title: Heterogeneities in the transmission of infectious agents: implications for the design of control programs.
abstract: From an analysis of the distributions of measures of transmission rates among hosts, we identify an empirical relationship suggesting that, typically, 20% of the host population contributes at least 80% of the net transmission potential, as measured by the basic reproduction number, R0. This is an example of a statistical pattern known as the 20/80 rule. The rule applies to a variety of disease systems, including vector-borne parasites and sexually transmitted pathogens. The rule implies that control programs targeted at the "core" 20% group are potentially highly effective and, conversely, that programs that fail to reach all of this group will be much less effective than expected in reducing levels of infection in the population as a whole.
authors.affiliation: Wellcome Trust Centre for the Epidemiology of Infectious Disease, Department of Zoology, University of Oxford, United Kingdom. mejw@vax.ox.ac.uk
authors.forename: M E
authors.initials: ME
authors.lastname: Woolhouse
authors.forename: C
authors.initials: C
authors.lastname: Dye
authors.forename: J F
authors.initials: JF
authors.lastname: Etard
authors.forename: T
authors.initials: T
authors.lastname: Smith
authors.forename: J D
authors.initials: JD
authors.lastname: Charlwood
authors.forename: G P
authors.initials: GP
authors.lastname: Garnett
authors.forename: P
authors.initials: P
authors.lastname: Hagan
authors.forename: J L
authors.initials: JL
authors.lastname: Hii
authors.forename: P D
authors.initials: PD
authors.lastname: Ndhlovu
authors.forename: R J
authors.initials: RJ
authors.lastname: Quinnell
authors.forename: C H
authors.initials: CH
authors.lastname: Watts
authors.forename: S K
authors.initials: SK
authors.lastname: Chandiwana
authors.forename: R M
authors.initials: RM
authors.lastname: Anderson
mesh_terms: D000818:Animals; D003140:Communicable Disease Control; D018562:Disease Transmission, Infectious; D004199:Disease Vectors; D015658:HIV Infections / Q000517:prevention & control / Q000635:transmission; D006285:Health Planning; D006801:Humans; D007896:Leishmaniasis / Q000517:prevention & control / Q000635:transmission; D008288:Malaria / Q000517:prevention & control / Q000635:transmission; D008962:Models, Theoretical; D012552:Schistosomiasis / Q000517:prevention & control / Q000635:transmission