bacteria-phage interaction to show that the intensity of host-parasite coevolution peaked in environments that oscillate in their resource supply with intermediate amplitude. Our experimentally parameterized mathematical model explains that this pattern is primarily driven by the ecological effects of resource oscillations on host growth rates. Our findings suggest that in host-parasite systems where the host's but not the parasite's population growth dynamics are subject to seasonal forcing, the intensity of coevolution will peak at intermediate amplitudes but be constrained at extreme amplitudes of environmental oscillation.

Seasonal dynamics of haemosporidian (Apicomplexa, Haemosporida) parasites in house sparrows Passer domesticus at four European sites: comparison between lineages and the importance of screening methods

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Haemosporidae prevalence and diversity in house sparrows decreased with increasing latitude.

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The nested PCR method underestimates co-infections and biases results.

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Seasonal dynamics varied between sites, lineages, species and genera.

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Seasonality of single lineages (P_SGS1) also varied between sites.

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Unexpectedly, seasonality was greatest at the southernmost site.

Infectious diseases often vary seasonally in a predictable manner, and seasonality may be responsible for geographical differences in prevalence. In temperate regions, vector-borne parasites such as malaria are expected to evolve lower virulence and a time-varying strategy to invest more in transmission when vectors are available. A previous model of seasonal variation of avian malaria described a double peak in prevalence of Plasmodium parasites in multiple hosts resulting from spring relapses and transmission to susceptible individuals in summer. However, this model was rejected by a study describing different patterns of seasonal variation of two Plasmodium spp. at the same site, with the double peak only apparent when these species were combined. Here, we assessed the seasonal variation in prevalence of haemosporidian parasites (Plasmodium, Haemoproteus and Leucocytozoon) in house sparrows (Passer domesticus) sampled across 1 year at four temperate European sites spanning a latitudinal range of 17°. We showed that parasite prevalence and diversity decreased with increasing latitude, but the parasite communities differed between sites, with only one Plasmodium lineage (P_SGS1) occurring at all sites. Moreover, the nested PCR method commonly used to detect and identify haemosporidian parasites strongly underestimated co-infections of Haemoproteus and Plasmodium, significantly biasing the pattern of seasonal variation, so additional molecular methods were used. Finally, we showed that: (i) seasonal variation in prevalence of haemosporidian parasites varied between study sites and parasite lineages/species/genera, describing further cases where the double peak model is not met; (ii) the seasonal dynamics of single lineages (P_SGS1) varied between sites; and (iii) unexpectedly, seasonality was greatest at the southernmost site, a pattern that was mostly driven by lineage H_PADOM05. Limitations of the genotyping methods and consequences of pooling (parasite lineages, sites and years) in studies of haemosporidian parasites are discussed and recommendations proposed, since these actions may obscure the patterns of prevalence and limit ecological inferences.

Seasonal fluctuation of beak and feather disease virus (BFDV) infection in wild Crimson Rosellas (Platycercus elegans)

Understanding patterns of pathogen emergence can help identify mechanisms involved in transmission dynamics. Beak and feather disease virus (BFDV) poses a major threat world-wide to wild and captive parrots. Yet data from wild birds on seasonal fluctuations in prevalence and infection intensity, and thereby the potential high-risk times for virus transmission, have been lacking. We screened wild Crimson Rosellas (Platycercus elegans) for BFDV in blood and cloacal swabs. Prevalence in blood samples and cloacal swabs, as well as viral load varied with Julian date and in blood, were highest after the breeding season. Breeding birds had lower viral load and lower BFDV prevalence in blood than non-breeding birds (10.1% prevalence in breeding vs. 43.2% in non-breeding birds). BFDV prevalence was much higher in younger (<3 years) than older (≥3 years) birds for both blood samples (42.9% vs. 4.5%) and cloacal swabs (56.4% vs. 12.3%). BFDV status in blood and cloacal samples was not correlated within individuals. We show that, at least in P. elegans, BFDV infection seems to occur year-round, with seasonal changes in prevalence and load found in our samples. Our analyses suggest that the seasonal changes were associated primarily with the breeding season. We also discuss age and sex as important predictors of BFDV infection.

Living with liver flukes: Does migration matter?

Migration is typically thought to be an evolved trait driven by responses to forage or predation, but recent studies have demonstrated avoidance of parasitism can also affect success of migratory tactics within a population. We evaluated hypotheses of how migration alters parasite exposure in a partially migratory elk (Cervus canadensis) population in and adjacent to Banff National Park, Alberta, Canada. Equal numbers of elk remain year-round on the winter range or migrate to summer range. We quantified diversity and abundance of parasites in faecal elk pellets, and prevalence (number of infected individuals) and intensity (egg counts) of giant liver fluke eggs (Fascioloides magna) in faeces across migratory tactics. We tested whether giant liver fluke intensity in faeces was affected by elk use of wetlands, elevation, forage biomass, and elk concentration in the previous summer. We rejected the "migratory escape" hypothesis that suggests migration allowed elk to escape parasite exposure because migrant elk had the highest richness and evenness of parasite groups. We also rejected the hypothesis that prevalence was highest at highest summer densities because higher-density resident elk had the lowest diversity and giant liver fluke egg presence and intensity. Instead, the high prevalence and intensity of giant liver flukes in migrants was consistent with both the hypothesis of "environmental tracking", because elk that migrated earlier may expose themselves to favourable parasite conditions, and with the "environmental sampling" hypothesis, because giant liver fluke intensity increased with increased exposure to secondary host habitat (i.e., wetland). Our results indicate that differential exposure of different migratory tactics that leave the winter range has a greater influence on parasites than the concentration of elk that reside on the winter range year-round.

Seasonal dietary shifts enhance parasite transmission to lake salmonids during ice cover

Changes in abiotic and biotic factors between seasons in subarctic lake systems are often profound, potentially affecting the community structure and population dynamics of parasites over the annual cycle. However, few winter studies exist and interactions between fish hosts and their parasites are typically confined to snapshot studies restricted to the summer season whereas host-parasite dynamics during the ice-covered period rarely have been explored. The present study addresses seasonal patterns in the infections of intestinal parasites and their association with the diet of sympatric living Arctic charr (Salvelinus alpinus) and brown trout (Salmo trutta) in Lake Takvatn, a subarctic lake in northern Norway. In total, 354 Arctic charr and 203 brown trout were sampled from the littoral habitat between June 2017 and May 2018. Six trophically transmitted intestinal parasite taxa were identified and quantified, and their seasonal variations were contrasted with dietary information from both stomachs and intestines of the fish. The winter period proved to be an important transmission window for parasites, with increased prevalence and intensity of amphipod-transmitted parasites in Arctic charr and parasites transmitted through fish prey in brown trout. In Arctic charr, seasonal patterns in parasite infections resulted mainly from temporal changes in diet toward amphipods, whereas host body size and the utilization of fish prey were the main drivers in brown trout. The overall dynamics in the community structure of parasites chiefly mirrored the seasonal dietary shifts of their fish hosts.

