Climate, human behaviour or environment: individual-based modelling of Campylobacter seasonality and strategies to reduce disease burden.

Autor: Rushton SP; Modelling, Evidence and Policy Research Group, School of Natural and Environmental Science, Newcastle University, Newcastle upon Tyne, NE1 7RU, UK., Sanderson RA; Modelling, Evidence and Policy Research Group, School of Natural and Environmental Science, Newcastle University, Newcastle upon Tyne, NE1 7RU, UK. roy.sanderson@newcastle.ac.uk., Diggle PJ; Lancaster Medical School, Lancaster University, Lancaster, LA1 4YG, UK., Shirley MDF; Modelling, Evidence and Policy Research Group, School of Natural and Environmental Science, Newcastle University, Newcastle upon Tyne, NE1 7RU, UK., Blain AP; Modelling, Evidence and Policy Research Group, School of Natural and Environmental Science, Newcastle University, Newcastle upon Tyne, NE1 7RU, UK., Lake I; School of Environmental Sciences, University of East Anglia, Norwich, NR4 7TJ, UK., Maas JA; Norwich Medical School, University of East Anglia, Norwich 33, NR4 7TJ, UK., Reid WDK; Ecology Research Group, School of Natural and Environmental Science, Newcastle University, Newcastle upon Tyne, NE1 7RU, UK., Hardstaff J; Institute of Psychology, Health and Society, University of Liverpool, Liverpool, L69 3BX, UK., Williams N; Institute of Infection and Global Health, Liverpool University, Liverpool, L69 7BE, UK., Jones NR; School of Environmental Sciences, University of East Anglia, Norwich, NR4 7TJ, UK., Rigby D; School of Social Sciences, The University of Manchester, Manchester, M13 9PL, UK., Strachan NJC; School of Natural and Computing Sciences/Food Standards Agency Scotland, University of Aberdeen, Aberdeen, AB24 3FX, UK., Forbes KJ; School of Medicine, Medical Sciences and Nutrition, University of Aberdeen, Aberdeen, AB25 2ZD, UK., Hunter PR; Norwich Medical School, University of East Anglia, Norwich 33, NR4 7TJ, UK.; NIHR Health Protection Research Unit in Gastrointestinal Infections, University of Liverpool, Liverpool, UK., Humphrey TJ; School of Medicine, Swansea University, Swansea, SA2 8PP, UK., O'Brien SJ; Institute of Infection and Global Health, Liverpool University, Liverpool, L69 7BE, UK.; NIHR Health Protection Research Unit in Gastrointestinal Infections, University of Liverpool, Liverpool, UK.
Jazyk: angličtina
Zdroj: Journal of translational medicine [J Transl Med] 2019 Jan 21; Vol. 17 (1), pp. 34. Date of Electronic Publication: 2019 Jan 21.
DOI: 10.1186/s12967-019-1781-y
Abstrakt: Background: With over 800 million cases globally, campylobacteriosis is a major cause of food borne disease. In temperate climates incidence is highly seasonal but the underlying mechanisms are poorly understood, making human disease control difficult. We hypothesised that observed disease patterns reflect complex interactions between weather, patterns of human risk behaviour, immune status and level of food contamination. Only by understanding these can we find effective interventions.
Methods: We analysed trends in human Campylobacter cases in NE England from 2004 to 2009, investigating the associations between different risk factors and disease using time-series models. We then developed an individual-based (IB) model of risk behaviour, human immunological responses to infection and environmental contamination driven by weather and land use. We parameterised the IB model for NE England and compared outputs to observed numbers of reported cases each month in the population in 2004-2009. Finally, we used it to investigate different community level disease reduction strategies.
Results: Risk behaviours like countryside visits (t = 3.665, P < 0.001 and t = - 2.187, P = 0.029 for temperature and rainfall respectively), and consumption of barbecued food were strongly associated with weather, (t = 3.219, P = 0.002 and t = 2.015, P = 0.045 for weekly average temperature and average maximum temperature respectively) and also rain (t = 2.254, P = 0.02527). This suggests that the effect of weather was indirect, acting through changes in risk behaviour. The seasonal pattern of cases predicted by the IB model was significantly related to observed patterns (r = 0.72, P < 0.001) indicating that simulating risk behaviour could produce the observed seasonal patterns of cases. A vaccination strategy providing short-term immunity was more effective than educational interventions to modify human risk behaviour. Extending immunity to 1 year from 20 days reduced disease burden by an order of magnitude (from 2412-2414 to 203-309 cases per 50,000 person-years).
Conclusions: This is the first interdisciplinary study to integrate environment, risk behaviour, socio-demographics and immunology to model Campylobacter infection, including pathways to mitigation. We conclude that vaccination is likely to be the best route for intervening against campylobacteriosis despite the technical problems associated with understanding both the underlying human immunology and genetic variation in the pathogen, and the likely cost of vaccine development.
Databáze: MEDLINE
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