Infectious diseases are a
well-studied public health issue. However, the factors that
influence infectious disease dynamics that involve
elements of population ecology are just as important to study. Spatial and geographical patterns play a large role in the
spread, transmission, and elimination of infectious diseases. For
example, understanding human population density gives insight to the rate of which an
infectious disease will spread. Also studying the patterns presented in
previous occurrences of infectious diseases are a key element in preventing
future outbreaks of these diseases. This understanding of
density-dependence, which is population growth dependent on the average number
of individuals per unit area, also accounts for the persistence and transmission dynamics of infectious diseases. Studying the patterns presented
in previous occurrences of infectious diseases are a key element in preventing
future outbreaks of these diseases.
Figure: Infectious diseases that affect human populations can be spread through a multitude of animal hosts
Chowell et al. studied the spatial
variations (regions and counties) in transmissibility and mortality of the
1918-1919 H1N1 influenza pandemic in rural and urban areas of England and
Wales (2008). The authors collected data from the British Ministry of health about
weekly influenza-related deaths. Decennial census data provided the demographic
information needed to evaluate the effect of the socio-demographic factors-population
size and density, residential crowding and urbanization-that led to differential
rates in transmissibility (reproductive number), and mortality rural and urban.
This study looked at these factors from the autumn of 1918 compared to the
winter of 1919. The rate of influenza transmissibility was the highest and also
the most statistically significant during autumn 1918 in both urban and rural
areas while transmissibility was low and not significant during the winter of
1919. From the socio-demographic factors analyzed, population size and
urbanization were found to be significant predictors of the death rate during
both times frames of the influenza pandemic. There was a much higher
experienced per capita death rate in urban areas during both autumn and winter
periods while rural areas with the smallest population sizes experienced the
highest death rate overall. Population size was also a significant predictor of
the onset of the disease since early onset of influenza was found in areas with
larger population sizes.
Figure 1: Weekly number
of influenza during 1918-1919 pandemic at spatial scales of regions
(administrative units) and counties
This paper addresses important aspects
of spatial variations found within a disease epidemic while leaving some
questions unanswered. For example, the effects of population density on
transmissibility and mortality rates were left unexplained. The Chowell et al. study
does not completely compare the factors that differ between rural and urban
areas that could have led to these spatial differences except for population
size. In a more recent paper, the influenza pandemic of 1918 was studied in
England, Wales and the US further exploring the factors that led to the spatial
spread of the disease paying attention transmission, population size and
distance while specifically analyzing the extent to which density-dependence
played a role in the results found without looking at these differences in
specifically rural and urban areas (Eggo et al., 2011). I think it would be extremely important to do a qualitative analysis of the factors that influence the transmissibility and mortality of human influenza in rural and urban areas, looking at population density as a
major factor. I would conduct this study in Iowa, a state with both rural
and urban counties, where I would collect data on reported incidences of influenza through public health records and analyze density through census data. Once this data is collected, I would conduct analyses using statistical tests, spatial tests, and general model testing to truly quantify my results. The results of this study
would add to the knowledge of the more recent human influenza dynamics, while
examining the importance of population type that affect the spread of disease,
access to preventative measure, etc.
Works Cited
Chowell, G., L. Bettencourt, N. Johnson, W. Alonso, and C. Viboud. 2008. The 1918-1919
Influenza Pandemic in England and Wales: Spatial Patterns in Transmissibility and Mortality Impact. Proceedings: Biological Sciences, 275:501-509.
Eggo, R. M., S. Cauchemez, and N. M. Ferguson. 2011 Spatial dynamics of the 1918 influenza pandemic in England, Wales and the United States. Journal of The Royal Society Interface. 8:233-243.