Rubella metapopulation dynamics and importance of spatial coupling to the risk of congenital rubella syndrome in Peru

C. J E Metcalf, C. V. Munayco, G. Chowell, B. T. Grenfell, O. N. Bjørnstad

Research output: Contribution to journalArticle

30 Citations (Scopus)

Abstract

Rubella is generally a mild childhood disease, but infection during early pregnancy may cause spontaneous abortion or congenital rubella syndrome (CRS), which may entail a variety of birth defects. Consequently, understanding the age-structured dynamics of this infection has considerable public health value. Vaccination short of the threshold for local elimination of transmission will increase the average age of infection. Accordingly, the classic concern for this infection is the potential for vaccination to increase incidence in individuals of childbearing age. A neglected aspect of rubella dynamics is how age incidence patterns may be moulded by the spatial dynamics inherent to epidemic metapopulations. Here, we use a uniquely detailed dataset from Peru to explore the implications of this for the burden of CRS. Our results show that the risk of CRS may be particularly severe in small remote regions, a prediction at odds with expectations in the endemic situation, and with implications for the outcome of vaccination. This outcome results directly from the metapopulation context: specifically, extinction-re-colonization dynamics are crucial because they allow for significant leakage of susceptible individuals into the older age classes during inter-epidemic periods with the potential to increase CRS risk by as much as fivefold.

Original languageEnglish (US)
Pages (from-to)369-376
Number of pages8
JournalJournal of the Royal Society Interface
Volume8
Issue number56
DOIs
StatePublished - Mar 6 2011

Fingerprint

Congenital Rubella Syndrome
Peru
Rubella
Vaccination
Infection
Incidence
Public health
Spontaneous Abortion
Public Health
Pregnancy
Defects

Keywords

  • Congenital rubella syndrome
  • Epidemiology
  • Metapopulation
  • Rubella

ASJC Scopus subject areas

  • Biophysics
  • Biotechnology
  • Bioengineering
  • Biomedical Engineering
  • Biomaterials
  • Biochemistry

Cite this

Rubella metapopulation dynamics and importance of spatial coupling to the risk of congenital rubella syndrome in Peru. / Metcalf, C. J E; Munayco, C. V.; Chowell, G.; Grenfell, B. T.; Bjørnstad, O. N.

In: Journal of the Royal Society Interface, Vol. 8, No. 56, 06.03.2011, p. 369-376.

Research output: Contribution to journalArticle

Metcalf, C. J E ; Munayco, C. V. ; Chowell, G. ; Grenfell, B. T. ; Bjørnstad, O. N. / Rubella metapopulation dynamics and importance of spatial coupling to the risk of congenital rubella syndrome in Peru. In: Journal of the Royal Society Interface. 2011 ; Vol. 8, No. 56. pp. 369-376.
@article{de72f06ab8b2442abb96ad30aef40d66,
title = "Rubella metapopulation dynamics and importance of spatial coupling to the risk of congenital rubella syndrome in Peru",
abstract = "Rubella is generally a mild childhood disease, but infection during early pregnancy may cause spontaneous abortion or congenital rubella syndrome (CRS), which may entail a variety of birth defects. Consequently, understanding the age-structured dynamics of this infection has considerable public health value. Vaccination short of the threshold for local elimination of transmission will increase the average age of infection. Accordingly, the classic concern for this infection is the potential for vaccination to increase incidence in individuals of childbearing age. A neglected aspect of rubella dynamics is how age incidence patterns may be moulded by the spatial dynamics inherent to epidemic metapopulations. Here, we use a uniquely detailed dataset from Peru to explore the implications of this for the burden of CRS. Our results show that the risk of CRS may be particularly severe in small remote regions, a prediction at odds with expectations in the endemic situation, and with implications for the outcome of vaccination. This outcome results directly from the metapopulation context: specifically, extinction-re-colonization dynamics are crucial because they allow for significant leakage of susceptible individuals into the older age classes during inter-epidemic periods with the potential to increase CRS risk by as much as fivefold.",
keywords = "Congenital rubella syndrome, Epidemiology, Metapopulation, Rubella",
author = "Metcalf, {C. J E} and Munayco, {C. V.} and G. Chowell and Grenfell, {B. T.} and Bj{\o}rnstad, {O. N.}",
year = "2011",
month = "3",
day = "6",
doi = "10.1098/rsif.2010.0320",
language = "English (US)",
volume = "8",
pages = "369--376",
journal = "Journal of the Royal Society Interface",
issn = "1742-5689",
publisher = "Royal Society of London",
number = "56",

}

TY - JOUR

T1 - Rubella metapopulation dynamics and importance of spatial coupling to the risk of congenital rubella syndrome in Peru

AU - Metcalf, C. J E

AU - Munayco, C. V.

AU - Chowell, G.

AU - Grenfell, B. T.

AU - Bjørnstad, O. N.

PY - 2011/3/6

Y1 - 2011/3/6

N2 - Rubella is generally a mild childhood disease, but infection during early pregnancy may cause spontaneous abortion or congenital rubella syndrome (CRS), which may entail a variety of birth defects. Consequently, understanding the age-structured dynamics of this infection has considerable public health value. Vaccination short of the threshold for local elimination of transmission will increase the average age of infection. Accordingly, the classic concern for this infection is the potential for vaccination to increase incidence in individuals of childbearing age. A neglected aspect of rubella dynamics is how age incidence patterns may be moulded by the spatial dynamics inherent to epidemic metapopulations. Here, we use a uniquely detailed dataset from Peru to explore the implications of this for the burden of CRS. Our results show that the risk of CRS may be particularly severe in small remote regions, a prediction at odds with expectations in the endemic situation, and with implications for the outcome of vaccination. This outcome results directly from the metapopulation context: specifically, extinction-re-colonization dynamics are crucial because they allow for significant leakage of susceptible individuals into the older age classes during inter-epidemic periods with the potential to increase CRS risk by as much as fivefold.

AB - Rubella is generally a mild childhood disease, but infection during early pregnancy may cause spontaneous abortion or congenital rubella syndrome (CRS), which may entail a variety of birth defects. Consequently, understanding the age-structured dynamics of this infection has considerable public health value. Vaccination short of the threshold for local elimination of transmission will increase the average age of infection. Accordingly, the classic concern for this infection is the potential for vaccination to increase incidence in individuals of childbearing age. A neglected aspect of rubella dynamics is how age incidence patterns may be moulded by the spatial dynamics inherent to epidemic metapopulations. Here, we use a uniquely detailed dataset from Peru to explore the implications of this for the burden of CRS. Our results show that the risk of CRS may be particularly severe in small remote regions, a prediction at odds with expectations in the endemic situation, and with implications for the outcome of vaccination. This outcome results directly from the metapopulation context: specifically, extinction-re-colonization dynamics are crucial because they allow for significant leakage of susceptible individuals into the older age classes during inter-epidemic periods with the potential to increase CRS risk by as much as fivefold.

KW - Congenital rubella syndrome

KW - Epidemiology

KW - Metapopulation

KW - Rubella

UR - http://www.scopus.com/inward/record.url?scp=79251499579&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=79251499579&partnerID=8YFLogxK

U2 - 10.1098/rsif.2010.0320

DO - 10.1098/rsif.2010.0320

M3 - Article

C2 - 20659931

AN - SCOPUS:79251499579

VL - 8

SP - 369

EP - 376

JO - Journal of the Royal Society Interface

JF - Journal of the Royal Society Interface

SN - 1742-5689

IS - 56

ER -