Abstract
Preventing and controlling zoonoses through the design and implementation of public health policies requires a thorough understanding of transmission pathways. Modelling jointly the epidemiological data and genetic information of microbial isolates derived from cases provides a methodology for tracing back the source of infection. In this paper, the attribution probability for human cases of campylobacteriosis for each source, conditional on the extent to which each case resides in a rural compared to urban environment, is estimated. A model that incorporates genetic data and evolutionary processes is applied alongside a newly developed genetic-free model. We show that inference from each model is comparable except for rare microbial genotypes. Further, the effect of ‘rurality’ may be modelled linearly on the logit scale, with increasing rurality leading to the increasing likelihood of ruminant-sourced campylobacteriosis.
Highlights
Modelling of disease surveillance data to explore patterns of infectious diseases has had a long history in public health
For the Dirichlet and asymmetric Island models, the linear and categorical models of rurality show broadly the same trend, suggesting that the additional flexibility given by the categorical model is not required and that the shift in attribution as rurality changes is adequately modelled by a linear trend on the logit scale
There are some small differences between the genotype models, with the Dirichlet model showing a greater attribution to poultry than the asymmetric Island model
Summary
Modelling of disease surveillance data to explore patterns of infectious diseases has had a long history in public health. The annual number of global deaths caused by infections has levelled off at approximate 15 million and may remain at this level for the three decades [1,2]. In order for such an enormous health burden to be reduced, preventing and controlling infectious diseases becomes extraordinarily important, and our ability to intervene depends on how much we know about the nature of disease transmission. Transmission to humans from animal reservoirs may be complex, involving many sources and exposures linked by different pathways, via food, water, through environmental contamination or direct contact with animals. Tracing the source of infection becomes crucial to increasing the ability to implement risk management and intervention [4,5]
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