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James M. McCaw

Publications and source records attributed to James M. McCaw.

At least 19 recordsLinked to original sources

On-farm management strategies for reducing H5N1 transmission in dairy cattle

Introductions of H5N1 clade 2.3.4.4b into dairy cattle have resulted in outbreaks on dairy farms across the United States since early-2024. Outbreaks have significant consequences for animal health, result in economic losses for the dairy industry, and pose a threat to human health. Though the relative contributions of different on-farm transmission pathways remain a key uncertainty, a major route is considered to be through repeated contamination of milking stalls (i.e. the equipment and area where an individual cow is milked) due to the milking of infected animals. Here we develop mathematical models of H5N1 transmission dynamics on dairy farms, considering multiple possible transmission pathways, and identify factors that contribute to outbreak risk and on-farm interventions for mitigating risk. In particular, we demonstrate that dividing cattle into 'milking cohorts', with cohorts kept in separate pens or paddocks and milked in the same order every day, would be highly effective at mitigating outbreaks irrespective of the dominant transmission pathway. Cohorting cattle is most effective when implemented pre-emptively (i.e. before an outbreak) and when newly introduced cattle are kept in the final milking cohort. Additionally, we demonstrate that frequent bulk milk sample testing (e.g. weekly) would enable the rapid detection of outbreaks and implementation of reactive interventions (or scaling up of existing interventions). Our findings can support the development of management guidelines for effectively responding to H5N1 outbreaks in dairy cattle.

q-bio.PE

Incorporating vaccine effects into epidemiological models: common pitfalls and solutions

Incorporating vaccination into mathematical models appears deceptively simple: models integrate vaccine-derived protections, such as reduced susceptibility to infection, using parameters informed by empirical estimates of vaccine efficacy or effectiveness (VE). In practice, however, empirical VE estimates often do not correspond directly to the parameters of epidemiological models. Here, we extend previous work to demonstrate that in order to accurately parameterize a model, one must consider both a vaccine's mechanism of action and the statistic used to infer VE from empirical data. When a vaccine confers leaky protection -- that is, vaccination partially rather than completely reduces individual infection risk -- we show that common empirical VE estimation methods do not provide directly applicable values for model parameters. Naive (i.e. direct) incorporation of these VE estimates into models results in an underestimate of population-level vaccine impact. To make progress when these estimates are the only available sources for VE, we introduce a parameterization approach which more accurately aligns the modeled effect of vaccination with empirical estimates. Under this adjusted parameterization approach, models predict fewer total infections and lower herd immunity thresholds for leaky vaccines than would be predicted under current parameterization practices. Our parameterization guidelines and adjustment approach can be used to improve accuracy in models that are used in vaccine decision making and public health planning.

q-bio.PE

How complex behavioural contagion can prevent infectious diseases from becoming endemic

Infectious disease transmission in human populations has a complex two-way interaction with changes in host behaviour. It is increasingly recognised that incorporating adaptive behavioural change into epidemic models is important for improving understanding of infectious disease dynamics and developing policy-relevant modelling tools. An important aspect of behavioural dynamics is social contagion, where people tend to adopt behaviours exhibited by others around them. In a simple behavioural contagion model, the behaviour uptake rate increases linearly with the number of contacts who have adopted a given behaviour. Here, we explore an epidemic model with complex behavioural contagion, where the behaviour uptake rate is a nonlinear function of the number of behaving contacts. We identify key bifurcation parameters of the model, which include the basic reproduction number $R_0$, the strength of the behavioural effect on disease transmission, and the speed of behaviour uptake relative to behaviour abandonment. We show that, in some regions of parameter space, the model has multiple disease-free equilibria. In this situation, the occurrence of an epidemic in a population with an initially low level of behaviour practice can trigger a self-sustaining increase in behaviour, which then causes the disease to be eliminated. In some cases, while moderate values of $R_0$ lead to the disease becoming endemic, higher values of $R_0$ may lead to behaviour-driven disease elimination. We demonstrate that this mechanism of epidemic-triggered uptake of behaviour leading to disease elimination can occur in the presence and absence of temporary post-infection immunity.