Coexisting attractors in the context of cross-scale population dynamics: measles in London as a case study

Patterns of measles infection in large urban populations have long been considered the paradigm of synchronized nonlinear dynamics. Indeed, recurrent epidemics appear approximately mass-action despite underlying heterogeneity. However, using a subset of rich, newly digitized mortality data (1897–1906), we challenge that proposition. We find that sub-regions of London exhibited a mixture of simultaneous annual and biennial dynamics, while the aggregate city-level dynamics appears firmly annual. Using a simple stochastic epidemic model and maximum-likelihood inference methods, we show that we can capture this observed variation in periodicity. We identify agreement between theory and data, indicating that both changes in periodicity and epidemic coupling between regions can follow relatively simple rules; in particular we find local variation in seasonality drives periodicity. Our analysis underlines that multiple attractors can coexist in a strongly mixed population and follow theoretical predictions.

Rainfall as a driver of seasonality in parasitism

Parasite burdens are known to vary seasonally in wildlife, and rainfall is one key aspect of seasonality that has been linked to parasitism in a range of systems. Rainfall can have immediate effects on parasitism rates by affecting parasite survival and movement in the environment, or it can have delayed effects by affecting host susceptibility to parasites through changes in host body condition or immune function. In this study, we examined how helminth infection in a wild ungulate (Grant's gazelle, Nanger granti) is impacted by seasonal changes in rainfall. We looked at how the burdens of three helminth parasites varied in relation to current (immediate effect) and prior (delayed effect) rainfall by comparing parasite fecal egg and larval counts to rainfall 0, 1, and 2 months prior to parasite sampling. We found burdens of all three parasites to be negatively associated with rainfall, and that delayed effects were stronger than immediate effects. Our findings implicate rainfall as a driver of seasonal variation in infection and suggest one important mechanism may be through delayed effects on host susceptibility.

Winter is coming - Impact of temperature on the variation of beta-lactamase and mcr genes in a wastewater treatment plant

Wastewater treatment plants (WWTP) play a key role in the dissemination of antibiotic resistance and analyzing the abundance of antibiotic resistance genes (ARGs) and resistant bacteria is necessary to evaluate the risk of proliferation caused by WWTPs. Since few studies investigated the seasonal variation of antibiotic resistance, this study aimed to determine the abundance of beta-lactamase and mcr genes and to characterize phenotypic resistant strains in a WWTP in Germany over the seasons. Wastewater, sewage sludge and effluent samples were collected over a one year period and analyzed using quantitative real-time PCR. Resistant strains were isolated, followed by identification and antibiotic susceptibility testing using VITEK 2. The results show a significantly higher occurrence of nearly all investigated ARGs in the wastewater compared to sewage sludge and effluent. ARG abundance and temperature showed a negative correlation in wastewater and significant differences between ARG abundance during warmer and colder seasons were determined, indicating a seasonal effect. Co-occurrence of mcr-1 and carbapenemase genes in a multi-drug resistant Enterobacter cloacae and Escherichia coli producing extended-spectrum beta-lactamase (ESBL) was determined. To the best of our knowledge, this is the first detection of mcr-1, bla_VIM and bla_OXA-48 in an ESBL-producing E. coli. Although wastewater treatment reduced the abundance of ARGs and resistant strains, a dissemination into the river might be possible because carbapenemase-, CTX-M- and mcr-1-gene harboring strains were still present in the effluent.

Models with environmental drivers offer a plausible mechanism for the rapid spread of infectious disease outbreaks in marine organisms

The first signs of sea star wasting disease (SSWD) epidemic occurred in just few months in 2013 along the entire North American Pacific coast. Disease dynamics did not manifest as the typical travelling wave of reaction-diffusion epidemiological model, suggesting that other environmental factors might have played some role. To help explore how external factors might trigger disease, we built a coupled oceanographic-epidemiological model and contrasted three hypotheses on the influence of temperature on disease transmission and pathogenicity. Models that linked mortality to sea surface temperature gave patterns more consistent with observed data on sea star wasting disease, which suggests that environmental stress could explain why some marine diseases seem to spread so fast and have region-wide impacts on host populations.

Geographic variation in baseline innate immune function does not follow variation in aridity along a tropical environmental gradient

Geographic variation in aridity determines environmental productivity patterns, including large-scale variability in pathogens, vectors and associated diseases. If disease risk decreases with increasing aridity and is matched by immune defense, we predict a decrease in innate immune function along a gradient of increasing aridity from the cool-wet forest to the hot-dry Sahel, from south to north in Nigeria. We sampled blood and measured five innate immune indices from 286 Common Bulbuls Pycnonotus barbatus between 6 and 13°N. We sampled in the dry season; we resampled the first location (Jos) also as the last sample location to test temporal change in immune function. Immune indices did not decrease with aridity. One immune index, nitric oxide concentration showed a weak quadratic pattern. In Jos, ovotransferrin concentration, haemagglutination and haemolysis titres increased 12 weeks into the dry season, contrary to expectations that immune indices should decrease with increased dryness. In this tropical system, innate immune function does not decrease with increasing aridity but temporal factors within a location may influence immune function more strongly than spatial variation in aridity, suggesting that immune variation does not follow a simple environmental productivity pattern. Consequently, caution should probably be exercised in predicting effects of climate variability on immune function or disease risk.

Patterns of parasite eggs, oocysts and larvae shedding by moose in the Biebrza marshland (NE Poland)

The study analyses patterns of endoparasite eggs, oocysts and larvae shedding by moose from the relict population in the Biebrza marshland, NE Poland, which has grown to be one of the largest in Central Europe since the ban on hunting imposed in 2001. The analysis identified 10 species or groups of parasites among 230 faecal moose samples collected over 16 consequent months. The most prevalent were the eggs of Trichostrongylidae, Trichuris spp., Nematodirella alcidis, Parafasciolopsis fasciolaemorpha and the larvae of Elaphostrongylus sp. Four parasite species were more prevalent in males, indicating male-biased parasitism, and the studied moose population exhibited a female-skewed sex ratio. Nematodirella alcidis eggs and Protostrongylid larvae were more prevalent during winter, which indicated their resistance to harsh weather conditions. The prevalence of Eimeria alces and Aonchotheca sp. increased during the growing season, as did the number of eggs per gram of faeces (EPG) of P. fasciolaemorpha, possibly due to the availability of water sources. Higher mean monthly temperature was also found to have a positive effect on the excretion of Trichostrongylidae and Moniezia spp. eggs. In addition, the time of infection and the specificity of the parasite life cycle, being sensitive to certain climatic conditions, also appeared to have a strong influence on eggs, oocysts and larvae shedding in this non-harvested moose population.

