Modern Infectious Disease Epidemiology: Concepts, Methods, Mathematical Models, and Public Health

441 Pages·2010·10.31 MB·English

by  Paulo Pinheiro

Statistics for Biology and Health
SeriesEditors:
M.Gail
K.Krickeberg
J.M.Samet
A.Tsiatis
W.Wong
Forothertitlespublishedinthisseries,goto
http://www.springer.com/series/2848
· ·
Alexander Krämer Mirjam Kretzschmar
Klaus Krickeberg
Editors
Modern Infectious
Disease Epidemiology
Concepts, Methods, Mathematical Models,
and Public Health
123
Editors
AlexanderKrämer MirjamKretzschmar
UniversitätBielefeldFak. UniversityMedicalCenterUtrecht
Gesundheitswissenschaften JuliusCenterforHealth
Universitätsstr.25 Sciences&PrimaryCare
33615Bielefeld Heidelberglaan100
Germany 3584CXUtrecht
[email protected] TheNetherlands
[email protected]
KlausKrickeberg
LeChâtelet
F-63270Manglieu
France
[email protected]
StatisticsforBiologyandHealthSeriesEditors
M.Gail A.Tsiatis
NationalCancerInstitute DepartmentofStatistics
Bethesda,MD20892 NorthCarolinaStateUniversity
USA Raleigh,NC27695
USA
KlausKrickeberg
LeChâtelet W.Wong
F-63270Manglieu DepartmentofStatistics
France StanfordUniversity
Stanford,CA94305-4065
JonathanM.Samet
USA
DepartmentofPreventiveMedicine
KeckSchoolofMedicine
UniversityofSouthernCalifornia
1441EastlakeAve.Room4436,MC9175
LosAngles,CA90089
ISSN1431-8776
ISBN978-0-387-93834-9 e-ISBN978-0-387-93835-6
DOI10.1007/978-0-387-93835-6
SpringerNewYorkDordrechtHeidelbergLondon
LibraryofCongressControlNumber:2009939504
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Foreword
Infectious diseases have been, alongside cardiovascular diseases and cancer, the
mainthreattohumanhealth.Acuteandchronicrespiratorydiseases,especiallypul-
monary tuberculosis, but also malaria, AIDS and acute infections of the digestive
tractareresponsibleforalargeportionofmortality,bothindevelopinganddevel-
oped countries. Moreover, the role of infectious agents in the genesis of various
severe ailments, such as cardiovascular diseases, certain carcinomas and stomach
ulcers,ismoreandmorebeingbroughttolight.
Fighting infectious diseases has many aspects – all of them characterized by
theirdynamicnature.First,infectionstravel.Theplaguedidsoextensivelyalready
in the Middle Ages and up to the end of the nineteenth century. The Spanish flu
at the end of World War I cost the lives of several million people all over the
world.Atpresent,highmobilityofpeoplethroughtravelandmigrationandanever-
increasingexchangeofgoodsaredrivingtherapidspreadofinfectionsaroundthe
world. The first aspect of the fight against these infections is, therefore, what is
commonly called “epidemic control”. This means fast information on new cases,
on incidences and mortalities, on strains and transmission routes of the infectious
pathogen, if possible centralized in a supranational institution such as the World
HealthOrganization(WHO).Italsomeansmakingrapiddecisionsonintervention
and treatment strategies, for example, isolation and prophylaxis or treatment with
antivirals,forexample,stockpilingdrugs.Theefficacy ofmodernmethods ofepi-
demiccontrolwasdemonstratedduringrecentlyemergingdiseaseslikethebovine
spongiform encephalopathy (mad cow disease), the severe acute respiratory syn-
drome (SARS) and avian influenza (A|H N ), which finally did not reach large
5 1
proportionsofthepopulation,especiallycomparedtothediseasesmentionedinthe
beginning.ItistobehopedthatA|H N canalsobecontainedbyrigorouscontrol.
1 1
Asecondaspectofthefightagainstinfectiousdiseasesisthechangingenviron-
mentinwhichdiseasetransmissionistakingplace.Thetransmissionofaninfection
in a community or between communities is influenced by many characteristics of
modernsocietiessuchasgrowingurbanizationaccompaniedbychangingstructures
ofcitiesaswellasofthecountryside,differenthousingconditions,growingsocial
inequalities that imply growing health inequalities, pollution and malnutrition that
may weaken the immune system, and consequences of climate change. Classical
v
vi Foreword
hygiene,bothpublicandpersonal,stillplaysapivotalroleinenvironmentalpreven-
tion,butneedstobecomplementedbymeasuresthatrespondtotheaforementioned
factors.