q-bio.PE

Spatially-Structured Models of Viral Dynamics: A Scoping Review

There is growing recognition in both the experimental and modelling literature of the importance of spatial structure to the dynamics of viral infections in tissues. Aided by the evolution of computing power and motivated by recent biological insights, there has been an explosion of new, spatially-explicit models for within-host viral dynamics in recent years. This development has only been accelerated in the wake of the COVID-19 pandemic. Spatially-structured models offer improved biological realism and can account for dynamics which cannot be well-described by conventional, mean-field approaches. However, despite their growing popularity, spatially-structured models of viral dynamics are underused in biological applications. One major obstacle to the wider application of such models is the huge variety in approaches taken, with little consensus as to which features should be included and how they should be implemented for a given biological context. Previous reviews of the field have focused on specific modelling frameworks or on models for particular viral species. Here, we instead apply a scoping review approach to the literature of spatially-structured viral dynamics models as a whole to provide an exhaustive update of the state of the field. Our analysis is structured along two axes, methodology and viral species, in order to examine the breadth of techniques used and the requirements of different biological applications. We then discuss the contributions of mathematical and computational modelling to our understanding of key spatially-structured aspects of viral dynamics, and suggest key themes for future model development to improve robustness and biological utility.

q-bio.QM

Accounting for the geometry of the respiratory tract in viral infections

Increasingly, experimentalists and modellers alike have come to recognise the important role of spatial structure in infection dynamics. Almost invariably, spatial computational models of viral infections - as with in vitro experimental systems - represent the tissue as wide and flat, which is often assumed to be representative of entire affected tissue within the host. However, this assumption fails to take into account the distinctive geometry of the respiratory tract in the context of viral infections. The respiratory tract is characterised by a tubular, branching structure, and moreover is spatially heterogeneous: deeper regions of the lung are composed of far narrower airways and are associated with more severe infection. Here, we extend a typical multicellular model of viral dynamics to account for two essential features of the geometry of the respiratory tract: the tubular structure of airways, and the branching process between airway generations. We show that, with this more realistic tissue geometry, the dynamics of infection are substantially changed compared to standard computational and experimental approaches, and that the resulting model is equipped to tackle important biological phenomena that do not arise in a flat host tissue, including viral lineage dynamics, and heterogeneity in immune responses to infection in different regions of the respiratory tree. Our findings suggest aspects of viral dynamics which current in vitro systems may be insufficient to describe, and point to several features of respiratory infections which can be experimentally assessed.

q-bio.QM

Should public health policy exempt cases with low viral load from isolation during an epidemic?: a modelling study

During the COVID-19 pandemic, case isolation emerged as a key non-pharmaceutical intervention in pandemic response. Its effectiveness hinges on the timing of isolation, which is often dictated by the onset of contagiousness. While minimizing isolation delays is crucial, the impact of evolving epidemic dynamics, such as changes in viral load distributions among cases, is less understood. These dynamics could inform more efficient isolation strategies. We developed a multi-scale agent-based model to assess isolation policies that consider viral loads. Our model compares the outcomes of universal isolation with strategies that exempt low viral load cases post-peak. We found that most low viral load cases identified after the peak are less contagious, raising the question of their need for isolation. Our analysis reveals that exempting these individuals slightly increases new infections and, unexpectedly, reduces efficiency, defined as infections averted per isolation. These results advise caution with adaptive isolation policies. Our flexible model can evaluate complex strategies, aiding future public health planning.