Separate seasons of infection and reproduction can lead to multi-year population cycles

Many host-pathogen systems are characterized by a temporal order of disease transmission and host reproduction. For example, this can be due to pathogens infecting certain life cycle stages of insect hosts; transmission occurring during the aggregation of migratory birds; or plant diseases spreading between planting seasons. We develop a simple discrete-time epidemic model with density-dependent transmission and disease affecting host fecundity and survival. The model shows sustained multi-annual cycles in host population abundance and disease prevalence, both in the presence and absence of density dependence in host reproduction, for large horizontal transmissibility, imperfect vertical transmission, high virulence, and high reproductive capability. The multi-annual cycles emerge as invariant curves in a Neimark-Sacker bifurcation. They are caused by a carry-over effect, because the reproductive fitness of an individual can be reduced by virulent effects due to infection in an earlier season. As the infection process is density-dependent but shows an effect only in a later season, this produces delayed density dependence typical for second-order oscillations. The temporal separation between the infection and reproduction season is crucial in driving the cycles; if these processes occur simultaneously as in differential equation models, there are no sustained oscillations. Our model highlights the destabilizing effects of inter-seasonal feedbacks and is one of the simplest epidemic models that can generate population cycles.

Multi-Scale Drivers of Immunological Variation and Consequences for Infectious Disease Dynamics

The immune system is the primary barrier to parasite infection, replication, and transmission following exposure, and variation in immunity can accordingly manifest in heterogeneity in traits that govern population-level infectious disease dynamics. While much work in ecoimmunology has focused on individual-level determinants of host immune defense (e.g., reproductive status and body condition), an ongoing challenge remains to understand the broader evolutionary and ecological contexts of this variation (e.g., phylogenetic relatedness and landscape heterogeneity) and to connect these differences into epidemiological frameworks. Ultimately, such efforts could illuminate general principles about the drivers of host defense and improve predictions and control of infectious disease. Here, we highlight recent work that synthesizes the complex drivers of immunological variation across biological scales of organization and scales these within-host differences to population-level infection outcomes. Such studies note the limitations involved in making species-level comparisons of immune phenotypes, stress the importance of spatial scale for immunology research, showcase several statistical tools for translating within-host data into epidemiological parameters, and provide theoretical frameworks for linking within- and between-host scales of infection processes. Building from these studies, we highlight several promising avenues for continued work, including the application of machine learning tools and phylogenetically controlled meta-analyses to immunology data and quantifying the joint spatial and temporal dependencies in immune defense using range expansions as model systems. We also emphasize the use of organismal traits (e.g., host tolerance, competence, and resistance) as a way to interlink various scales of analysis. Such continued collaboration and disciplinary cross-talk among ecoimmunology, disease ecology, and mathematical modeling will facilitate an improved understanding of the multi-scale drivers and consequences of variation in host defense.

Environmental reservoir dynamics predict global infection patterns and population impacts for the fungal disease white-nose syndrome

Infectious diseases can have devastating effects on populations, and the ability of a pathogen to persist in the environment can amplify these impacts. Understanding how environmental pathogen reservoirs influence the number of individuals that become infected and suffer mortality is essential for disease control and prevention. We integrated disease data with population surveys to examine the influence of the environmental reservoir on disease impacts for a devastating fungal disease of bats, white-nose syndrome. We find that the extent of pathogen present in the environment predicts how many hosts become infected and suffer mortality during disease outbreaks. These results provide a target for managing contamination levels in the environment to reduce population impacts.

Disease outbreaks and pathogen introductions can have significant effects on host populations, and the ability of pathogens to persist in the environment can exacerbate disease impacts by fueling sustained transmission, seasonal epidemics, and repeated spillover events. While theory suggests that the presence of an environmental reservoir increases the risk of host declines and threat of extinction, the influence of reservoir dynamics on transmission and population impacts remains poorly described. Here we show that the extent of the environmental reservoir explains broad patterns of host infection and the severity of disease impacts of a virulent pathogen. We examined reservoir and host infection dynamics and the resulting impacts of Pseudogymnoascus destructans, the fungal pathogen that causes white-nose syndrome, in 39 species of bats at 101 sites across the globe. Lower levels of pathogen in the environment consistently corresponded to delayed infection of hosts, fewer and less severe infections, and reduced population impacts. In contrast, an extensive and persistent environmental reservoir led to early and widespread infections and severe population declines. These results suggest that continental differences in the persistence or decay of P. destructans in the environment altered infection patterns in bats and influenced whether host populations were stable or experienced severe declines from this disease. Quantifying the impact of the environmental reservoir on disease dynamics can provide specific targets for reducing pathogen levels in the environment to prevent or control future epidemics.

High relative humidity might trigger the occurrence of the second seasonal peak of dengue in the Philippines

BACKGROUND

Dengue in some regions has a bimodal seasonal pattern, with a first big seasonal peak followed by a second small seasonal peak. The factors associated with the second small seasonal peak remain unclear.

METHODS

Monthly data on dengue cases in the Philippines and its 17 regions from 2008 to 2017 were collected and underwent a time series seasonal decomposition analysis. The associations of monthly average mean temperature, average relative humidity, and total rainfall with dengue in 19 provinces were assessed with a generalized additive model. Logistic regression and a classification and regression tree (CART) model were used to identify the factors associated with the second seasonal peak of dengue.

RESULTS

Dengue incidence rate in the Philippines increased substantially in the period 2013-2017, particularly for the regions in south Philippines. Dengue peaks in south Philippines predominantly occurred in August, with the peak in the national capital region (NCR) (i.e., Metropolitan Manila) occurring in September. The association between mean temperature and dengue appeared J-shaped or upside-down-V-shaped, and the association between relative humidity (or rainfall) and dengue was heterogeneous across different provinces (e.g., J shape, reverse J shape, or upside-down V shape, etc). Relative humidity was the only factor associated with the second seasonal peak of dengue (odds ratio: 1.144; 95% confidence interval: 1.023-1.279; threshold: 77%).

CONCLUSIONS

Dengue control and prevention resources are increasingly required in regions beyond the NCR, and relative humidity can be used as a predictor of the second seasonal peak of dengue in the Philippines.

