Hydroclimatology of dual-peak annual cholera incidence: Insights from a spatially explicit model

Enrico Bertuzzo, Marino Gatto, Lorenzo Mari, Lorenzo Righetto, Andrea Rinaldo
2012
Journal paper

Abstract

Cholera incidence in some regions of the Indian subcontinent may exhibit two annual peaks although the main environmental drivers that have been linked to the disease (e.g., sea surface temperature, zooplankton abundance, river discharge) peak once per year during the summer. An empirical hydroclimatological explanation relating cholera transmission to river flows and to the disease spatial spreading has been recently proposed. We specifically support and substantiate mechanistically such hypothesis by means of a spatially explicit model of cholera transmission. Our framework directly accounts for the role of a model river network in transporting and redistributing cholera bacteria among human communities as well as for spatial and temporal annual fluctuations of river flows. The model is forced by seasonal environmental drivers, namely river flow, temperature and chlorophyll concentration in the coastal environment, a proxy for Vibrio cholerae concentration. Our results show that these drivers may suffice to generate dual-peak cholera prevalence patterns for proper combinations of timescales involved in pathogen transport, hydrologic variability and disease unfolding. The model explains the possible occurrence of spatial patterns of cholera incidence characterized by a spring peak confined to coastal areas and a fall peak involving inland regions. Our modeling framework suggests insights on how environmental drivers concert the generation of complex spatiotemporal infections and proposes an explanation for the different cholera patterns (dual or single annual peaks) exhibited by regions that share similar hydroclimatological forcings. Citation: Bertuzzo, E., L. Mari, L. Righetto, M. Gatto, R. Casagrandi, I. Rodriguez-Iturbe, and A. Rinaldo (2012), Hydroclimatology of dual-peak annual cholera incidence: Insights from a spatially explicit model, Geophys. Res. Lett., 39, L05403, doi:10.1029/2011GL050723.

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Enrico Bertuzzo, Marino Gatto, Lorenzo Mari, Lorenzo Righetto, Andrea Rinaldo
2012
Journal paper

Abstract

Official source

https://infoscience.epfl.ch/record/176168?ln=en

About this result

Related concepts (15)

Related concepts

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We propose and analyze an important extension of standard cholera epidemiological models, explicitly accounting for fluctuations of water availability to the human community under study. The seasonality of water input in the reservoir drives the variation of concentration of Vibrio cholerae. Two compartments are added to the Susceptible-Infected-Bacteria model. First, the recovered individuals, which, over many seasons, lose their immunity to the disease and replenish the Susceptible group. Second, the water volume of the reservoir, which determines bacterial dilution and, consequently, the probability of contracting cholera by ingesting contaminated water. By forcing the model with a seasonally varying hydrologic input, we obtain simulations that can be compared to available data for various regions of the World characterized by different hydrological and epidemiological regimes. The model is shown to satisfactorily reproduce important characteristics of disease insurgence and long-term persistence. Using bifurcation analysis of nonlinear systems, we also explore how different degrees of seasonality and values of the basic reproductive number can change the expected long-term epidemiological time series. We find that there exist parametric conditions where the model shows chaotic patterns - i.e. high unpredictability especially in the amplitude of prevalence peaks - which very much resemble actual data on long-term cholera insurgence. (C) 2011 Elsevier B. V. All rights reserved.

2012

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Following the empirical evidence of a clear correlation between rainfall events and cholera resurgence that was observed in particular during the recent outbreak in Haiti, a spatially explicit model of epidemic cholera is re-examined. Specifically, we test a multivariate Poisson rainfall generator, with parameters varying in space and time, as a driver of enhanced disease transmission. The relevance of the issue relates to the key insight that predictive mathematical models may provide into the course of an ongoing cholera epidemic aiding emergency management (say, in allocating life-saving supplies or health care staff) or in evaluating alternative management strategies. Our model consists of a set of dynamical equations (SIRB-like i.e. subdivided into the compartments of Susceptible, Infected and Recovered individuals, and including a balance of Bacterial concentrations in the water reservoir) describing a connected network of human communities where the infection results from the exposure to excess concentrations of pathogens in the water. These, in turn, are driven by rainfall washout of open-air defecation sites or cesspool overflows, hydrologic transport through waterways and by mobility of susceptible and infected individuals. We perform an a posteriori analysis (from the beginning of the epidemic in October 2010 until December 2011) to test the model reliability in predicting cholera cases and in testing control measures, involving vaccination and sanitation campaigns, for the ongoing epidemic. Even though predicting reliably the timing of the epidemic resurgence proves difficult due to rainfall inter-annual variability, we find that the model can reasonably quantify the total number of reported infection cases in the selected time-span. We then run a multi-seasonal prediction of the course of the epidemic until December 2015, to investigate conditions for further resurgences and endemicity of cholera in the region with a view to policies which may bring to the eradication of the disease in Haiti. The projections, although strongly depending on still uncertain epidemiological processes, show an endemic, seasonal pattern establishing in the region, which can be better forestalled by an improvement of the sanitation system only, rather than by vaccination alone. We thus conclude that hydrologic drivers and water resources management prove central to prediction, emergency management and long-term control of epidemic cholera. (C) 2013 Elsevier Ltd. All rights reserved.

Elsevier Sci Ltd2013

An epidemic model for the interactions between thermal regime of rivers and transmission of proliferative kidney disease in salmonid fish

Enrico Bertuzzo, Luca Carraro, Marino Gatto, Lorenzo Mari, Andrea Rinaldo

Proliferative kidney disease (PKD) affects salmonid populations in European and North-American rivers. It is caused by the endoparasitic myxozoan Tetracapsuloides bryosalmonae, which exploits freshwater bryozoans (Fredericella sultana) and salmonids as primary and secondary hosts, respectively. Incidence and mortality, which can reach up to 90-100%, are known to be strongly related to water temperature. PKD has been present in brown trout population for a long time but has recently increased rapidly in incidence and severity causing a decline in fish catches in many countries. In addition, environmental changes are feared to cause PKD outbreaks at higher latitude and altitude regions as warmer temperatures promote disease development. This calls for a better comprehension of the interactions between disease dynamics and the thermal regime of rivers, in order to possibly devise strategies for disease management. In this perspective, a spatially explicit model of PKD epidemiology in riverine host metacommunities is proposed. The model aims at summarizing the knowledge on the modes of transmission of the disease and the life-cycle of the parasite, making the connection between temperature and epidemiological parameters explicit. The model accounts for both local population and disease dynamics of bryozoans and fish and hydrodynamic dispersion of the parasite spores and hosts along the river network. The model is time-hybrid, coupling inter-seasonal and intra-seasonal dynamics, the former being described in a continuous time domain, the latter seen as time steps of a discrete time domain. In order to test the model, a case study is conducted in river Wigger (Cantons of Aargau and Lucerne, Switzerland), where data about water temperature, brown trout and bryozoan populations and PKD prevalence are being collected.

2015

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Elsevier Sci Ltd2013

An epidemic model for the interactions between thermal regime of rivers and transmission of proliferative kidney disease in salmonid fish

Enrico Bertuzzo, Luca Carraro, Marino Gatto, Lorenzo Mari, Andrea Rinaldo

2015