A third aspect of dealing with infectious diseases is large-scale primary pre-
vention, of which immunization is by far the most important tool. Starting with
vaccination against smallpox, this public health measure has helped to reduce the
burden of vaccine-preventable infections enormously. In many scientific studies,
both the effectiveness and possible adverse effects of large-scale immunizations
havebeeninvestigated.
However, fighting infectious diseases is like shooting at a moving target.
Pathogensarecontinuouslyevolving,amongothersunderthepressureoflarge-scale
infection control measures like antibiotic treatment and vaccination. This aspect
generatesrenewedchallengestoinfectiousdiseasecontrolandcreatestheneedfor
continued efforts in the development of monitoring and control. While antibiotic
andantiviralresistancehaveemergedandledtoincreasingproblemsinthecontrol
of infections like tuberculosis and hospital infections around the world, molecu-
larbiologyandbioinformaticshave,ontheotherhand,provideduswithtoolsthat
allow increasingly detailed insight into the transmission patterns and dynamics of
pathogens.Molecularsequencingincombinationwithepidemiologicalstudieshas
elucidatedtransmissionroutesamongindividuals,riskgroupsandpopulations.
Thesuccessfulimplementationofinfectiousdiseasecontroldependscritically,if
not predominantly, on thorough knowledge of epidemiologic facts. Epidemic con-
trolisbasedonsurveillanceanddetailedknowledgeofthepathsoftransmissionin
a population. Environmental prevention rests on epidemiological studies of envi-
ronmental risk factors. The planning and monitoring of immunization measures
requires a deep understanding of their mechanisms and effects on transmission
dynamics in a given community. Mathematical modelling is employed to com-
puteandestimateparametersthatareimportantforunderstandingthetransmission
dynamics. Mathematical modelling can be used to simulate outbreaks and to
assess the effectiveness of different prevention and intervention strategies. Results
from modelling studies help with interpreting epidemiological data and support
evidence-baseddecisionsfortargetinginterventionsforeffectivediseasecontrol.
Theaimofourbookistopresentthereaderwithageneralpictureandthemain
ideas of the subject. We do not aim at covering the complete field of infectious
diseaseepidemiology,butmoretointroducethereadertodifferentmethodological
aspects of epidemiology that are specific for infectious diseases. Furthermore, we
giveinsightintotheepidemiologyofsomeclassesofinfectiousdiseasescharacter-
ized by their main modes of transmission. With this choice of topics we hope to
bridgethegapbetweenscientificresearchontheclinical,biological,mathematical,
socialandeconomic aspectsofinfectiousdiseasesandtheirapplications inpublic
health. We would like the reader to understand the impact of infectious diseases
on modern society and the instruments that policy makers have at their disposal
to deal with these challenges. Hardly a day goes by without news headlines con-
cerninginfectiousdiseasecontrol.Atthetimeofwritingtheselines,thespectreof
a pandemic of influenza A|H N is raising its head and containment seems a lost
1 1
Foreword vii
cause. At the same time, heated debates are taking place in many societies about
the pros and cons of vaccinating young girls against human papillomavirus, while
intheNetherlandsoneofthelargestoutbreaksofQfevereverobservedinhumans
is unfolding. It seems as if the momentum of the challenges posed by infectious
diseases to our ability to control them is increasing rather than decreasing, maybe
duetotheincreasingpaceofchangesinhumansocietiesandtheirnaturalenviron-
ments. In order to meet these challenges we need solid scientific knowledge and
an understanding of all aspects of infectious diseases and their controls. With this
bookwehopetoprovidethereaderwiththebasicgroundworkforthisknowledge
andunderstanding.Wehopethatitwillcontributetoanevidence-basedandrespon-
sible communication of infectious disease topics to avoid misunderstandings and
overreactionofthepublic.
Thebookiswrittenforstudentsofthehealthsciences,bothofcurativemedicine
andpublichealth,andforexpertsthatareactiveintheseandrelateddomains.Itmay
alsobeofinterestfortheeducatedlaymansincethetechnicalleveliskeptrelatively
low. It has evolved from a rich experience of continuous teaching and research in
manyplaces,butparticularlyattheSchoolofPublicHealthofBielefeldUniversity,
Germany, where an international summer school in our field has been held every
year since 1999. We hope that it will fill a gap and prove useful by “infecting”
the reader with fascination for the features and the dynamics of infectious disease
epidemiology.
