title: The intrinsic transmission dynamics of tuberculosis epidemics.
abstract: In developed countries the major tuberculosis epidemics declined long before the disease became curable in the 1940s. We present a theoretical framework for assessing the intrinsic transmission dynamics of tuberculosis. We demonstrate that it takes one to several hundred years for a tuberculosis epidemic to rise, fall and reach a stable endemic level. Our results suggest that some of the decline of tuberculosis is simply due to the natural behaviour of an epidemic. Although other factors must also have contributed to the decline, these causal factors were constrained to operate within the slow response time dictated by the intrinsic dynamics.
authors.affiliation: Department of Epidemiology & Biostatistics, University of California San Francisco, San Francisco General Hospital 94143-1347, USA.
authors.forename: S M
authors.initials: SM
authors.lastname: Blower
authors.forename: A R
authors.initials: AR
authors.lastname: McLean
authors.forename: T C
authors.initials: TC
authors.lastname: Porco
authors.forename: P M
authors.initials: PM
authors.lastname: Small
authors.forename: P C
authors.initials: PC
authors.lastname: Hopewell
authors.forename: M A
authors.initials: MA
authors.lastname: Sanchez
authors.forename: A R
authors.initials: AR
authors.lastname: Moss
mesh_terms: D004196:Disease Outbreaks; D005060:Europe / Q000453:epidemiology; D006801:Humans; D015233:Models, Statistical; D017711:Nonlinear Dynamics; D009656:North America / Q000453:epidemiology; D012494:Sampling Studies; D013997:Time Factors; D014397:Tuberculosis, Pulmonary / Q000453:epidemiology* / Q000635:transmission