q-bio.PE

Investigation of P. Vivax Elimination via Mass Drug Administration

Plasmodium vivax is the most geographically widespread malaria parasite due to its ability to remain dormant (as a hypnozoite) in the human liver and subsequently reactivate. Given the majority of P. vivax infections are due to hypnozoite reactivation, targeting the hypnozoite reservoir with a radical cure is crucial for achieving P. vivax elimination. Stochastic effects can strongly influence dynamics when disease prevalence is low or when the population size is small. Hence, it is important to account for this when modelling malaria elimination.cWe use a stochastic multiscale model of P. vivax transmission to study the impacts of multiple rounds of mass drug administration (MDA) with a radical cure, accounting for superinfection and hypnozoite dynamics. Our results indicate multiple rounds of MDA with a high-efficacy drug are needed to achieve a substantial probability of elimination. This work has the potential to help guide P. vivax elimination strategies by quantifying elimination probabilities for an MDA approach.

q-bio.PE

Spatial information allows inference of the prevalence of direct cell-to-cell viral infection

The role of direct cell-to-cell spread in viral infections - where virions spread between host and susceptible cells without needing to be secreted into the extracellular environment - has come to be understood as essential to the dynamics of medically significant viruses like hepatitis C and influenza. Recent work in both the experimental and mathematical modelling literature has attempted to quantify the prevalence of cell-to-cell infection compared to the conventional free virus route using a variety of methods and experimental data. However, estimates are subject to significant uncertainty and moreover rely on data collected by inhibiting one mode of infection by either chemical or physical factors, which may influence the other mode of infection to an extent which is difficult to quantify. In this work, we conduct a simulation-estimation study to probe the practical identifiability of the proportion of cell-to-cell infection, using two standard mathematical models and synthetic data that would likely be realistic to obtain in the laboratory. We show that this quantity cannot be estimated using non-spatial data alone, and that the collection of a data which describes the spatial structure of the infection is necessary to infer the proportion of cell-to-cell infection. Our results provide guidance for the design of relevant experiments and mathematical tools for accurately inferring the prevalence of cell-to-cell infection in $\textit{in vitro}$ and $\textit{in vivo}$ contexts.

q-bio.QM

Mathematical models of Plasmodium vivax transmission: a scoping review

Plasmodium vivax is one of the most geographically widespread malaria parasites in the world due to its ability to remain dormant in the human liver as hypnozoites and subsequently reactivate after the initial infection (i.e. relapse infections). More than 80% of P. vivax infections are due to hypnozoite reactivation. Mathematical modelling approaches have been widely applied to understand P. vivax dynamics and predict the impact of intervention outcomes. In this article, we provide a scoping review of mathematical models that capture P. vivax transmission dynamics published between January 1988 and May 2023 to provide a comprehensive summary of the mathematical models and techniques used to model P. vivax dynamics. We aim to assist researchers working on P. vivax transmission and other aspects of P. vivax malaria by highlighting best practices in currently published models and highlighting where future model development is required. We provide an overview of the different strategies used to incorporate the parasite's biology, use of multiple scales (within-host and population-level), superinfection, immunity, and treatment interventions. In most of the published literature, the rationale for different modelling approaches was driven by the research question at hand. Some models focus on the parasites' complicated biology, while others incorporate simplified assumptions to avoid model complexity. Overall, the existing literature on mathematical models for P. vivax encompasses various aspects of the parasite's dynamics. We recommend that future research should focus on refining how key aspects of P. vivax dynamics are modelled, including spatial heterogeneity in exposure risk, the accumulation of hypnozoite variation, the interaction between P. falciparum and P. vivax, acquisition of immunity, and recovery under superinfection.

q-bio.PE

Superinfection and the hypnozoite reservoir for Plasmodium vivax: a general framework

