title: Global biogeography of human infectious diseases.
abstract: The distributions of most infectious agents causing disease in humans are poorly resolved or unknown. However, poorly known and unknown agents contribute to the global burden of disease and will underlie many future disease risks. Existing patterns of infectious disease co-occurrence could thus play a critical role in resolving or anticipating current and future disease threats. We analyzed the global occurrence patterns of 187 human infectious diseases across 225 countries and seven epidemiological classes (human-specific, zoonotic, vector-borne, non-vector-borne, bacterial, viral, and parasitic) to show that human infectious diseases exhibit distinct spatial grouping patterns at a global scale. We demonstrate, using outbreaks of Ebola virus as a test case, that this spatial structuring provides an untapped source of prior information that could be used to tighten the focus of a range of health-related research and management activities at early stages or in data-poor settings, including disease surveillance, outbreak responses, or optimizing pathogen discovery. In examining the correlates of these spatial patterns, among a range of geographic, epidemiological, environmental, and social factors, mammalian biodiversity was the strongest predictor of infectious disease co-occurrence overall and for six of the seven disease classes examined, giving rise to a striking congruence between global pathogeographic and "Wallacean" zoogeographic patterns. This clear biogeographic signal suggests that infectious disease assemblages remain fundamentally constrained in their distributions by ecological barriers to dispersal or establishment, despite the homogenizing forces of globalization. Pathogeography thus provides an overarching context in which other factors promoting infectious disease emergence and spread are set.
authors.affiliation: Grantham Institute-Climate Change and the Environment, Faculty of Natural Sciences, Imperial College London, London SW7 2AZ, United Kingdom; School of Public Health, Faculty of Medicine, Imperial College London, London W2 1PG, United Kingdom; kris.murray@imperial.ac.uk.
authors.forename: Kris A
authors.initials: KA
authors.lastname: Murray
authors.affiliation: Children's Hospital Informatics Program, Boston Children's Hospital, Boston, MA 02215;
authors.forename: Nicholas
authors.initials: N
authors.lastname: Preston
authors.affiliation: EcoHealth Alliance, New York, NY 10001.
authors.forename: Toph
authors.initials: T
authors.lastname: Allen
authors.affiliation: EcoHealth Alliance, New York, NY 10001.
authors.forename: Carlos
authors.initials: C
authors.lastname: Zambrana-Torrelio
authors.affiliation: EcoHealth Alliance, New York, NY 10001.
authors.forename: Parviez R
authors.initials: PR
authors.lastname: Hosseini
authors.affiliation: EcoHealth Alliance, New York, NY 10001.
authors.forename: Peter
authors.initials: P
authors.lastname: Daszak
mesh_terms: D003141:Communicable Diseases / Q000453:epidemiology*; D004196:Disease Outbreaks; D006801:Humans; D058974:Phylogeography
keywords: biogeography; distribution; globalization; infectious disease; pathogeography