Thursday, March 26, 2009

Why doesn’t this pathogen kill me and why is it taking so long to clear?

This week the Coevolvers read a brand new paper by King et al (2009). The authors present a pathogen model that incorporates within host dynamics of pathogen growth as well as multiple forms of transmission among hosts which depend on pathogen load. The authors do motivate the study by telling us about two human disease pathogens, Bordetella pertussis and Bordetella parapertussis (which can cause whooping cough), but model is not meant to be a predictive model of future outbreaks. The main message of the paper is that including within host dynamics in conjunction with SIR models of populations leads to a better understand of disease evolution. Mideo et al (2008) wrote a recent review on including within host dynamics in evolutionary epidemiological models for more general information on this approach.

While the outline of the model was well written, how they combined the multiple different parts was unclear. The model consisted of three components: 1) within host pathogen replication 2) dose dependent transmission and 3) between host/SIR type model. What we found hard to understand was how the model incorporated the variation in pathogen loads among the hosts into the overall transmission rate. It appeared as if the model integrates over a number of classes of hosts (depending on their age of infection), but we felt that this then removed quite a bit of the variation that was being captured by including within host dynamics. A simplifying assumption that the authors made also was that each host was always infected with the same dose of pathogens and that their immune system had to be restarted each time. The authors do state that they have already worked on a stochastic model of this system which hasn't yet been published. We are very interested on the quantitative results from that analysis since some of these problems could be addressed there.

Why not make a population genetics model to address the questions posed by the authors at the beginning of the paper. This was question stimulated by our previous reading of Boots et al (2009) and Day and Gandon (2007) that provide detailed reviews of different modeling approaches as well as addressing specific problems in evolutionary epidemiology. King et al (2009) present their results of how intermediate within host pathogen growth rates can maximize R0 under some transmission models, but what they don't do is present an analysis where they look at how different pathogens might evolve. Is the intermediate growth rate a stable strategy? Given the model framework, there might be complex interactions between different pathogens mediated through hosts. Higher growth rates of an aggressive pathogen could lead to a tragedy of the commons.


Boots, M., A. Best, M. R. Miller, and A. White. 2009. The role of ecological feedbacks in the evolution of host defence: what does theory tell us? Philos. Trans. R. Soc. B-Biol. Sci. 364:27-36.

Day, T and S Gandon. 2007. Applying population-genetic models in theoretical evolutionary epidemiology. Ecology Letters 10 (10), 876–888.

King, A. A., S. Shrestha, E. T. Harvill, and O. N. Bjørnstad. 2009. Evolution of Acute Infections and the Invasion-Persistence Trade-Off. The American Naturalist 173:446-455.

Mideo, N., S. Alizon, and T. Day. 2008. Linking within- and between-host dynamics in the evolutionary epidemiology of infectious diseases. Trends in Ecology and Evolution 23(9): 511-517.

Paper read:

King, A., Shrestha, S., Harvill, E., & Bjørnstad, O. (2009). Evolution of Acute Infections and the Invasion‐Persistence Trade‐Off The American Naturalist, 173 (4), 446-455 DOI: 10.1086/597217

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