On modeling airborne infection risk

Airborne infection risk analysis is usually performed for enclosed spaces where susceptible individuals are exposed to infectious airborne respiratory droplets by inhalation. It is usually based on exponential, dose-response models of which a widely used variant is the Wells-Riley (WR) model. We employ a population-based Susceptible-Exposed-Droplet-Infected-Recovered (SEDIR) model to revisit the infection-risk estimate at the population level during an epidemic. We demonstrate the link between epidemiological models and the WR model, including its Gammaitoni-Nucci (GN) generalization. This connection shows how infection quanta are related to the number of infectious airborne droplets. For long latent periods, the SEDIR model reduces to the GN model with parameters that depend on biological properties of the pathogen (size-dependent pathogen droplet concentration, infection probability of a deposited infectious droplet), physical droplet properties (lung-deposition probability), and individual behavioral properties (exposure time). In two scenarios we calculate the probability of infection during the epidemic. The WR and GN limits of the SEDIR model reproduce accurately the SEDIR-calculated infection risk.Comment: 14 pages, 3 figure

Migratory birds, the H5N1 influenza virus and the scientific method

<p>Abstract</p> <p>Background</p> <p>The role of migratory birds and of poultry trade in the dispersal of highly pathogenic H5N1 is still the topic of intense and controversial debate. In a recent contribution to this journal, Flint argues that the strict application of the scientific method can help to resolve this issue.</p> <p>Discussion</p> <p>We argue that Flint's identification of the scientific method with null hypothesis testing is misleading and counterproductive. There is far more to science than the testing of hypotheses; not only the justification, bur also the discovery of hypotheses belong to science. We also show why null hypothesis testing is weak and that Bayesian methods are a preferable approach to statistical inference. Furthermore, we criticize the analogy put forward by Flint between involuntary transport of poultry and long-distance migration.</p> <p>Summary</p> <p>To expect ultimate answers and unequivocal policy guidance from null hypothesis testing puts unrealistic expectations on a flawed approach to statistical inference and on science in general.</p

Ecologic Immunology of Avian Influenza (H5N1) in Migratory Birds

Studies do not support the claim that migratory birds can spread highly pathogenic avian influenza (H5N1) over long distances

Dynamics of infectious disease transmission by inhalable respiratory droplets

Transmission of respiratory infectious diseases in humans, for instance influenza, occurs by several modes. Respiratory droplets provide a vector of transmission of an infectious pathogen that may contribute to different transmission modes. An epidemiological model incorporating the dynamics of inhalable respiratory droplets is developed to assess their relevance in the infectious process. Inhalable respiratory droplets are divided into respirable droplets, with droplet diameter less than 10 µm, and inspirable droplets, with diameter in the range 10–100 µm: both droplet classes may be inhaled or settle. Droplet dynamics is determined by their physical properties (size), whereas population dynamics is determined by, among other parameters, the pathogen infectivity and the host contact rates. Three model influenza epidemic scenarios, mediated by different airborne or settled droplet classes, are analysed. The scenarios are distinguished by the characteristic times associated with breathing at contact and with hand-to-face contact. The scenarios suggest that airborne transmission, mediated by respirable droplets, provides the dominant transmission mode in middle and long-term epidemics, whereas inspirable droplets, be they airborne or settled, characterize short-term epidemics with high attack rates. The model neglects close-contact transmission by droplet sprays (direct projection onto facial mucous membranes), retaining close-contact transmission by inspirable droplets

West Nile neuroinvasive disease (WNND) cases among West Nile virus (WNV) confirmed cases by year and rural/urban classification of the place of infection (predominantly rural [Rur]/intermediate [Int]/predominantly urban [Urb] and missing [<i>NaN</i>]) as well as International Organization for Standardization (ISO) Country code of the reporting country.

