Abstract: Heterogeneity is a fundamental issue in epidemiology, as many factors influencing disease transmission vary within and across populations. For diseases spread through multiple transmission pathways, sources of variation may affect each transmission pathway differently. In this talk I consider a disease that can be spread via direct and indirect transmission, such as the waterborne disease cholera. Specifically, I consider a system of multiple patches with direct transmission occurring entirely within patch and indirect transmission via a single water source that is shared by all patches. I investigate the effect of heterogeneity in dual transmission pathways on the spread of the disease, as measured by the basic reproduction number R_0. I examine the effect of variation in each pathway separately, proposing a measure of heterogeneity which incorporates both transmission mechanisms and is predictive of R_0. I also explore how heterogeneity affects the final outbreak size and the efficacy of intervention measures.
Heterogeneity in multiple transmission pathways: modeling the spread of waterborne disease in networks with a common water source
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