Unintended consequences and the paradox of control: Management of emerging pathogens with age-specific virulence.
We project forward total Zika virus disease (ZVD) under varying hazards of infection and consider how the age distribution of disease burden varies between these scenarios. Pathogens with age structured disease outcomes, such as rubella and Zika virus, require that management decisions consider thei...
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ftdoajarticles:oai:doaj.org/article:aa53ce6d3e5f4ed68b1e2727d9c48003 2023-05-15T15:07:24+02:00 Unintended consequences and the paradox of control: Management of emerging pathogens with age-specific virulence. Spencer Carran Matthew Ferrari Timothy Reluga 2018-04-01T00:00:00Z https://doi.org/10.1371/journal.pntd.0005997 https://doaj.org/article/aa53ce6d3e5f4ed68b1e2727d9c48003 EN eng Public Library of Science (PLoS) http://europepmc.org/articles/PMC5908194?pdf=render https://doaj.org/toc/1935-2727 https://doaj.org/toc/1935-2735 1935-2727 1935-2735 doi:10.1371/journal.pntd.0005997 https://doaj.org/article/aa53ce6d3e5f4ed68b1e2727d9c48003 PLoS Neglected Tropical Diseases, Vol 12, Iss 4, p e0005997 (2018) Arctic medicine. Tropical medicine RC955-962 Public aspects of medicine RA1-1270 article 2018 ftdoajarticles https://doi.org/10.1371/journal.pntd.0005997 2022-12-31T01:48:39Z We project forward total Zika virus disease (ZVD) under varying hazards of infection and consider how the age distribution of disease burden varies between these scenarios. Pathogens with age structured disease outcomes, such as rubella and Zika virus, require that management decisions consider their impact not only on total disease incidence but also on distribution of disease burden within a population. Some situations exhibit a "paradox of control" in which reductions of overall transmission decrease the total incidence but increase the incidence of severe disease. This happens because of corresponding increases in the average age of infection. Beginning with the current population structure and demographic rates of Brazil, we project forward total ZVD burden as measured by cases occurring in pregnant women and document the scenarios under which a paradox of control for ZVD management emerges. We conclude that while a paradox of control can occur for ZVD, the higher total costs from increasing the average age of infection will only be realized after several decades and vanish under conservative discounting of future costs. This indicates that managers faced with an emerging pathogen are justified to prioritize current disease incidence over potential increases in severe disease outcomes in the endemic state. Article in Journal/Newspaper Arctic Directory of Open Access Journals: DOAJ Articles Arctic PLOS Neglected Tropical Diseases 12 4 e0005997 |
institution |
Open Polar |
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Directory of Open Access Journals: DOAJ Articles |
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ftdoajarticles |
language |
English |
topic |
Arctic medicine. Tropical medicine RC955-962 Public aspects of medicine RA1-1270 |
spellingShingle |
Arctic medicine. Tropical medicine RC955-962 Public aspects of medicine RA1-1270 Spencer Carran Matthew Ferrari Timothy Reluga Unintended consequences and the paradox of control: Management of emerging pathogens with age-specific virulence. |
topic_facet |
Arctic medicine. Tropical medicine RC955-962 Public aspects of medicine RA1-1270 |
description |
We project forward total Zika virus disease (ZVD) under varying hazards of infection and consider how the age distribution of disease burden varies between these scenarios. Pathogens with age structured disease outcomes, such as rubella and Zika virus, require that management decisions consider their impact not only on total disease incidence but also on distribution of disease burden within a population. Some situations exhibit a "paradox of control" in which reductions of overall transmission decrease the total incidence but increase the incidence of severe disease. This happens because of corresponding increases in the average age of infection. Beginning with the current population structure and demographic rates of Brazil, we project forward total ZVD burden as measured by cases occurring in pregnant women and document the scenarios under which a paradox of control for ZVD management emerges. We conclude that while a paradox of control can occur for ZVD, the higher total costs from increasing the average age of infection will only be realized after several decades and vanish under conservative discounting of future costs. This indicates that managers faced with an emerging pathogen are justified to prioritize current disease incidence over potential increases in severe disease outcomes in the endemic state. |
format |
Article in Journal/Newspaper |
author |
Spencer Carran Matthew Ferrari Timothy Reluga |
author_facet |
Spencer Carran Matthew Ferrari Timothy Reluga |
author_sort |
Spencer Carran |
title |
Unintended consequences and the paradox of control: Management of emerging pathogens with age-specific virulence. |
title_short |
Unintended consequences and the paradox of control: Management of emerging pathogens with age-specific virulence. |
title_full |
Unintended consequences and the paradox of control: Management of emerging pathogens with age-specific virulence. |
title_fullStr |
Unintended consequences and the paradox of control: Management of emerging pathogens with age-specific virulence. |
title_full_unstemmed |
Unintended consequences and the paradox of control: Management of emerging pathogens with age-specific virulence. |
title_sort |
unintended consequences and the paradox of control: management of emerging pathogens with age-specific virulence. |
publisher |
Public Library of Science (PLoS) |
publishDate |
2018 |
url |
https://doi.org/10.1371/journal.pntd.0005997 https://doaj.org/article/aa53ce6d3e5f4ed68b1e2727d9c48003 |
geographic |
Arctic |
geographic_facet |
Arctic |
genre |
Arctic |
genre_facet |
Arctic |
op_source |
PLoS Neglected Tropical Diseases, Vol 12, Iss 4, p e0005997 (2018) |
op_relation |
http://europepmc.org/articles/PMC5908194?pdf=render https://doaj.org/toc/1935-2727 https://doaj.org/toc/1935-2735 1935-2727 1935-2735 doi:10.1371/journal.pntd.0005997 https://doaj.org/article/aa53ce6d3e5f4ed68b1e2727d9c48003 |
op_doi |
https://doi.org/10.1371/journal.pntd.0005997 |
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PLOS Neglected Tropical Diseases |
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12 |
container_issue |
4 |
container_start_page |
e0005997 |
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1766338916293541888 |