Malaria is a parasitic disease, transmitted by mosquito vectors. Plasmodium vivax presents particular challenges for disease control, in light of an undetectable reservoir of latent parasites (hypnozoites) within the host liver. Superinfection, which is driven by temporally proximate mosquito inoculation and/or hypnozoite activation events, is an important feature of P. vivax. Here, we present a model of hypnozoite accrual and superinfection for P. vivax. To couple host and vector dynamics, we construct a density-dependent Markov population process with countably many types, for which disease extinction is shown to occur almost surely. We also establish a functional law of large numbers, taking the form of an infinite-dimensional system of ordinary differential equations that can also be recovered under the hybrid approximation or a standard compartment modelling approach. Recognising that the subset of these equations that models the infection status of human hosts has precisely the same form as the Kolmogorov forward equations for a Markovian network of infinite server queues with an inhomogeneous batch arrival process, we use physical insight into the evolution of the latter to write down a time-dependent multivariate generating function for the solution. We use this characterisation to collapse the infinite-compartment model into a single integrodifferential equation (IDE) governing the intensity of mosquito-to-human transmission. Through a steady state analysis, we recover a threshold phenomenon for this IDE in terms of a bifurcation parameter $R_0$, with the disease-free equilibrium shown to be uniformly asymptotically stable if $R_0<1$ and an endemic equilibrium solution emerging if $R_0>1$. Our work provides a theoretical basis to explore the epidemiology of P. vivax, and introduces a general strategy for constructing tractable population-level models of malarial superinfection.

q-bio.PE

The role of the mathematical sciences in supporting the COVID-19 response in Australia and New Zealand

Mathematical modelling has been used to support the response to the COVID-19 pandemic in countries around the world including Australia and New Zealand. Both these countries have followed similar pandemic response strategies, using a combination of strict border measures and community interventions to minimise infection rates until high vaccine coverage was achieved. This required a different set of modelling tools to those used in countries that experienced much higher levels of prevalence throughout the pandemic. In this article, we provide an overview of some of the mathematical modelling and data analytics work that has helped to inform the policy response to the pandemic in Australia and New Zealand. This is a reflection on our experiences working at the modelling-policy interface and the impact this has had on the pandemic response. We outline the various types of model outputs, from short-term forecasts to longer-term scenario models, that have been used in different contexts. We discuss issues relating to communication between mathematical modellers and stakeholders such as health officials and policymakers. We conclude with some future challenges and opportunities in this area.

physics.soc-ph

Key challenges for the surveillance of respiratory viruses: transitioning out of the acute phase of the SARS-CoV-2 pandemic

To support the ongoing management of viral respiratory diseases, many countries are moving towards an integrated model of surveillance for SARS-CoV-2, influenza, and other respiratory pathogens. While many surveillance approaches catalysed by the COVID-19 pandemic provide novel epidemiological insight, continuing them as implemented during the pandemic is unlikely to be feasible for non-emergency surveillance, and many have already been scaled back. Furthermore, given anticipated co-circulation of SARS-CoV-2 and influenza, surveillance activities in place prior to the pandemic require review and adjustment to ensure their ongoing value for public health. In this perspective, we highlight key challenges for the development of integrated models of surveillance. We discuss the relative strengths and limitations of different surveillance practices and studies, their contribution to epidemiological assessment, forecasting, and public health decision making.

physics.soc-ph

Optimal interruption of P. vivax malaria transmission using mass drug administration

\textit{Plasmodium vivax} is the most geographically widespread malaria-causing parasite resulting in significant associated global morbidity and mortality. One of the factors driving this widespread phenomenon is the ability of the parasites to remain dormant in the liver. Known as hypnozoites, they reside in the liver following an initial exposure, before activating later to cause further infections, referred to as relapses. As around 79-96$\%$ of infections are attributed to relapses, we expect it will be highly impactful to apply treatment to target the hypnozoite reservoir to eliminate \textit{P. vivax}. Treatment with a radical cure to target the hypnozoite reservoir is a potential tool to control or eliminate \textit{P. vivax}. We have developed a multiscale mathematical model as a system of integro-differential equations that captures the complex dynamics of \textit{P. vivax} hypnozoites and the effect of hypnozoite relapse on disease transmission. Here, we use our model to study the anticipated effect of radical cure treatment administered via a mass drug administration (MDA) program. We implement multiple rounds of MDA with a fixed interval between rounds, starting from different steady-state disease prevalences. We then construct an optimisation model to obtain the optimal MDA interval. We also incorporate mosquito seasonality in our model to study its effect on the optimal treatment regime. We find that the effect of MDA interventions is temporary and depends on the pre-intervention disease prevalence (and choice of model parameters) as well as the number of MDA rounds under consideration. We find radical cure alone may not be enough to lead to \textit{P. vivax} elimination under our mathematical model (and choice of model parameters) since the prevalence of infection eventually returns to pre-MDA levels.

