Ecological theory to enhance infectious disease control and public health policy

  • Ewald P
  • McCann K
  • Koelle K
 et al. 
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Abstract

Through the work of international public health organizations and advancements in the biological and technological sciences, substantial progress has been made in our ability to prevent, control, locally eliminate, and in one case eradicate infectious diseases. Yet each successful control or local elimination has been met with the emergence of new pathogens, the evolution of novel strains, or different epidemiological circumstances that have limited or reversed control methods. To respond to the increasing threat of emerging infectious diseases and bioterrorism it is vital that we design and implement efficient programs that prevent and control infectious pathogen transmission. The theoretical tools of ecology and epidemiology may be the cornerstone in constructing future programs aimed at preventing and controlling infectious diseases throughout the world. Discussion Ecologists first became interested in human infectious diseases because they provided rich datasets for testing mathematical models developed to understand the population dynamics of host–pathogen interactions. It quickly became apparent that attempts to control infectious diseases could be perceived as experimental interventions, the impact of which could be used to parameterize and test the assumptions underlying such models. Perhaps most importantly, these models provided a novel way of examining the efficacy of public health interventions to control disease, and ultimately lead to numerous insights into the ways in which vaccination programs and other interventions may be carried out. As evidenced by the examples presented here, disease prevention and control has depended upon public health officials applying knowledge gained from the work of population ecologists. This has resulted in an increasing realization that understanding the dynamics of infectious diseases is as much an ecological as a medical problem and that future public policy initiatives cannot afford to ignore the results of research on disease ecology. Past contributions of ecological theory to infectious disease control and prevention • Determining sensitivity in pathogen transmission cycles • Determining rate-limiting steps in pathogen population growth • Establishing effective and efficient vaccine strategies • Understanding pharmacological treatment regimes • Determining antimicrobial resistance among pathogens • Establishing the spatial dynamics of pathogen spread • Understanding host immune-system dynamics • Determining the impact of host sub-population characteristics on pathogen spread • Understanding critical community size and herd immunity Present and future contributions of ecological theory to infectious disease control and prevention • Using host demography and distribution to predict the emergence of infectious diseases • Using ecological and evolutionary dynamics to predict pathogen–host shifts • Using time-series analyses to predict temporal instability in disease epidemics • Planning for biopreparedness • Determining effective and efficient allocation of resources to disease surveillance • Using “end-game theory” to determine the appropriate time to stop control program

Author-supplied keywords

  • Animals
  • Biological
  • Cholera
  • Communicable Disease Control
  • Communicable Diseases
  • Disease
  • Ecology
  • Epidemiology
  • Evolution
  • Human
  • Humans
  • Influenza
  • Models
  • Myxoma virus
  • Rabies
  • Review
  • Sanitation
  • Vibrio cholerae
  • Virulence
  • epidemiology
  • microbiology
  • parasitology
  • pathogenicity
  • transmission
  • virology

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Authors

  • Pw Ewald

  • Kevin Shear McCann

  • Katia Koelle

  • Sarah Cobey

  • Bryan Grenfell

  • Mercedes Pascual

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