Current Status of Mumps Virus Infection: Epidemiology, Pathogenesis, and Vaccine

Mumps is an important childhood infectious disease caused by mumps virus (MuV). We reviewed the epidemiology, pathogenesis, and vaccine development of mumps. Previous studies were identified using the key words “mumps” and “epidemiology”, “pathogenesis” or “vaccine” in MEDLINE, PubMed, Embase, Web of Science, and Google Scholar. We excluded the articles that were not published in the English language, manuscripts without abstracts, and opinion articles from the review. The number of cases caused by MuV decreased steeply after the introduction of the mumps vaccine worldwide. In recent years, a global resurgence of mumps cases in developed countries and cases of aseptic meningitis caused by some mumps vaccine strains have renewed the importance of MuV infection worldwide. The performance of mumps vaccination has become an important issue for controlling mumps infections. Vaccine development and routine vaccination are still effective measures to globally reduce the incidence of mumps infections. During outbreaks, a third of MMR vaccine is recommended for groups of persons determined by public authorities.

Spectrum and environmental risks of residual pharmaceuticals in stream water with emphasis on its relation to epidemic infectious disease and anthropogenic activity in watershed

Pharmaceuticals vastly consumed by modern human for health and food might track anthropogenic impacts on aquatic ecosystem via their wide residual spectrum. This study investigated the spectrum of pharmaceutical residuals in stream water at confluence point of each subwatershed with various land use pattern in Jiulong River watershed, southeastern China. Stream water was sampled in both wet and dry seasons of 2016. Results showed that 59 out of the selected 94 compounds from 6 pharmaceutical categories were quantified among these stream water samples, up to 1488 ng L^-1 for caffeine (CAF). Antibiotics and central nervous system drugs (CNs) collectively dominated the quantified instream pharmaceutical residuals. Outbreaks of epidemic infectious diseases for human and livestock partially but significantly matched seasonality of instream pharmaceutical residuals. Anthropogenic impact as land use composition of subwatersheds was significant on instream pharmaceutical loadings, especially urban land use. Cocktail risk of instream pharmaceutical residuals to aquatic organisms was assessed ranging from low to medium among the subwatersheds except high risk for the W-01 subwatershed in the dry season. Evidence from this study indicated that seasonality and wide spectrum of instream pharmaceutical residual determination could reveal anthropogenic impacts to aquatic ecosystem, such as epidemic disease and land use.

Within-host priority effects and epidemic timing determine outbreak severity in co-infected populations

Co-infections of hosts by multiple pathogen species are ubiquitous, but predicting their impact on disease remains challenging. Interactions between co-infecting pathogens within hosts can alter pathogen transmission, with the impact on transmission typically dependent on the relative arrival order of pathogens within hosts (within-host priority effects). However, it is unclear how these within-host priority effects influence multi-pathogen epidemics, particularly when the arrival order of pathogens at the host-population scale varies. Here, we combined models and experiments with zooplankton and their naturally co-occurring fungal and bacterial pathogens to examine how within-host priority effects influence multi-pathogen epidemics. Epidemiological models parametrized with within-host priority effects measured at the single-host scale predicted that advancing the start date of bacterial epidemics relative to fungal epidemics would decrease the mean bacterial prevalence in a multi-pathogen setting, while models without within-host priority effects predicted the opposite effect. We tested these predictions with experimental multi-pathogen epidemics. Empirical dynamics matched predictions from the model including within-host priority effects, providing evidence that within-host priority effects influenced epidemic dynamics. Overall, within-host priority effects may be a key element of predicting multi-pathogen epidemic dynamics in the future, particularly as shifting disease phenology alters the order of infection within hosts.

Norway rat (Rattus norvegicus) ectoparasites in livestock production systems from central Argentina: Influencing factors on parasitism

Haematophagous ectoparasites are worldwide vectors of many zoonotic bacterial diseases, both emerging and re-emerging, whose incidences are rising. Livestock development alters different environmental characteristics such as the microclimate of a site, changing the availability, density and susceptibility of the hosts to pathogens and vectors, indirectly influencing the spread and persistence of a disease within an ecosystem. The Norway rat (Rattus norvegicus), the most abundant vertebrate pest species found on livestock farms from Argentina, is a reservoir for several important zoonotic bacteria and may harbor ectoparasite species, which act as their vectors. Even though the Norway rat is widely known for its role as an ectoparasite host, the ecological characteristics of their ectoparasite communities and the related factors with parasitism on livestock farms have never been described. In the present study, we describe the ectoparasite community in Norway rats from central Argentina livestock farms, while also depicting the influencing factors on both ectoparasite occurrence and abundance. Ectoparasites were collected from rats captured in 20 sites from Buenos Aires province, between the winter of 2016 and the summer of 2018. A total of 1441 ectoparasite individuals were collected from 159 Norway rat individuals [Total ectoparasite prevalence = 69.2%; Mean ectoparasite specimen abundance (± CI) = 9.06 ± 2.32 ectoparasite individuals per rat; Mean ectoparasite specimen intensity (±CI) = 13.10 ± 3.08 ectoparasite individuals per infested rat found]. Ectoparasite assemblage consisted of four cosmopolitan species, recognized for their sanitary relevance: mites (Laelapidae: Laelaps nuttalli and Laelaps echidninus), lice (Polyplacidae: Polyplax spinulosa) and fleas (Pulicidae: Xenopsylla cheopis). We observed higher Norway rat abundance in sites related to higher ectoparasite occurrence and abundance frequencies on the rats. Additionally, ectoparasites were more abundant on rats in warm seasons and on male individuals, over female rats. Moreover, the geographical location of the studied sites influenced the ectoparasite assemblage structure observed on the rats. This study broadens the knowledge on the role of Norway rats as zoonotic ectoparasites hosts and analyzes the drivers influencing ectoparasite occurrence and abundance on the most populated region of Argentina, which is also the region with the most intensive livestock farming. Therefore, this survey may assist in evaluating potential risks for humans and generate effective sanitary control strategies for ectoparasite-borne infectious diseases.

Experiments Investigating the Competitive Growth Advantage of Two Different Genotypes of Human Metapneumovirus: Implications for the Alternation of Genotype Prevalence

Human metapneumovirus (hMPV) is an important pathogen that causes upper and lower respiratory tract infections in children worldwide. hMPV has two major genotypes, hMPV-A and hMPV-B. Epidemiological studies have shown that the two hMPV genotypes alternate in predominance worldwide in recent years. Co-circulation of the two genotypes of hMPV was usually observed and there is no study about the interaction between them, such as competitive replication, which maybe the possible mechanisms for alternating prevalence of subtypes. Our present study have used two different genotypes of hMPV (genotype A: NL/1/00; B: NL/1/99) in different proportions in animal model (BALB/c mice) and cell model (Vero-E6) separately. The result showed that the competitive growth does exist in BALB/c mice, genotype B had a strong competitive advantage. However, genotype B did not cause more severe disease than non-predominant (genotype A) or mixed strains in the study, which were evaluated by the body weight, airway hyperresponsiveness and lung pathology of mouse. In cell model, competitive growth and the two genotypes alternately prevalence were observed. In summary, we confirmed that there was a competitive replication between hMPV genotype A and B, and no difference in disease severity caused by the two subtypes. This study shows a new insight to understand the alternation of hMPV genotype prevalence through genotype competition and provide experimental evidence for disease control and vaccine design.

