title: Markers of disease evolution: the case of tuberculosis.
abstract: Abrupt changes in environmental conditions--broadly understood to include demographic and social dynamics--can seriously impact the local or global disease dynamics of a population. These changes in the evolutionary landscape, which may occur over relatively short time-scales, are very likely to play a critical role in disease evolution. The potential impact of demographic, social and epidemiological shifts on the evolution of tuberculosis epidemics in the United States over the past century and a half is the main subject of this article. Evidence is provided to support the hypothesis that the observed substantial decreases in the incidence of active tuberculosis are the result of abrupt reductions in the rates of disease progression.
authors.affiliation: Department of Biometrics & Mathematical and Theoretical Biology Institute, Cornell University, 431 Warren Hall, Ithaca, NY 14853-7801, USA. jpa9@cornell.edu
authors.forename: Juan P
authors.initials: JP
authors.lastname: Aparicio
authors.forename: AngelL F
authors.initials: AF
authors.lastname: Capurro
authors.forename: Carlos
authors.initials: C
authors.lastname: Castillo-Chavez
mesh_terms: D004196:Disease Outbreaks; D018450:Disease Progression; D006801:Humans; D008019:Life Style; D015233:Models, Statistical; D009747:Nutritional Physiological Phenomena; D015995:Prevalence; D012931:Social Environment; D014376:Tuberculosis / Q000453:epidemiology* / Q000382:microbiology / Q000635:transmission; D014481:United States / Q000453:epidemiology; D014507:Urbanization