Included are the proportion of sex (expressed as absolute and relative frequencies of female cases), and of imported cases (absolute and relative frequencies), mean age in years (and standard deviation [sd]) and mean (and sd) of the time between onset of symptoms and diagnosis (OD) expressed in days.</p

Host selection and forage ratio in West Nile virus-transmitting Culex mosquitoes: Challenges and knowledge gaps

Background: To date, no specific therapy or vaccination is available for West Nile virus (WNV) infections in humans; preventive strategies represent the only possibility to control transmission. To focus these strategies, detailed knowledge of the virus dynamics is of paramount importance. However, several aspects of WNV transmission are still unclear, especially regarding the role of potential vertebrate host species. Whereas mosquitoes' intrinsic characteristics cause them to favour certain hosts (host preference), absolute selection is impossible in natural settings. Conversely, the selection carried out among available hosts and influenced from hosts' availability and other ecological/environmental factors is defined as host selection. Methodology/principal findings: In July 2022, we searched PubMed database for original articles exploring host selection among WNV-transmitting Culex mosquitoes, the main WNV vector. We considered only original field studies estimating and reporting forage ratio. This index results from the ratio between the proportion of blood meals taken by mosquitoes on potential host species and the hosts' relative abundance. From the originally retrieved 585 articles, 9 matched the inclusion criteria and were included in this review. All but one of the included studies were conducted in the Americas, six in the United States, and one each in Mexico and Colombia. The remaining study was conducted in Italy. American Robin, Northern Cardinal, and House Finch were the most significantly preferred birds in the Americas, Common Blackbird in Italy. Conclusions/significance: Although ornithophilic, all observed WNV-transmitting mosquitoes presented opportunistic feeding behaviour. All the observed species showed potential to act as bridges for zoonotic diseases, feeding also on humans. All the observed mosquitoes presented host selection patterns and did not feed on hosts as expected by chance alone. The articles observe different species of mosquitoes in different environments. In addition, the way the relative host abundance was determined differed. Finally, this review is not systematic. Therefore, the translation of our results to different settings should be conducted cautiously

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BackgroundWith a case-fatality-risk ranging from 3.0 to >20.0% and life-long sequelae, West Nile neuroinvasive disease (WNND) is the most dangerous outcome of West Nile virus (WNV) infection in humans. As no specific prophylaxis nor therapy is available for these infections, focus is on preventive strategies. We aimed to find variables associated with WNND diagnosis, hospitalisation or death, to identify high-risk sub-groups of the population, on whom to concentrate these strategies.MethodsWe used data from The European Surveillance System–TESSy, provided by National Public Health Authorities, and released by the European Centre for Disease Prevention and Control (ECDC). In two Firth-penalised logistic regression models, we considered age, sex, clinical criteria, epidemiological link to other cases (epi-link), calendar year, and season as potential associated variables. In one model we considered also the rural/urban classification of the place of infection (RUC), while in the other the specific reporting country.FindingsAmong confirmed West Nile Virus cases, 2,916 WNND cases were registered, of which 2,081 (71.4%), and 383 (13.1%) resulted in the hospitalisation and death of the patient, respectively. Calendar year, RUC/country, age, sex, clinical criteria, and epi-link were associated with WNND diagnosis. Hospitalisation was associated with calendar year and RUC/country; whereas death was associated with age, sex and country.InterpretationOur results support previous findings on WNND associated variables (most notably age and sex); while by observing the whole population of WNND cases in the considered area and period, they also allow for stronger generalizations, conversely to the majority of previous studies, which used sample populations.</div

Effects of climatic and environmental factors on mosquito population inferred from West Nile virus surveillance in Greece

Abstract Mosquito-borne diseases’ impact on human health is among the most prominent of all communicable diseases. With limited pool of tools to contrast these diseases, public health focus remains preventing mosquito-human contacts. Applying a hierarchical spatio-temporal Bayesian model on West Nile virus (WNV) surveillance data from Greece, we aimed to investigate the impact of climatic and environmental factors on Culex mosquitoes’ population. Our spatio-temporal analysis confirmed climatic factors as major drivers of WNV-transmitting-Culex mosquitoes population dynamics, with temperature and long periods of moderate-to-warm climate having the strongest positive effect on mosquito abundance. Conversely, rainfall, high humidity, and wind showed a negative impact. The results suggest the presence of statistically significant differences in the effect of regional and seasonal characteristics, highlighting the complex interplay between climatic, geographical and environmental factors in the dynamics of mosquito populations. This study may represent a relevant tool to inform public health policymakers in planning preventive measures