Modeling Pathogen Dispersal in Marine Fish and Shellfish

In marine ecosystems, oceanographic processes often govern host contacts with infectious agents. Consequently, many approaches developed to quantify pathogen dispersal in terrestrial ecosystems have limited use in the marine context. Recent applications in marine disease modeling demonstrate that physical oceanographic models coupled with biological models of infectious agents can characterize dispersal networks of pathogens in marine ecosystems. Biophysical modeling has been used over the past two decades to model larval dispersion but has only recently been utilized in marine epidemiology. In this review, we describe how biophysical models function and how they can be used to measure connectivity of infectious agents between sites, test hypotheses regarding pathogen dispersal, and quantify patterns of pathogen spread, focusing on fish and shellfish pathogens.

Effects of temperature and viscosity on miracidial and cercarial movement of Schistosoma mansoni: ramifications for disease transmission

Parasites with complex life cycles can be susceptible to temperature shifts associated with seasonal changes, especially as free-living larvae that depend on a fixed energy reserve to survive outside the host. The life cycle of Schistosoma, a trematode genus containing some species that cause human schistosomiasis, has free-living, aquatic miracidial and cercarial larval stages that swim using cilia or a forked tail, respectively. The small size of these swimmers (150-350 µm) dictates that their propulsion is dominated by viscous forces. Given that viscosity inhibits the swimming ability of small organisms and is inversely correlated with temperature, changes in temperature should affect the ability of free-living larval stages to swim and locate a host. By recording miracidial and cercarial movement of Schistosoma mansoni using a high-speed camera and manipulating temperature and viscosity independently, we assessed the role each factor plays in the swimming mechanics of the parasite. We found a positive effect of temperature and a negative effect of viscosity on miracidial and cercarial speed. Reynolds numbers, which describe the ratio of inertial to viscous forces exerted on an aquatic organism, were <1 across treatments. Q₁₀ values were <2 when comparing viscosity treatments at 20 °C and 30 °C, further supporting the influence of viscosity on miracidial and cercarial speed. Given that both larval stages have limited energy reserves and infection takes considerable energy, successful transmission depends on both speed and lifespan. We coupled our speed data with mortality measurements across temperatures and discovered that the theoretical maximum distance travelled increased with temperature and decreased with viscosity for both larval stages. Thus, our results suggest that S. mansoni transmission is high during warm times of the year, partly due to improved swimming performance of the free-living larval stages, and that increases in temperature variation associated with climate change might further increase transmission.

Phenological synchrony shapes pathology in host-parasite systems

A key challenge surrounding ongoing climate shifts is to identify how they alter species interactions, including those between hosts and parasites. Because transmission often occurs during critical time windows, shifts in the phenology of either taxa can alter the likelihood of interaction or the resulting pathology. We quantified how phenological synchrony between vulnerable stages of an amphibian host (Pseudacris regilla) and infection by a pathogenic trematode (Ribeiroia ondatrae) determined infection prevalence, parasite load and host pathology. By tracking hosts and parasite infection throughout development between low- and high-elevation regions (San Francisco Bay Area and the Southern Cascades (Mt Lassen)), we found that when phenological synchrony was high (Bay Area), each established parasite incurred a 33% higher probability of causing severe limb malformations relative to areas with less synchrony (Mt Lassen). As a result, hosts in the Bay Area had up to a 50% higher risk of pathology even while controlling for the mean infection load. Our results indicate that host-parasite interactions and the resulting pathology were the joint product of infection load and phenological synchrony, highlighting the sensitivity of disease outcomes to forecasted shifts in climate.

Humidity-Dependent Decay of Viruses, but Not Bacteria, in Aerosols and Droplets Follows Disinfection Kinetics

The transmission of some infectious diseases requires that pathogens can survive (i.e., remain infectious) in the environment, outside the host. Relative humidity (RH) is known to affect the survival of some microorganisms in the environment; however, the mechanism underlying the relationship has not been explained, particularly for viruses. We investigated the effects of RH on the viability of bacteria and viruses in both suspended aerosols and stationary droplets using traditional culture-based approaches. Results showed that viability of bacteria generally decreased with decreasing RH. Viruses survived well at RHs lower than 33% and at 100%, whereas their viability was reduced at intermediate RHs. We then explored the evaporation rate of droplets consisting of culture media and the resulting changes in solute concentrations over time; as water evaporates from the droplets, solutes such as sodium chloride in the media become more concentrated. Based on the results, we suggest that inactivation of bacteria is influenced by osmotic pressure resulting from elevated concentrations of salts as droplets evaporate. We propose that the inactivation of viruses is governed by the cumulative dose of solutes or the product of concentration and time, as in disinfection kinetics. These findings emphasize that evaporation kinetics play a role in modulating the survival of microorganisms in droplets.

Impact of Ambient Temperature and Relative Humidity on the Incidence of Hand-Foot-Mouth Disease in Wuhan, China

Background: Few studies have previously explored the relationship between hand, foot, and mouth disease (HFMD) and meteorological factors with the effect modification of air pollution, and these studies had inconsistent findings. We therefore applied a time-series analysis assessing the effects of temperature and humidity on the incidence of HFMD in Wuhan, China to deepen our understanding of the relationship between meteorological factors and the risk of HFMD. Methods: Daily HFMD cases were retrieved from Hubei Provincial Center for Disease Control and Prevention from 1 February 2013 to 31 January 2017. Daily meteorological data including 24 h average temperature, relative humidity, wind velocity, and atmospheric pressure were obtained from Hubei Meteorological Bureau. Data on Air pollution was collected from 10 national air-monitoring stations in Wuhan city. We adopted a distributed lag non-linear model (DLNM) combined with Poisson regression and time-series analysis to estimate the effects of temperature and relative humidity on the incidence HFMD. Results: We found that the association between temperature and HFMD incidence was non-linear, exhibiting an approximate "M" shape with two peaks occurring at 2.3 °C (RR = 1.760, 95% CI: 1.218-2.542) and 27.9 °C (RR = 1.945, 95% CI: 1.570-2.408), respectively. We observed an inverted "V" shape between relative humidity and HFMD. The risk of HFMD reached a maximum value at a relative humidity of 89.2% (RR = 1.553, 95% CI: 1.322-1.824). The largest delayed cumulative effects occurred at lag 6 for temperature and lag 13 for relative humidity. Conclusions: The non-linear relationship between meteorological factors and the incidence of HFMD on different lag days could be used in the early targeted warning system of infectious diseases, reducing the possible outbreaks and burdens of HFMD among sensitive populations.

