Some Mathematical Models in Epidemiology
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Preliminary Definitions and Assumptions Mathematical Models and their analysis Some Mathematical Models in Epidemiology by Peeyush Chandra Department of Mathematics and Statistics Indian Institute of Technology Kanpur, 208016 Email: [email protected] Peeyush Chandra Some Mathematical Models in Epidemiology Preliminary Definitions and Assumptions Mathematical Models and their analysis Definition (Epidemiology) It is a discipline, which deals with the study of infectious diseases in a population. It is concerned with all aspects of epidemic, e.g. spread, control, vaccination strategy etc. WHY Mathematical Models ? The aim of epidemic modeling is to understand and if possible control the spread of the disease. In this context following questions may arise: • How fast the disease spreads ? • How much of the total population is infected or will be infected ? • Control measures ! • Effects of Migration/ Environment/ Ecology, etc. • Persistence of the disease. Peeyush Chandra Some Mathematical Models in Epidemiology Preliminary Definitions and Assumptions Mathematical Models and their analysis Infectious diseases are basically of two types: Acute (Fast Infectious): • Stay for a short period (days/weeks) e.g. Influenza, Chickenpox etc. Chronic Infectious Disease: • Stay for larger period (month/year) e.g. hepatitis. In general the spread of an infectious disease depends upon: • Susceptible population, • Infective population, • The immune class, and • The mode of transmission. Peeyush Chandra Some Mathematical Models in Epidemiology Preliminary Definitions and Assumptions Mathematical Models and their analysis Assumptions We shall make some general assumptions, which are common to all the models and then look at some simple models before taking specific problems. • The disease is transmitted by contact (direct or indirect) between an infected individual and a susceptible individual. • There is no latent period for the disease, i.e., the disease is transmitted instantaneously when the contact takes place. • All susceptible individuals are equally susceptible and all infected ones are equally infectious. • The population size is large enough to take care of the fluctuations in the spread of the disease, so a deterministic model is considered. • The population, under consideration is closed, i.e. has a fixed size. Peeyush Chandra Some Mathematical Models in Epidemiology Preliminary Definitions and Assumptions Mathematical Models and their analysis • X (t)- population of susceptible, Y (t)- population of infected ones. • If B is the average contact number with susceptible which leads to new infection per unit time per infective, then Y (t + ∆t) = Y (t) + BY (t)∆t dY which in the limit ∆t ! 0 gives dt = BY (t). S-I Model • It is observed that B depends upon the susceptible population. So, define β = average number of contact between susceptible and infective which leads to new infection per unit time per susceptible per infective, then B = βX (t), which gives, dY = βX (t)Y (t) = β(N − Y )Y : dt where N = X + Y is the total population, which is fixed as per the above assumption. Peeyush Chandra Some Mathematical Models in Epidemiology Preliminary Definitions and Assumptions Mathematical Models and their analysis • Pathogen causes illness for a period of time followed by immunity. S(Susseptible) −! I (Infected) • S: Previously unexposed to the pathogen. • I: Currently colonized by pathogen. • Proportion of populations: S = X =N; I = Y =N: • We ignore demography of population (death/birth & migration). Peeyush Chandra Some Mathematical Models in Epidemiology Preliminary Definitions and Assumptions Mathematical Models and their analysis SIS (No Immunity) [Ross, 1916 for Malaria] 1 • Recovery rate α Infectious period is taken to be constant though infection period (the time spent in the infectious class) is distributed about a mean value & can be estimated from the clinical data. In the above model, it is assumed that the whole population is divided into two classes susceptible and infective; and that if one is infected then it remains in that class. However, this is not the case, as an infected person may recover from the disease. • If γ is the rate of recovery from infective class to susceptible class, then dS dt = γI − βSI ; dI (3) dt = βSI − γI ; dI 1 β = β 1 − − I I ; R0 = : dt R0 γ S∗ = 1 and I ∗ = 1 − 1 , feasible if R > 1. R0 R0 0 Peeyush Chandra Some Mathematical Models in Epidemiology Preliminary Definitions and Assumptions Mathematical Models and their analysis SIR Model (Kermack & McKendrick 1927) • Pathogen causes illness for a period of time followed by immunity. S(Susseptible) −! I (Infected) −! R(Recovered) • S: Previously unexposed to the pathogen. • I: Currently colonized by pathogen. • R: Successfully cleared from the infection. • Proportion of populations: S = X =N; I = Y =N; R = Z=N: • We ignore demography of population (death/birth & migration). Peeyush Chandra Some Mathematical Models in Epidemiology Preliminary Definitions and Assumptions Mathematical Models and their analysis In view of the above assumption the SIR model is given by 8 dS = −βSI ; > dt > < dI dt = βSI − γI ; (4) > > :> dR dt = γI ; with initial conditions: S(0) > 0; I (0) > 0 & R(0) = 0. 