title: Dynamics of the force of infection: insights from Echinococcus multilocularis infection in foxes.
abstract: Characterizing the force of infection (FOI) is an essential part of planning cost effective control strategies for zoonotic diseases. Echinococcus multilocularis is the causative agent of alveolar echinococcosis in humans, a serious disease with a high fatality rate and an increasing global spread. Red foxes are high prevalence hosts of E. multilocularis. Through a mathematical modelling approach, using field data collected from in and around the city of Zurich, Switzerland, we find compelling evidence that the FOI is periodic with highly variable amplitude, and, while this amplitude is similar across habitat types, the mean FOI differs markedly between urban and periurban habitats suggesting a considerable risk differential. The FOI, during an annual cycle, ranges from (0.1,0.8) insults (95% CI) in urban habitat in the summer to (9.4, 9.7) (95% CI) in periurban (rural) habitat in winter. Such large temporal and spatial variations in FOI suggest that control strategies are optimal when tailored to local FOI dynamics.
authors.affiliation: Section of Veterinary Epidemiology, University of Zürich, Zürich, Switzerland.
authors.forename: Fraser I
authors.initials: FI
authors.lastname: Lewis
authors.affiliation: Section of Veterinary Epidemiology, University of Zürich, Zürich, Switzerland.
authors.forename: Belen
authors.initials: B
authors.lastname: Otero-Abad
authors.affiliation: Institute of Parasitology, University of Zürich, Zürich, Switzerland.
authors.forename: Daniel
authors.initials: D
authors.lastname: Hegglin
authors.affiliation: Institute of Parasitology, University of Zürich, Zürich, Switzerland.
authors.forename: Peter
authors.initials: P
authors.lastname: Deplazes
authors.affiliation: Section of Veterinary Epidemiology, University of Zürich, Zürich, Switzerland.
authors.forename: Paul R
authors.initials: PR
authors.lastname: Torgerson
mesh_terms: D000818:Animals; D004443:Echinococcosis / Q000453:epidemiology / Q000662:veterinary*; D048210:Echinococcus multilocularis / Q000302:isolation & purification*; D017753:Ecosystem; D005589:Foxes / Q000469:parasitology*; D008962:Models, Theoretical; D010273:Parasitic Diseases, Animal / Q000453:epidemiology* / Q000469:parasitology; D012621:Seasons; D013557:Switzerland; D015047:Zoonoses / Q000453:epidemiology* / Q000469:parasitology