Impact of Ambient Temperature and Relative Humidity on the Incidence of Hand-Foot-Mouth Disease in Wuhan, China

Background: Few studies have previously explored the relationship between hand, foot, and mouth disease (HFMD) and meteorological factors with the effect modification of air pollution, and these studies had inconsistent findings. We therefore applied a time-series analysis assessing the effects of temperature and humidity on the incidence of HFMD in Wuhan, China to deepen our understanding of the relationship between meteorological factors and the risk of HFMD. Methods: Daily HFMD cases were retrieved from Hubei Provincial Center for Disease Control and Prevention from 1 February 2013 to 31 January 2017. Daily meteorological data including 24 h average temperature, relative humidity, wind velocity, and atmospheric pressure were obtained from Hubei Meteorological Bureau. Data on Air pollution was collected from 10 national air-monitoring stations in Wuhan city. We adopted a distributed lag non-linear model (DLNM) combined with Poisson regression and time-series analysis to estimate the effects of temperature and relative humidity on the incidence HFMD. Results: We found that the association between temperature and HFMD incidence was non-linear, exhibiting an approximate "M" shape with two peaks occurring at 2.3 °C (RR = 1.760, 95% CI: 1.218-2.542) and 27.9 °C (RR = 1.945, 95% CI: 1.570-2.408), respectively. We observed an inverted "V" shape between relative humidity and HFMD. The risk of HFMD reached a maximum value at a relative humidity of 89.2% (RR = 1.553, 95% CI: 1.322-1.824). The largest delayed cumulative effects occurred at lag 6 for temperature and lag 13 for relative humidity. Conclusions: The non-linear relationship between meteorological factors and the incidence of HFMD on different lag days could be used in the early targeted warning system of infectious diseases, reducing the possible outbreaks and burdens of HFMD among sensitive populations.

Inferring seasonal infection risk at population and regional scales from serology samples

Accurate estimates of seasonal infection risk can be used by animal health officials to predict future disease risk and improve understanding of the mechanisms driving disease dynamics. It can be difficult to estimate seasonal infection risk in wildlife disease systems because surveillance assays typically target antibodies (serosurveillance), which are not necessarily indicative of current infection, and serosurveillance sampling is often opportunistic. Recently developed methods estimate past time of infection from serosurveillance data using quantitative serological assays that indicate the amount of antibodies in a serology sample. However, current methods do not account for common opportunistic and uneven sampling associated with serosurveillance data. We extended the framework of survival analysis to improve estimates of seasonal infection risk from serosurveillance data across population and regional scales. We found that accounting for the right-censored nature of quantitative serology samples greatly improved estimates of seasonal infection risk, even when sampling was uneven in time. Survival analysis can also be used to account for common challenges when estimating infection risk from serology data, such as biases induced by host demography and continually elevated antibodies following infection. The framework developed herein is widely applicable for estimating seasonal infection risk from serosurveillance data in humans, wildlife, and livestock.

Great spotted cuckoos show dynamic patterns of host selection during the breeding season. The importance of laying stage and parasitism status of magpie nests

Avian brood parasites depend entirely on their hosts to raise their nestlings until independence. Thus, parasite females should select suitable host nests for egg laying according to traits that enhance offspring survival. The availability of nests of certain characteristics influencing the survival of parasitic offspring is, however, temporally dynamic and, thus, patterns of host selection should be evaluated considering characteristics of available host nests the day of parasitism. This allows detecting possible seasonal changes and, therefore, a more realistic picture of host selection by brood parasites. In this paper, we adopt such a new approach and consider daily availability of magpie (Pica pica) host nests at different breeding stage that were or were not parasitized by the great spotted cuckoo (Clamator glandarius). Theory predicts that cuckoos should select host nests at the laying stage. Accordingly, we detected that cuckoos preferred to parasitize magpie nests at the laying stage but, mainly, those that already harbored one or two cuckoo eggs, which may seem counterintuitive. We also showed that patterns of host selection by cuckoos varied during the breeding season, which implies that brood parasite–host interaction is dynamic depending on phenology. These patterns are hidden when not considering the temporally dynamic nature of the availability of host nests of characteristics of interest. We discuss the importance of such patterns and considering diary hosts nests availability for detecting them.

Direct and indirect effects of forest microclimate on pathogen spillover

Disease dynamics are governed by variation of individuals, species, and environmental conditions across space and time. In some cases, an alternate reservoir host amplifies pathogen loads and drives disease transmission to less competent hosts in a process called pathogen spillover. Spillover is frequently associated with multi-host disease systems where a single species is more tolerant of infection and more competent in pathogen transmission compared to other hosts. Pathogen spillover must be driven by biotic factors, including host and community characteristics, yet biotic factors interact with the abiotic environment (e.g., temperature) to create disease. Despite its fundamental role in disease dynamics, the influence of the abiotic environment on pathogen spillover has seldom been examined. Improving our understanding of disease processes such as pathogen spillover hinges on disentangling the effects of interrelated biotic and abiotic factors over space and time. We applied 10 yr of fine-scale microclimate, disease, and tree community data in a path analysis to investigate the relative influence of biotic and abiotic factors on pathogen spillover for the emerging infectious forest disease sudden oak death (SOD). Disease transmission in SOD is primarily driven by the reservoir host California bay laurel, which supports high foliar pathogen loads that spillover onto neighboring oak trees and create lethal canker infections. The foliar pathogen load and susceptibility of oaks is expected to be sensitive to forest microclimate conditions. We found that biotic factors of pathogen load and tree diversity had relatively stronger effects on pathogen spillover compared to abiotic microclimate factors, with pathogen load increasing oak infection and tree diversity reducing oak infection. Abiotic factors still had significant effects, with greater heat exposure during summer months reducing pathogen loads and optimal pathogen conditions during the wet season increasing oak infection. Our results offer clues to possible disease dynamics under future climate change where hotter and drier or warmer and wetter conditions could have opposing effects on pathogen spillover in the SOD system. Disentangling direct and indirect effects of biotic and abiotic factors affecting disease processes can provide key insights into disease dynamics including potential avenues for reducing disease spread and predicting future epidemics.

