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At least 37 records · Page 2

Multiscale Airborne Infectious Disease Transmission

Airborne disease transmission is central to many scientific disciplines, including agriculture, veterinary biosafety, medicine, and public health. Legal and regulatory standards are in place to prevent agricultural, nosocomial, and community airborne disease transmission. However, the overall importance of the airborne pathway is underappreciated; e.g., the U.S. National Library of Medicine’s Medical Subjects Headings (MESH) thesaurus lacks an airborne disease transmission indexing term. This has practical consequences, as airborne precautions to control epidemic disease spread may not be taken when airborne transmission is important but unrecognized. Publishing clearer practical methodological guidelines for surveillance studies and disease outbreak evaluations could help address this situation. To inform future work, this paper highlights selected, well-established airborne transmission events, largely cases replicated in multiple, independently conducted scientific studies. Methodologies include field experiments, modeling, epidemiology studies, disease outbreak investigations, and mitigation studies. Collectively, this literature demonstrates that airborne viruses, bacteria, and fungal pathogens have the ability to cause disease in plants, animals, and humans over multiple distances, from near range (<5 m) to continental (>500 km) in scale. The plausibility and implications of undetected airborne disease transmission are discussed, including the notable underreporting of disease burdens for several airborne-transmitted diseases.

59 BASIC BIOLOGICAL SCIENCES↗

Control of airborne infectious disease in buildings: Evidence and research priorities

The evolution of SARS-CoV-2 virus has resulted in variants likely to be more readily transmitted through respiratory aerosols, underscoring the increased potential for indoor environmental controls to mitigate risk. Use of tight-fitting face masks to trap infectious aerosol in exhaled breath and reduce inhalation exposure to contaminated air is of critical importance for disease control. Administrative controls including the regulation of occupancy and interpersonal spacing are also important, while presenting social and economic challenges. Indoor engineering controls including ventilation, exhaust, air flow control, filtration, and disinfection by germicidal ultraviolet irradiation can reduce reliance on stringent occupancy restrictions. However, the effects of controls-individually and in combination-on reducing infectious aerosol transfer indoors remain to be clearly characterized to the extent needed to support widespread implementation by building operators. We review aerobiologic and epidemiologic evidence of indoor environmental controls against transmission and present a quantitative aerosol transfer scenario illustrating relative differences in exposure at close-interactive, room, and building scales. We identify an overarching need for investment to implement building controls and evaluate their effectiveness on infection in well-characterized and real-world settings, supported by specific, methodological advances. Finally, improved understanding of engineering control effectiveness guides implementation at scale while considering occupant comfort, operational challenges, and energy costs.

60 APPLIED LIFE SCIENCES↗

Mechanistic modelling of SARS-CoV-2 and other infectious diseases and the effects of therapeutics

Modern viral kinetic modeling and its application to therapeutics is a field that attracted the attention of the medical, pharmaceutical and modeling communities during the early days of the AIDS epidemic. Its successes lead to applications of modeling methods not only to HIV but a plethora of other viruses, such as hepatitis C virus (HCV), hepatitis B virus (HBV) and cytomegalovirus (CMV), which along with HIV cause chronic diseases, and viruses such as influenza, respiratory syncytial virus (RSV), West Nile virus (WNV), Zika virus, and SAR-CoV-2, which generally cause acute infections. Here we first review the historical development of mathematical models to understand HIV and HCV infections and the effects of treatment by fitting the models to clinical data. Furthermore, we then focus on recent efforts and contributions of applying these models towards understanding SARS-CoV-2 infection and highlight outstanding questions where modeling can provide crucial insights and help to optimize non-pharmaceutical and pharmaceutical interventions of the COVID-19 pandemic. The review is written from our personal perspective emphasizing the power of simple target cell limited models that provided important insights and then their evolution into more complex models that captured more of the virology and immunology. To quote Albert Einstein “Everything should be made as simple as possible, but not simpler”, and this idea underlies the modeling we describe below.

