Co-infection and super-infection models in evolutionary epidemiology

Multiple infections are intensively studied because of their consequences for the health of the host but also because they can radically alter the selective pressures acting on parasites. I discuss how multiple infections have been modelled in evolutionary epidemiology. First, I briefly mention within-host models, which are at the root of these epidemiological models. Then, I present the super-infection framework, with an original focus on how the definition of the super-infection function can lead to evolutionary branching. There are several co-infection models and, for each of them, I briefly go through the underlying mathematics (especially the invasion fitness of a mutant strain) and I discuss the biological assumptions they make and the questions they consequently may ask. In particular, I show that a widely used co-infection model should not be invoked for invasion analyses because it confers a frequency-dependent advantage to rare neutral mutants. Finally, I present more recent frameworks, such as the Price equation framework in epidemiology, that can account for increased parasite diversity. To conclude, I discuss some perspectives for the study of multiple infections in evolutionary epidemiology.

Transient virulence of emerging pathogens

Should emerging pathogens be unusually virulent? If so, why? Existing theories of virulence evolution based on a tradeoff between high transmission rates and long infectious periods imply that epidemic growth conditions will select for higher virulence, possibly leading to a transient peak in virulence near the beginning of an epidemic. This transient selection could lead to high virulence in emerging pathogens. Using a simple model of the epidemiological and evolutionary dynamics of emerging pathogens, along with rough estimates of parameters for pathogens such as severe acute respiratory syndrome, West Nile virus and myxomatosis, we estimated the potential magnitude and timing of such transient virulence peaks. Pathogens that are moderately evolvable, highly transmissible, and highly virulent at equilibrium could briefly double their virulence during an epidemic; thus, epidemic-phase selection could contribute significantly to the virulence of emerging pathogens. In order to further assess the potential significance of this mechanism, we bring together data from the literature for the shapes of tradeoff curves for several pathogens (myxomatosis, HIV, and a parasite of Daphnia) and the level of genetic variation for virulence for one (myxomatosis). We discuss the need for better data on tradeoff curves and genetic variance in order to evaluate the plausibility of various scenarios of virulence evolution.

The curse of the pharaoh hypothesis

The 'curse of the pharaoh' has been used as a metaphor for the hypothesis that higher parasite propagule survival selects for higher virulence. Indeed, the mysterious death of Lord Carnavon after entering the tomb of the Egyptian pharaoh Tutankhamen could potentially be explained by an infection with a highly virulent and very long-lived pathogen. In this paper, I investigate whether parasite virulence increases with high propagule survival. In this respect, I derive an analytic expression of the evolutionarily stable level of parasite virulence as a function of propagule survival rate when the host-parasite system has reached a stable ecological equilibrium. This result shows that, if multiple infection occurs, higher propagule survival generally increases parasite virulence. This effect is enhanced when parasite dispersal coevolves with parasite virulence. In a more general perspective, the model shows the importance of taking into account the combination of direct and indirect effects (which I call inclusive effects) of higher transmission ability on the evolution of parasite virulence. The recognition of these effects has several practical implications for virulence management.