Temporal and spatial limitations in global surveillance for bat filoviruses and henipaviruses

Sampling reservoir hosts over time and space is critical to detect epizootics, predict spillover and design interventions. However, because sampling is logistically difficult and expensive, researchers rarely perform spatio-temporal sampling of many reservoir hosts. Bats are reservoirs of many virulent zoonotic pathogens such as filoviruses and henipaviruses, yet the highly mobile nature of these animals has limited optimal sampling of bat populations. To quantify the frequency of temporal sampling and to characterize the geographical scope of bat virus research, we here collated data on filovirus and henipavirus prevalence and seroprevalence in wild bats. We used a phylogenetically controlled meta-analysis to next assess temporal and spatial variation in bat virus detection estimates. Our analysis shows that only one in four bat virus studies report data longitudinally, that sampling efforts cluster geographically (e.g. filovirus data are available across much of Africa and Asia but are absent from Latin America and Oceania), and that sampling designs and reporting practices may affect some viral detection estimates (e.g. filovirus seroprevalence). Within the limited number of longitudinal bat virus studies, we observed high heterogeneity in viral detection estimates that in turn reflected both spatial and temporal variation. This suggests that spatio-temporal sampling designs are important to understand how zoonotic viruses are maintained and spread within and across wild bat populations, which in turn could help predict and preempt risks of zoonotic viral spillover.

Geographic distribution of Trypanosoma cruzi genotypes detected in chronic infected people from Argentina. Association with climatic variables and clinical manifestations of Chagas disease

Chronic Chagas disease affects large number of people in Latin America where it remains one of the biggest public health problems. Trypanosoma cruzi is genetically divided into seven discrete typing units (DTUs), TcI-TcVI and Tcbat, and exhibits differential distribution across vectors, host and transmission cycles. Clinical manifestations (cardiac, digestive and / or neurological) vary according to the geographical region; and the DTUs more frequently found in any of the chronic form of the disease, indeterminate or clinical, are TcI, TcII, TcV and TcVI. However, why they have a particular geographical distribution and how they affect the development of Chagas disease is still unknown. In this study, we assessed the geographic distribution of T. cruzi genotypes detected in chronic infected people from 57 localities of endemic regions of Argentina and analyzed their association with climatic variables. The prevalent DTUs detected in the whole population were TcV (47.4%) and TcVI (66.0%). TcI and TcII were identified in 5.2% each. All DTUs were detected in single and mixed infections (78.4% and 21.6%, respectively). TcV was found in infected people from localities with significantly higher average annual temperature, seasonal temperature and annual temperature range than those infected with TcVI. When we evaluated the association of DTUs with clinical manifestations of Chagas disease, the probability of finding TcVI in subjects with chronic Chagas cardiomyopathy (CCC) was higher than other DTUs, but without reaching statistical significance. Moreover, the probability of finding TcV in those who have not developed the disease after 20 years of infection was significantly higher than in CCC, either if it was present as unique DTU (reciprocal OR=4.95 95%CI: 1.42 to 17.27) (p=0.0117) or if it was also part of mixed infections (reciprocal OR=3.375; 95%CI: 1.227 to 9.276) (p=0.0264). There was no difference in the distribution of TcI between asymptomatic people and those with clinical manifestations, while TcII appeared more frequently in CCC cases, but without statiscal significance.

LETHAL AND SUBLETHAL AMPHIBIAN HOST RESPONSES TO BATRACHOCHYTRIUM DENDROBATIDIS EXPOSURE ARE DETERMINED BY THE ADDITIVE INFLUENCE OF HOST RESOURCE AVAILABILITY

Host species may differ in their responses to pathogen exposures based on host energy reserves, which could be important for long-term trends in host population growth. Batrachochytrium dendrobatidis (BD) is a pathogen associated with amphibian population declines but also occurs without causing mass mortalities. The impact of BD in populations without associated declines is not well understood, and food abundance could play a role in determining the magnitude of its effects. We exposed American toad (Anaxyrus americanus), northern leopard frog (Lithobates pipiens), and cricket frog (Acris blanchardi) metamorphs to BD under low or high food treatments. Overall, anuran species responded differently to BD exposure and the combined effect of BD exposure and food abundance was additive. American toad survival was lowered by BD exposure and low food availability. Based on these results, we developed a population model for American toads to estimate how reductions in survival could influence population growth. We found that BD could reduce population growth by 14% with high food availability and 21% with low food availability. In contrast, survival of northern leopard frogs was high across all treatments, but their growth was negatively impacted by the additive effects of BD exposure and low food availability. Cricket frog growth and survival were unaffected by BD exposure, suggesting that this species is not sensitive to the effects of this pathogen in terms of growth and survival across environments of different quality in the time period examined. Our results showed that low food availability additively increased the species-specific lethal and sublethal impacts of BD on hosts, which could have implications for long-term host population dynamics.

Parasite induced mortality is context dependent in Atlantic salmon: insights from an individual-based model

An individual-based model was parameterized to explore the impact of a crustacean ectoparasite (sea louse, Lepeophtheirus salmonis & Caligus spp.) on migrating Atlantic salmon smolt. The model explores how environmental and intrinsic factors can modulate the effect of sea lice on survival, growth and maturation of Atlantic salmon at sea. Relative to other effects, the parasite infestation pressure from fish farms and the encounter process emerge as the most important parameters. Although small variations in parasite-induced mortality may be masked by variable environmental effects, episodes of high infestation pressure from fish farms should be observable in wild populations of Atlantic salmon if laboratory studies accurately reflect the physiological effects of sea lice. Increases in temperature in the model negatively influenced fish survival by affecting the development time of the parasite at a rate that was not compensated for by the growth of the host. Discharge from rivers was parameterized to increase migration speed and influenced parasite induced mortality by decreasing time spent in areas with increased infestation pressure. Initial size and growth of the host was inversely related to the impact of the parasite because of size-dependent parasite-induced mortality in the early phase of migration. Overall, the model illustrates how environmental factors modulate effects on the host population by impacting either the parasite load or the relative effect of the parasite. The results suggest that linking population-level effects to parasite infestation pressure across climatic and environmental gradients may be challenging without correctly accounting for these effects.

Predicting Ebola virus disease risk and the role of African bat birthing

Ebola virus disease (EVD) presents a threat to public health throughout equatorial Africa. Despite numerous 'spillover' events into humans and apes, the maintenance reservoirs and mechanism of spillover are poorly understood. Evidence suggests fruit bats play a role in both instances, yet data remain sparse and bats exhibit a wide range of life history traits. Here we pool sparse data and use a mechanistic approach to examine how birthing cycles of African fruit bats, molossid bats, and non-molossid microbats inform the spatio-temporal occurrence of EVD spillover. We create ensemble niche models to predict spatio-temporally varying bat birthing and model outbreaks as spatio-temporal Poisson point processes. We predict three distinct annual birthing patterns among African bats along a latitudinal gradient. Of the EVD spillover models tested, the best by quasi-Akaike information criterion (qAIC) and by out of sample prediction included significant African bat birth-related terms. Temporal bat birthing terms fit in the best models for both human and animal outbreaks were consistent with hypothesized viral dynamics in bat populations, but purely spatial models also performed well. Our best model predicted risk of EVD spillover at locations of the two 2018 EVD outbreaks in the Democratic Republic of the Congo was within the top 12-35% and 0.1% of all 25 × 25 km spatial cells analyzed in sub-Saharan Africa. Results suggest that sparse data can be leveraged to help understand complex systems.