q-bio.PE

A hybrid transmission model for Plasmodium vivax accounting for superinfection, immunity and the hypnozoite reservoir

Malaria is a vector-borne disease that exacts a grave toll in the Global South. The epidemiology of Plasmodium vivax, the most geographically expansive agent of human malaria, is characterised by the accrual of a reservoir of dormant parasites known as hypnozoites. Relapses, arising from hypnozoite activation events, comprise the majority of the blood-stage infection burden, with implications for the acquisition of immunity and the distribution of superinfection. Here, we construct a hybrid transmission model for P. vivax that concurrently accounts for the accrual of the hypnozoite reservoir, (blood-stage) superinfection and the acquisition of immunity. We begin by analytically characterising within-host dynamics as a function of mosquito-to-human transmission intensity, extending our previous model (comprising an open network of infinite server queues) to capture a discretised immunity level. To model transmission-blocking and antidisease immunity, we allow for geometric decay in the respective probabilities of successful human-to-mosquito transmission and symptomatic blood-stage infection as a function of this immunity level. Under a hybrid approximation -- whereby probabilistic within-host distributions are cast as expected population-level proportions -- we couple host and vector dynamics to recover a deterministic compartmental model in line with Ross-Macdonald theory. We then perform a steady-state analysis for this compartmental model, informed by the (analytic) distributions derived at the within-host level. To characterise transient dynamics, we derive a reduced system of integrodifferential equations (IDEs), likewise informed by our within-host queueing network, allowing us to recover population-level distributions for various quantities of epidemiological interest. Our model provides insights into important, but poorly understood, epidemiological features of P. vivax.

q-bio.PE

A model for malaria treatment evaluation in the presence of multiple species

Plasmodium (P.) falciparum and P. vivax are the two most common causes of malaria. While the majority of deaths and severe morbidity are due to P. falciparum, P. vivax poses a greater challenge to eliminating malaria outside of Africa due to its ability to form latent liver stage parasites (hypnozoites), which can cause relapsing episodes within an individual patient. In areas where P. falciparum and P. vivax are co-endemic, individuals can carry parasites of both species simultaneously. These mixed infections complicate dynamics in several ways; treatment of mixed infections will simultaneously affect both species, P. falciparum can mask the detection of P. vivax, and it has been hypothesised that clearing P. falciparum may trigger a relapse of dormant P. vivax. When mixed infections are treated for only blood-stage parasites, patients are at risk of relapse infections due to P. vivax hypnozoites. We present a stochastic mathematical model that captures interactions between P. falciparum and P. vivax, and incorporates both standard schizontocidal treatment (which targets blood-stage parasites) and radical treatment (which additionally targets liver-stage parasites). We apply this model to assess the implications of different treatment coverage of radical cure for mixed and P. vivax infections and a so-called "unified radical cure" treatment strategy for P. falciparum, P. vivax and mixed infections. We find that a unified radical cure strategy, with G6PD screening, leads to a substantially lower incidence of malaria cases and deaths overall. We perform a one-way sensitivity analysis to highlight important model parameters.

q-bio.PE

From climate change to pandemics: decision science can help scientists have impact

