title: Calling in sick: impacts of fever on intra-urban human mobility.
abstract: Pathogens inflict a wide variety of disease manifestations on their hosts, yet the impacts of disease on the behaviour of infected hosts are rarely studied empirically and are seldom accounted for in mathematical models of transmission dynamics. We explored the potential impacts of one of the most common disease manifestations, fever, on a key determinant of pathogen transmission, host mobility, in residents of the Amazonian city of Iquitos, Peru. We did so by comparing two groups of febrile individuals (dengue-positive and dengue-negative) with an afebrile control group. A retrospective, semi-structured interview allowed us to quantify multiple aspects of mobility during the two-week period preceding each interview. We fitted nested models of each aspect of mobility to data from interviews and compared models using likelihood ratio tests to determine whether there were statistically distinguishable differences in mobility attributable to fever or its aetiology. Compared with afebrile individuals, febrile study participants spent more time at home, visited fewer locations, and, in some cases, visited locations closer to home and spent less time at certain types of locations. These multifaceted impacts are consistent with the possibility that disease-mediated changes in host mobility generate dynamic and complex changes in host contact network structure.
authors.affiliation: Department of Biological Sciences and Eck Institute for Global Health, University of Notre Dame, Notre Dame, IN, USA Department of Entomology and Nematology, University of California, Davis, CA, USA Fogarty International Center, National Institutes of Health, Bethesda, MD, USA taperkins@nd.edu.
authors.forename: T Alex
authors.initials: TA
authors.lastname: Perkins
authors.affiliation: Department of Global Health Systems and Development, Tulane University School of Public Health and Tropical Medicine, New Orleans, LA, USA Facultad de Salud Pública y Administración, Universidad Peruana Cayetano Heredia, Lima, Peru.
authors.forename: Valerie A
authors.initials: VA
authors.lastname: Paz-Soldan
authors.affiliation: Department of Entomology and Nematology, University of California, Davis, CA, USA.
authors.forename: Steven T
authors.initials: ST
authors.lastname: Stoddard
authors.affiliation: Department of Entomology and Nematology, University of California, Davis, CA, USA United States Naval Medical Research Unit No. 6, Lima, Peru.
authors.forename: Amy C
authors.initials: AC
authors.lastname: Morrison
authors.affiliation: United States Naval Medical Research Unit No. 6, Lima, Peru.
authors.forename: Brett M
authors.initials: BM
authors.lastname: Forshey
authors.affiliation: Department of Entomology and Nematology, University of California, Davis, CA, USA Department of Biology, Andrews University, Berrien Springs, MI, USA.
authors.forename: Kanya C
authors.initials: KC
authors.lastname: Long
authors.affiliation: United States Naval Medical Research Unit No. 6, Lima, Peru.
authors.forename: Eric S
authors.initials: ES
authors.lastname: Halsey
authors.affiliation: United States Naval Medical Research Unit No. 6, Lima, Peru.
authors.forename: Tadeusz J
authors.initials: TJ
authors.lastname: Kochel
authors.affiliation: Institute for Behavioral and Community Health, Graduate School of Public Health, San Diego State University, San Diego, CA, USA.
authors.forename: John P
authors.initials: JP
authors.lastname: Elder
authors.affiliation: Fogarty International Center, National Institutes of Health, Bethesda, MD, USA Department of Environmental Sciences, Emory University, Atlanta, GA, USA.
authors.forename: Uriel
authors.initials: U
authors.lastname: Kitron
authors.affiliation: Department of Entomology and Nematology, University of California, Davis, CA, USA Fogarty International Center, National Institutes of Health, Bethesda, MD, USA.
authors.forename: Thomas W
authors.initials: TW
authors.lastname: Scott
authors.affiliation: Fogarty International Center, National Institutes of Health, Bethesda, MD, USA Department of Environmental Sciences, Emory University, Atlanta, GA, USA.
authors.forename: Gonzalo M
authors.initials: GM
authors.lastname: Vazquez-Prokopec
mesh_terms: D016022:Case-Control Studies; D002947:Cities; D003715:Dengue / Q000453:epidemiology; D005334:Fever / Q000453:epidemiology*; D006801:Humans; D016013:Likelihood Functions; D008962:Models, Theoretical; D010568:Peru / Q000453:epidemiology; D012189:Retrospective Studies; D014195:Travel
keywords: activity space; contact; dengue; infection; movement; network