60 APPLIED LIFE SCIENCES↗

Verifying infectious disease scenario planning for geographically diverse populations

In the face of the COVID-19 pandemic, the literature saw a spike in publications for epidemic models, and a renewed interest in capturing contact networks and geographic movement of populations. There remains a general lack of consensus in the modeling community around best practices for spatiotemporal epi-modeling, specifically as it pertains to the infection rate formulation and the underlying contact or mixing model. We mathematically verify several common modeling assumptions in the literature, to prove when certain choices can provide consistent results across different geographic resolutions, population densities and patterns, and mixing assumptions. The most common infection rate formulation, a computationally low cost per capita infection rate assumption, fails the consistency tests for heterogeneous populations and gravity-weighting assumptions. Future modeling efforts in spatiotemporal disease modeling should be wary of this limitation, particularly when working with more heterogeneous or sparse populations. Our results provide guidance for testing that a model preserves desirable properties even when model inputs mask potential problems due to symmetry or homogeneity. We also provide a recipe for performing this type of verification, strengthening decision support tools.

59 BASIC BIOLOGICAL SCIENCES↗

Cross-scale dynamics and the evolutionary emergence of infectious diseases

When emerging pathogens encounter new host species for which they are poorly adapted, they must evolve to escape extinction. Pathogens experience selection on traits at multiple scales, including replication rates within host individuals and transmissibility between hosts. We analyze a stochastic model linking pathogen growth and competition within individuals to transmission between individuals. Our analysis reveals a new factor, the cross-scale reproductive number of a mutant virion, that quantifies how quickly mutant strains increase in frequency when they initially appear in the infected host population. This cross-scale reproductive number combines with viral mutation rates, single-strain reproductive numbers, and transmission bottleneck width to determine the likelihood of evolutionary emergence, and whether evolution occurs swiftly or gradually within chains of transmission. We find that wider transmission bottlenecks facilitate emergence of pathogens with short-term infections, but hinder emergence of pathogens exhibiting cross-scale selective conflict and long-term infections. Furthermore, our results provide a framework to advance the integration of laboratory, clinical, and field data in the context of evolutionary theory, laying the foundation for a new generation of evidence-based risk assessment of emergence threats.

59 BASIC BIOLOGICAL SCIENCES↗

Improving probabilistic infectious disease forecasting through coherence

With an estimated $10.4 billion in medical costs and 31.4 million outpatient visits each year, influenza poses a serious burden of disease in the United States. To provide insights and advance warning into the spread of influenza, the U.S. Centers for Disease Control and Prevention (CDC) runs a challenge for forecasting weighted influenza-like illness (wILI) at the national and regional level. Many models produce independent forecasts for each geographical unit, ignoring the constraint that the national wILI is a weighted sum of regional wILI, where the weights correspond to the population size of the region. We propose a novel algorithm that transforms a set of independent forecast distributions to obey this constraint, which we refer to as probabilistically coherent. Enforcing probabilistic coherence led to an increase in forecast skill for 79% of the models we tested over multiple flu seasons, highlighting the importance of respecting the forecasting system’s geographical hierarchy.

59 BASIC BIOLOGICAL SCIENCES↗

Engineered human vascular models to study endothelial dysfunction in infectious disease

Vascular involvement plays a pivotal role in the pathogenesis of numerous emerging viral threats, with climate changes amplifying the likelihood of these diseases evolving into pandemics. Establishing an infectable and physiologically relevant human in vitro model holds immense importance in comprehending the pathogenesis of these threats and devising effective countermeasures. Although in vivo models provide valuable insight into disease, their application is restricted by interspecies variations, particularly concerning pathogens exclusive to humans. Moreover, animal models often fail to replicate comorbidities prevalent in patient populations, thus limiting our understanding of disease behavior in humans. In this study, we have devised a testing platform aimed at exploring pathogen interactions with innate immunity within the vasculature, encompassing both healthy and dysfunctional endothelial conditions.

42 ENGINEERING↗

Model-form Error Correction using Universal Differential Equations for an Agent-Based Model of Infectious Disease

This report demonstrates universal differential equations (UDEs) as an approach to bridge the gap between ordinary differential equations (ODE) models and agent-based models (ABMs). Using UDE models as surrogates for ABMs allows us to preserve the foundational ODE that represents global disease dynamics while coupling it with a neural network model to approximate functions for the local behaviors of the ABM.

59 BASIC BIOLOGICAL SCIENCES↗