Differential human mobility and local variation in human infection attack rate

Abstract

Infectious disease transmission in animals is an inherently spatial process in which a hosts home location and their social mixing patterns are important, with the mixing of infectious individuals often different to that of susceptible individuals. Although incidence data for humans have traditionally been aggregated into low-resolution data sets, modern representative surveillance systems such as electronic hospital records generate high volume case data with precise home locations. Here, we use a high resolution gridded spatial transmission model of arbitrary resolution to investigate the theoretical relationship between population density, differential population movement and local variability in incidence. We show analytically that uniform local attack rate is only possible for individual pixels in the grid if susceptible and infectious individuals move in the same way. Using a population in Guangdong, China, for which a robust quantitative description of movement is available (a movement kernel), and a natural history consistent with pandemic influenza; we show that for the estimated kernel, local cumulative incidence is positively correlated with population density when susceptible individuals are more connected in space than infectious individuals. Conversely, when infectious individuals are more connected, local cumulative incidence is negatively correlated with population density. The amplitude of correlation is substantial for the estimated kernel. However, the strength and direction of correlation changes sign for other kernel parameter values. These results describe a precise relationship between the spatio-social mixing of infectious and susceptible individuals and local variability in attack rates, and suggest a plausible mechanism for the counter-intuitive scenario in which local incidence is lower on average in less dense populations. Also, these results suggest that if spatial transmission models are implemented at high resolution to investigate local disease dynamics, including micro-tuning of interventions, the underlying detailed assumptions about the mechanisms of transmission become more important than when similar studies are conducted at larger spatial scales.\n\nAuthor SummaryWe know that some places have higher rates of infectious disease than others. However, at the moment, we usually only measure these differences for large towns and cities. With modern data, such as those we can get from mobile phones, we can measure rates of infection at much smaller scales. In this paper, we used a computer simulation of an epidemic to propose ways that rates of incidence in small local areas might be related to population density. We found that if infectious people are better connected than non-infectious people, perhaps because they receive visitors, then, on average, higher density areas would have lower rates of infection. If infectious people were less connected than non-infectious people then higher density areas would have higher rates of infection. As data get more accurate, this type of analysis will allow us to propose and test ways to optimize interventions such as the delivery of vaccines and antivirals during a pandemic.