Georgia Institute of Technology College of Sciences

The traditional epidemiological approach to characterize transmission of infectious disease consists of compartmentalizing hosts into susceptible, exposed, infected, recovered (SEIR), and vectors into susceptible, exposed and infected (SEI), and variations of this paradigm (e.g. SIR, SIR/SI, etc.). Compartmentalized models are based on a series of simplifying assumptions and have been successfully used to study a broad range of disease transmission dynamics. These paradigm is challenged when the within-host dynamics of disease is taken into account with aspects such as: (i) Simultaneous Infection: An infection can include the simultaneous presence of several distinct pathogen genomes, from the same or multiple species, thus an individual might belong to multiple compartments simultaneously. This precludes the traditional calculation of the basic reproductive number. (ii) Antigenic diversity and variation: Antigenic diversity, defined as antigenic differences between pathogens in a population, and antigenic variation, defined as the ability of a pathogen to change antigens presented to the immune system during an infection, are central to the pathogen's ability to 1) infect previously exposed hosts, and 2) maintain a long-term infection in the face of the host immune response. Immune evasion facilitated by this variability is a critical factor in the dynamics of pathogen growth, and therefore, transmission.This talk explores an alternate mechanistic formulation of epidemiological dynamics based upon studying the influence of within-host dynamics in environmental transmission. A basic propagation number is calculated that could guide public health policy.