The first two parts of the text are general, treating the background and general
methods for studying infectious diseases, while the third part deals with specific
transmissionroutesandrelatedinfectiousdiseases.
Acknowledgements
WewouldliketothankthedoctoralstudentArinaZanuzdanafromtheDepartment
ofPublicHealthMedicineoftheSchoolofPublicHealth,BielefeldUniversityfor
her great engagement as technical editor, Mrs. Regine Myska for her secretarial
assistance,andErichWehmeyerforhishelpinimprovingtheEnglishlanguageof
the chapters. In addition, we are indebted to the many critical comments of our
students and colleagues that will hopefully continue to improve the quality of our
bookinfutureeditions.
Bielefeld,Germany AlexanderKrämer
Utrecht,TheNetherlands MirjamKretzschmar
LeChâtelet(Manglieu),France KlausKrickeberg
ix
Contents
PartI Challenges
1 TheGlobalBurdenofInfectiousDiseases . . . . . . . . . . . . . . 3
PauloPinheiro,ColinD.Mathers,andAlexanderKrämer
2 GlobalChallengesofInfectiousDiseaseEpidemiology . . . . . . . 23
AlexanderKrämerandMd.MobarakHossainKhan
3 EmergingandRe-emergingInfectiousDiseases . . . . . . . . . . 39
ThomasLöscherandLuisePrüfer-Krämer
4 Infectious Disease Control Policies and the Role
ofGovernmentalandIntergovernmentalOrganisations . . . . . . 69
GérardKrause
PartII GeneralConceptsandMethods
5 PrinciplesofInfectiousDiseaseEpidemiology . . . . . . . . . . . 85
AlexanderKrämer,ManasAkmatov,andMirjamKretzschmar
6 SocialRiskFactors . . . . . . . . . . . . . . . . . . . . . . . . . . 101
KlausKrickebergandDavidKlemperer
7 Molecular Typing and Clustering Analysis as a Tool
forEpidemiologyofInfectiousDiseases . . . . . . . . . . . . . . . 117
SylviaM.BruistenandLeoSchouls
8 EpidemiologicSurveillance . . . . . . . . . . . . . . . . . . . . . . 143
RalfReintjesandKlausKrickeberg
9 OutbreakInvestigations . . . . . . . . . . . . . . . . . . . . . . . 159
RalfReintjesandAryna Zanuzdana
10 GeographicInformationSystems . . . . . . . . . . . . . . . . . . 177
PatrickHostertandOliverGruebner
11 MethodsandConceptsofEpidemiology . . . . . . . . . . . . . . 193
RafaelMikolajczyk
xi
xii Contents
12 MathematicalModelsinInfectiousDiseaseEpidemiology . . . . . 209
MirjamKretzschmarandJaccoWallinga
13 ImmunitytoInfectiousDiseases . . . . . . . . . . . . . . . . . . . 223
TimoUlrichs
14 PrinciplesandPracticeofVaccinology . . . . . . . . . . . . . . . 235
RichardPebodyandMirjamKretzschmar
15 HealthEconomicsofInfectiousDiseases . . . . . . . . . . . . . . 249
RobertWelte,ReinerLeidl,WolfgangGreiner,
andMaartenPostma
PartIII EpidemiologyofParticularInfectiousDiseases
16 AirborneTransmission:InfluenzaandTuberculosis . . . . . . . . 279
TimoUlrichs
17 InfectiousChildhoodDiarrheainDevelopingCountries . . . . . . 291
CharlesP.Larson,LarsHenning,StephenLuby,
andASGFaruque
18 BloodborneandSexualTransmission:HIV/AIDS . . . . . . . . . 309
CharlottevandenBerg,KarenLindenburg,andRoelCoutinho
19 BloodBorneandSexualTransmission:HepatitisBandC. . . . . 333
FrekeZuure,SusanHahné,ThijsvandeLaar,
MariaPrins,andJimvanSteenbergen
20 SexualTransmission:Chlamydiatrachomatis . . . . . . . . . . . . 357
RobertE.JohnsonandStuartM.Berman
21 Vector-BorneTransmission:Malaria,Dengue,andYellowFever . 381
TomasJelinek
22 Nosocomial Transmission: Methicillin-Resistant
Staphylococcusaureus(MRSA) . . . . . . . . . . . . . . . . . . . 395
M.J.M.BontenandM.C.J.Bootsma
23 InfectiousDiseasesandCancer:HPV . . . . . . . . . . . . . . . . 409
HelenTrottierandEduardoL.Franco
Index . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 431