1 • γ : Average infectious period. γ dI • Note that if S(0) < β , then initially dt < 0 and the infection dies out. • Threshold phenomenon. γ γ • Thus, for an infection to invade, S(0) > β or if β : removal rate is small enough then the disease will spread. • The inverse of removal rate is defined as 'basic reproductive γ ratio' R0 = β . Peeyush Chandra Some Mathematical Models in Epidemiology Preliminary Definitions and Assumptions Mathematical Models and their analysis Basic Reproduction Ratio It is defined as the average number of secondary cases arising from an average primary case in an entirely susceptible population i.e. the rate at which new infections are produces by an infectious individual in an entirely susceptible population. • It measures the maximum reproductive potential for an infectious disease. • If S(0) = 1, then disease will spread if R0 > 1. If the disease is transmitted to more than one host then it will spread. • R0 depends on disease and host population e.g. ◦ R0 = 2:6 for TB in cattle. ◦ R0 = 3 − 4 for Influenza in humans. ◦ R0 = 3:5 − 6 for small pox in humans. ◦ R0 = 16 − 18 for Measles in humans. Peeyush Chandra Some Mathematical Models in Epidemiology Preliminary Definitions and Assumptions Mathematical Models and their analysis Note 1 • For an infectious disease with an average infectious period γ and β transmission rate β, R0 = γ . • For a closed population, infection with specified R0, can invade only if threshold fraction of susceptible population is greater than 1 . R0 • Vaccination can be used to reduce the susceptible population below 1 . R0 Also we see that dS = −R S ) S(t) = S(0)e−R0R(t): dR 0 • This implies as the epidemic builds up S(t) # and so R(t) ". • There will always be same susceptible in the population as S(t) > 0. Peeyush Chandra Some Mathematical Models in Epidemiology Preliminary Definitions and Assumptions Mathematical Models and their analysis • The epidemic breaks down when I = 0, we can say S(1) = 1 − R(1) = S(0)e−R0R(1): or 1 − R(1) − S(0)e−R0R(1) = 0: (5) • R1 is the final proportion of individuals recovered = total number of infected proportion. • We can assume that for given S(0) > R0; the equation (2) has a roots between 0 & 1. −R0 [R1 = 0 ) 1 − S0 > 0 and R1 = 1 ) −S(0)e < 0]: • dR = γ(1 − S − R) = γ[1 − S(0)e−R0R − R]: dt • Solve it (i) Numerically. (ii) For small R0R, i.e. when R0 << 1 or at the start of the epidemic. Peeyush Chandra Some Mathematical Models in Epidemiology Preliminary Definitions and Assumptions Mathematical Models and their analysis SIR model with demography Assumptions • Population size does not change - good in developed countries. • New born are with passive immunity and hence susceptible. • This is good enough if the average age at which immunity is lost << typical age of infection.(e.g. in developed countries t1 = 6 months << t2 = 4 − 5 years.) • Vertical transmission is ignored. 8 dS dt = ν − βSI − µS; < dI dt = βSI − γI − µI ; (6) : dR dt = γI − µR; Peeyush Chandra Some Mathematical Models in Epidemiology Preliminary Definitions and Assumptions Mathematical Models and their analysis 1 • µ is the rate at which individual suffer natural mortality i.e. µ is natural host life span. β • R0 = γ+µ : 1 • γ+µ is the average time which an individual spends in each class. Equilibrium States (i) (S; I ; R) = (1; 0; 0), disease free. (ii) (S∗; I ∗; R∗) = ( 1 ; µ (R − 1); (1 − 1 )(1 − µ )), for µ < γ. R0 β 0 R0 γ • Clearly, R0 > 1 for endemic equilibrium. • It can be seen that endemic equilibrium is stable if R0 > 1, otherwise disease free equilibrium is stable. Peeyush Chandra Some Mathematical Models in Epidemiology Preliminary Definitions and Assumptions Mathematical Models and their analysis • The characteristic equation for Jacobian at endemic equilibrium 2 (λ + µ)[λ + µR0λ + (µ + γ)µ(R0 − 1)] = 0: (7) q 2 4 −µR µR0 − AG λ = −µ and λ = 0 ± ; 1 2;3 2 2 where, A = 1 , denotes mean age of infection. µ(R0−1) 1 G = µ+γ : typical period of infectivity. Peeyush Chandra Some Mathematical Models in Epidemiology Preliminary Definitions and Assumptions Mathematical Models and their analysis SIRS (Waning Immunity) 8 dS dt = ν + !R − βSI − µS; < dI dt = βSI − (γ + µ)I ; (8) : dR dt = γI − µR − !R; ! : the rate at which immunity is lost. β R = : 0 γ + µ SEIR Model Transmission of disease starts with a low number of pathogen (bacterial cells etc.) which reproduce rapidly within host. • At this time the pathogen is present in host but can not transmit disease to other susceptible. Peeyush Chandra Some Mathematical Models in Epidemiology Preliminary Definitions and Assumptions Mathematical Models and their analysis • Infected but not infectious ) E class.