A general framework for modelling the impact of co-infections on pathogen evolution

Mathematical modelling and analysis for the co-infection of viral and bacterial diseases: a systematic review protocol

INTRODUCTION

Breaking the chain of transmission of an infectious disease pathogen is a major public health priority. The challenges of understanding, describing and predicting the transmission dynamics of infections have led to a wide range of mathematical, statistical and biological research problems. Advances in diagnostic laboratory procedures with the ability to test multiple pathogens simultaneously mean that co-infections are increasingly being detected, yet little is known about the impact of co-infections in shaping the course of an infection, infectivity, and pathogen replication rate. This is particularly true of the apparent synergistic effects of viral and bacterial co-infections, which present the greatest threats to public health because of their lethal nature and complex dynamics. This systematic review protocol is the foundation of a critical review of co-infection modelling and an assessment of the key features of the models.

METHODS AND ANALYSIS

MEDLINE through PubMed, Web of Science, medRxiv and Scopus will be systematically searched between 1 December 2024 and 31 January 2025 for studies published between January 1980 and December 2024. Three reviewers will screen articles independently for eligibility, and quality assessment will be performed using the TRACE (TRAnsparent and Comprehensive Ecological) standard modelling guide. Data will be extracted using an Excel template in accordance with the Preferred Reporting Items for Systematic Review and Meta-Analysis standard reporting guidelines. This systematic review will apply the SWiM (Synthesis Without Meta-analysis) approach in its narrative synthesis coupled with tables and figures to present data. The synthesis will highlight key dynamical co-infection model features such as assumptions, data fitting and estimation methods, validation and sensitivity analyses, optimal control analyses, and the impact of co-infections.

ETHICS AND DISSEMINATION

Ethics approval is not required for a systematic review since it will be based on published work. The output of this study will be submitted for publication in a peer-reviewed journal.

PROSPERO REGISTRATION NUMBER

CRD42023481247.

A story of viral co-infection, co-transmission and co-feeding in ticks: how to compute an invasion reproduction number

With a single circulating vector-borne virus, the basic reproduction number incorporates contributions from tick-to-tick (co-feeding), tick-to-host and host-to-tick transmission routes. With two different circulating vector-borne viral strains, resident and invasive, and under the assumption that co-feeding is the only transmission route in a tick population, the invasion reproduction number depends on whether the model system of ordinary differential equations possesses the property of neutrality. We show that a simple model, with two populations of ticks infected with one strain, resident or invasive, and one population of co-infected ticks, does not have Alizon's neutrality property. We present model alternatives that are capable of representing the invasion potential of a novel strain by including populations of ticks dually infected with the same strain. The invasion reproduction number is analysed with the next-generation method and via numerical simulations.

Open questions in the social lives of viruses

Social interactions among viruses occur whenever multiple viral genomes infect the same cells, hosts, or populations of hosts. Viral social interactions range from cooperation to conflict, occur throughout the viral world, and affect every stage of the viral lifecycle. The ubiquity of these social interactions means that they can determine the population dynamics, evolutionary trajectory, and clinical progression of viral infections. At the same time, social interactions in viruses raise new questions for evolutionary theory, providing opportunities to test and extend existing frameworks within social evolution. Many opportunities exist at this interface: Insights into the evolution of viral social interactions have immediate implications for our understanding of the fundamental biology and clinical manifestation of viral diseases. However, these opportunities are currently limited because evolutionary biologists only rarely study social evolution in viruses. Here, we bridge this gap by (1) summarizing the ways in which viruses can interact socially, including consequences for social evolution and evolvability; (2) outlining some open questions raised by viruses that could challenge concepts within social evolution theory; and (3) providing some illustrative examples, data sources, and conceptual questions, for studying the natural history of social viruses.

Revisiting implementation of multiple natural enemies in pest management

A major goal of biological control is the reduction and/or eradication of pests using various natural enemies, in particular, via deliberate infection of the target species by parasites. To enhance the biological control, a promising strategy seems to implement a multi-enemy assemblage rather than a single control agent. Although a large body of theoretical studies exists on co-infections in epidemiology and ecology, there is still a big gap in modelling outcomes of multi-enemy biological control. Here we theoretically investigate how the efficiency of biological control of a pest depends on the number of natural enemies used. We implement a combination of eco-epidemiological modelling and the Adaptive Dynamics game theory framework. We found that a progressive addition of parasite species increases the evolutionarily stable virulence of each parasite, and thus enhances the mortality of the target pest. However, using multiple enemies may have only a marginal effect on the success of biological control, or can even be counter-productive when the number of enemies is excessive. We found the possibility of evolutionary suicide, where one or several parasite species go extinct over the course of evolution. Finally, we demonstrate an interesting scenario of coexistence of multiple parasites at the edge of extinction.

Effects of measures on phase transitions in two cooperative susceptible-infectious-recovered dynamics

In recent studies, it has been shown that a cooperative interaction in a co-infection spread can lead to a discontinuous transition at a decreased threshold. Here, we investigate the effects of immunization with a rate proportional to the extent of the infection on phase transitions of a cooperative co-infection. We use the mean-field approximation to illustrate how measures that remove a portion of the susceptible compartment, like vaccination, with high enough rates can change discontinuous transitions in two coupled susceptible-infectious-recovered dynamics into continuous ones while increasing the threshold of transitions. First, we introduce vaccination with a fixed rate into a symmetric spread of two diseases and investigate the numerical results. Second, we set the rate of measures proportional to the size of the infectious compartment and scrutinize the dynamics. We solve the equations numerically and analytically and probe the transitions for a wide range of parameters. We also determine transition points from the analytical solutions. Third, we adopt a heterogeneous mean-field approach to include heterogeneity and asymmetry in the dynamics and see if the results corresponding to homogeneous symmetric case stand.

Fitness Estimation for Viral Variants in the Context of Cellular Coinfection

Animal models are frequently used to characterize the within-host dynamics of emerging zoonotic viruses. More recent studies have also deep-sequenced longitudinal viral samples originating from experimental challenges to gain a better understanding of how these viruses may evolve in vivo and between transmission events. These studies have often identified nucleotide variants that can replicate more efficiently within hosts and also transmit more effectively between hosts. Quantifying the degree to which a mutation impacts viral fitness within a host can improve identification of variants that are of particular epidemiological concern and our ability to anticipate viral adaptation at the population level. While methods have been developed to quantify the fitness effects of mutations using observed changes in allele frequencies over the course of a host’s infection, none of the existing methods account for the possibility of cellular coinfection. Here, we develop mathematical models to project variant allele frequency changes in the context of cellular coinfection and, further, integrate these models with statistical inference approaches to demonstrate how variant fitness can be estimated alongside cellular multiplicity of infection. We apply our approaches to empirical longitudinally sampled H5N1 sequence data from ferrets. Our results indicate that previous studies may have significantly underestimated the within-host fitness advantage of viral variants. These findings underscore the importance of considering the process of cellular coinfection when studying within-host viral evolutionary dynamics.