title: Day-to-Day Population Movement and the Management of Dengue Epidemics.
abstract: Dengue is a growing public health problem in tropical and subtropical cities. It is transmitted by mosquitoes, and the main strategy for epidemic prevention and control is insecticide fumigation. Effective management is, however, proving elusive. People's day-to-day movement about the city is believed to be an important factor in the epidemiological dynamics. We use a simple model to examine the fundamental roles of broad demographic and spatial structures in epidemic initiation, growth and control. We show that the key factors are local dilution, characterised by the vector-host ratio, and spatial connectivity, characterised by the extent of habitually variable movement patterns. Epidemic risk in the population is driven by the demographic groups that frequent the areas with the highest vector-host ratio, even if they only spend some of their time there. Synchronisation of epidemic trajectories in different demographic groups is governed by the vector-host ratios to which they are exposed and the strength of connectivity. Strategies for epidemic prevention and management may be made more effective if they take into account the fluctuating landscape of transmission intensity associated with spatial heterogeneity in the vector-host ratio and people's day-to-day movement patterns.
authors.affiliation: Centro de Investigaciones sobre Enfermedades Infecciosas, Instituto Nacional de Salud Publica, Universidad 655, Colonia Sta. Maria Ahuacatitlán, Cerrada Los Pinos y Caminera. C.P., 62100, Cuernavaca, Morelos, Mexico.|Carlos Slim Health Institute, Lago Zurich 245, Edif. Presa Falcón piso 20, Ampliación Granada. Del. Miguel Hidalgo, C.P. 11529, Ciudad de Mexico, Mexico.
authors.forename: Jorge A
authors.initials: JA
authors.lastname: Falcón-Lezama
authors.affiliation: Organizacion Latinoamericana de Fomento a la Investigacion en Salud, Calle 110 No. 21-30, Of. 604, Bucaramanga, Santander, Colombia.
authors.forename: Ruth A
authors.initials: RA
authors.lastname: Martínez-Vega
authors.affiliation: Subsecretaría de Prevención y Promoción de la Salud, Lieja 7, 1er piso, Colonia Juárez, Del. Cuauhtémoc, C.P. 06600, Ciudad de Mexico, Mexico.
authors.forename: Pablo A
authors.initials: PA
authors.lastname: Kuri-Morales
authors.affiliation: Centro de Investigaciones sobre Enfermedades Infecciosas, Instituto Nacional de Salud Publica, Universidad 655, Colonia Sta. Maria Ahuacatitlán, Cerrada Los Pinos y Caminera. C.P., 62100, Cuernavaca, Morelos, Mexico.|UTMB Center for Tropical Diseases, University of Texas Medical Branch, 301 University Blvd., Galveston, TX, 77555-0435, USA.
authors.forename: José
authors.initials: J
authors.lastname: Ramos-Castañeda
authors.affiliation: Department of Mathematical Sciences, University of Bath, Bath, BA27AY, UK. b.adams@bath.ac.uk.
authors.forename: Ben
authors.initials: B
authors.lastname: Adams
mesh_terms: D000330:Aedes / Q000821:virology; D000818:Animals; D050936:Basic Reproduction Number; D003715:Dengue / Q000453:epidemiology* / Q000517:prevention & control / Q000635:transmission; D058872:Epidemics / Q000517:prevention & control / Q000706:statistics & numerical data; D063426:Human Migration; D006801:Humans; D055641:Mathematical Concepts; D008954:Models, Biological; D000072138:Mosquito Vectors / Q000821:virology
keywords: Control; Demography; Epidemic model; Host–vector; Metapopulation