Scientific knowledge and advances are a cornerstone of modern society. They improve our understanding of the world we live in and help us navigate global challenges including emerging infectious diseases, climate change and the biodiversity crisis. For any scientist, whether they work primarily in fundamental knowledge generation or in the applied sciences, it is important to understand how science fits into a decision-making framework. Decision science is a field that aims to pinpoint evidence-based management strategies. It provides a framework for scientists to directly impact decisions or to understand how their work will fit into a decision process. Decision science is more than undertaking targeted and relevant scientific research or providing tools to assist policy makers; it is an approach to problem formulation, bringing together mathematical modelling, stakeholder values and logistical constraints to support decision making. In this paper we describe decision science, its use in different contexts, and highlight current gaps in methodology and application. The COVID-19 pandemic has thrust mathematical models into the public spotlight, but it is one of innumerable examples in which modelling informs decision making. Other examples include models of storm systems (eg. cyclones, hurricanes) and climate change. Although the decision timescale in these examples differs enormously (from hours to decades), the underlying decision science approach is common across all problems. Bridging communication gaps between different groups is one of the greatest challenges for scientists. However, by better understanding and engaging with the decision-making processes, scientists will have greater impact and make stronger contributions to important societal problems.

cs.CY

Hypnozoite dynamics for Plasmodium vivax malaria: the epidemiological effects of radical cure

Malaria is a mosquito-borne disease with a devastating global impact. Plasmodium vivax is a major cause of human malaria beyond sub-Saharan Africa. Relapsing infections, driven by a reservoir of liver-stage parasites known as hypnozoites, present unique challenges for the control of P. vivax malaria. Following indeterminate dormancy periods, hypnozoites may activate to trigger relapses. Clearance of the hypnozoite reservoir through drug treatment (radical cure) has been proposed as a potential tool for the elimination of P. vivax malaria. Here, we introduce a stochastic, within-host model to jointly characterise hypnozoite and infection dynamics for an individual in a general transmission setting, allowing for radical cure. We begin by extending an existing activation-clearance model for a single hypnozoite, adapted to both short- and long-latency strains, to include drug treatment. We then embed this activation-clearance model in an epidemiological framework accounting for repeated mosquito inoculation and the administration of radical cure. By constructing an open network of infinite server queues, we derive analytic expressions for several quantities of epidemiological significance, including the size of the hypnozoite reservoir; the relative contribution of relapses to the infection burden; the distribution of multiple infections; the cumulative number of recurrences over time, and the time to first recurrence following drug treatment. By deriving, rather than assuming parameteric forms, we characterise the transient dynamics of the hypnozoite reservoir following radical cure more accurately than previous approaches. To yield population-level insights, our analytic within-host distributions can be embedded in multiscale models. Our work thus contributes to the epidemiological understanding of the effects of radical cure on P. vivax malaria.

q-bio.PE

An activation-clearance model for Plasmodium vivax malaria

Malaria is an infectious disease with an immense global health burden. Plasmodium vivax is the most geographically widespread species of malaria. Relapsing infections, caused by the activation of liver-stage parasites known as hypnozoites, are a critical feature of the epidemiology of Plasmodium vivax. Hypnozoites remain dormant in the liver for weeks or months after inoculation, but cause relapsing infections upon activation. Here, we introduce a dynamic probability model of the activation-clearance process governing both potential relapses and the size of the hypnozoite reservoir. We begin by modelling activation-clearance dynamics for a single hypnozoite using a continuous-time Markov chain. We then extend our analysis to consider activation-clearance dynamics for a single mosquito bite, which can simultaneously establish multiple hypnozoites, under the assumption of independent hypnozoite behaviour. We derive analytic expressions for the time to first relapse and the time to hypnozoite clearance for mosquito bites establishing variable numbers of hypnozoites, both of which are quantities of epidemiological significance. Our results extend those in the literature, which were limited due to an assumption of non-independence. Our within-host model can be embedded readily in multi-scale models and epidemiological frameworks, with analytic solutions increasing the tractability of statistical inference and analysis. Our work therefore provides a foundation for further work on immune development and epidemiological-scale analysis, both of which are important for achieving the goal of malaria elimination.

q-bio.PE