Modelled and observed mean and seasonal relationships between climate, population density and malaria indicators in Cameroon

Background

A major health burden in Cameroon is malaria, a disease that is sensitive to climate, environment and socio-economic conditions, but whose precise relationship with these drivers is still uncertain. An improved understanding of the relationship between the disease and its drivers, and the ability to represent these relationships in dynamic disease models, would allow such models to contribute to health mitigation and adaptation planning. This work collects surveys of malaria parasite ratio and entomological inoculation rate and examines their relationship with temperature, rainfall, population density in Cameroon and uses this analysis to evaluate a climate sensitive mathematical model of malaria transmission.

Methods

Co-located, climate and population data is compared to the results of 103 surveys of parasite ratio (PR) covering 18,011 people in Cameroon. A limited set of campaigns which collected year-long field-surveys of the entomological inoculation rate (EIR) are examined to determine the seasonality of disease transmission, three of the study locations are close to the Sanaga and Mefou rivers while others are not close to any permanent water feature. Climate-driven simulations of the VECTRI malaria model are evaluated with this analysis.

Results

The analysis of the model results shows the PR peaking at temperatures of approximately 22 °C to 26 °C, in line with recent work that has suggested a cooler peak temperature relative to the established literature, and at precipitation rates at 7 mm day⁻¹, somewhat higher than earlier estimates. The malaria model is able to reproduce this broad behaviour, although the peak occurs at slightly higher temperatures than observed, while the PR peaks at a much lower rainfall rate of 2 mm day⁻¹. Transmission tends to be high in rural and peri-urban relative to urban centres in both model and observations, although the model is oversensitive to population which could be due to the neglect of population movements, and differences in hydrological conditions, housing quality and access to healthcare. The EIR follows the seasonal rainfall with a lag of 1 to 2 months, and is well reproduced by the model, while in three locations near permanent rivers the annual cycle of malaria transmission is out of phase with rainfall and the model fails.

Conclusion

Malaria prevalence is maximum at temperatures of 24 to 26 °C in Cameroon and rainfall rates of approximately 4 to 6 mm day⁻¹. The broad relationships are reproduced in a malaria model although prevalence is highest at a lower rainfall maximum of 2 mm day⁻¹. In locations far from water bodies malaria transmission seasonality closely follows that of rainfall with a lag of 1 to 2 months, also reproduced by the model, but in locations close to a seasonal river the seasonality of malaria transmission is reversed due to pooling in the transmission to the dry season, which the model fails to capture.

A longitudinal molecular study of the ecology of malaria infections in free-ranging mandrills

Unravelling the determinants of host variation in susceptibility and exposure to parasite infections, infection dynamics and the consequences of parasitism on host health is of paramount interest to understand the evolution of complex host-parasite interactions. In this study, we evaluated the determinants, temporal changes and physiological correlates of Plasmodium infections in a large natural population of mandrills (Mandrillus sphinx). Over six consecutive years, we obtained detailed parasitological and physiological data from 100 male and female mandrills of all ages. The probability of infection by Plasmodium gonderi and P. mandrilli was elevated (ca. 40%) but most infections were chronical and dynamic, with several cases of parasite switching and clearance. Positive co-infections also occurred between both parasites. Individual age and sex influenced the probability of infections with some differences between parasites: while P. mandrilli appeared to infect its hosts rather randomly, P. gonderi particularly infected middle-aged mandrills. Males were also more susceptible to P. gonderi than females and were more likely to be infected by this parasite at the beginning of an infection by the simian immunodeficiency virus. P. gonderi, and to a lesser extent P. mandrilli, influenced mandrills’ physiology: skin temperatures and neutrophil/lymphocyte ratio were both impacted, generally depending on individual age and sex. These results highlight the ecological complexity of Plasmodium infections in nonhuman primates and the efforts that need to be done to decipher the epidemiology of such parasites.

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Longitudinal epidemiological and physiological data on Plasmodium infection obtained from a wild primate population.

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Elevated chronical infections by two species of Plasmodium.

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Contrasted dynamics of infection and physiological effects of P. gonderi and P. mandrilli.

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Elevated parasitaemia (P. gonderi) in male mandrills in primo-infection by the simian immunodeficiency virus.

Socio-economic inequality in health service utilisation: Does accounting for seasonality in health-seeking behaviour matter?

Seasonal variation exists in disease incidence. The variation could occur across the different regions in a country. This paper argues that using national household data that are not adjusted for seasonal and regional variations in disease incidence may not be directly suitable for assessing socio-economic inequality in annual outpatient service utilisation, including for cross-country comparison. In fact, annual health service utilisation may be understated or overstated depending on the period of data collection. This may lead to miss-estimation of socio-economic inequality in health service utilisation depending, among other things, on how health service utilisation, across geographical areas, varies by socio-economic status. Using a nationally representative dataset from South Africa, the paper applies a seasonality index that is constructed from the District Health Information System, an administrative dataset, to annualise public outpatient health service visits. Using the concentration index, socio-economic inequality in health service visits, after accounting for seasonal variations, was compared with that when seasonal variations are ignored. It was found that, in some cases, socio-economic inequality in outpatient health service visits depends on the socio-economic distribution of the seasonality index. This may justify the need to account for seasonal and geographical variations.

Temporal variation in indoor transfer of dirt-associated environmental bacteria in agricultural and urban areas

An agricultural environment and exposure to diverse environmental microbiota has been suggested to confer protection against immune-mediated disorders. As an agricultural environment may have a protective role, it is crucial to determine whether the limiting factors in the transfer of environmental microbiota indoors are the same in the agricultural and urban environments. We explored how sampling month, garden diversity and animal ownership affected the indoor-transfer of environmental microbial community. We collected litter from standardized doormats used for 2 weeks in June and August 2015 and February 2016 and identified bacterial phylotypes using 16S rRNA Illumina MiSeq sequencing. In February, the diversity and richness of the whole bacterial community and the relative abundance of environment-associated taxa were reduced, whereas human-associated taxa and genera containing opportunistic pathogens were enriched in the doormats. In summer, the relative abundances of several taxa associated previously with beneficial health effects were higher, particularly in agricultural areas. Surprisingly, the importance of vegetation on doormat microbiota was more observable in February, which may have resulted from snow cover that prevented contact with microbes in soil. Animal ownership increased the prevalence of genera Bacteroides and Acinetobacter in rural doormats. These findings underline the roles of season, living environment and lifestyle in the temporal variations in the environmental microbial community carried indoors. As reduced contact with diverse microbiota is a potential reason for immune system dysfunction, the results may have important implications in the etiology of immune-mediated, non-communicable diseases.