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The role of evolution in the emergence of infectious diseases Rustom Antia, Roland R. Regoes, Jacob C. Koella & Carl T. Bergstrom Nature 2003 Introduction – Novel Diseases ● Disease emergence requires 2 steps: – Introduction to new host population ● – Affected by ecological factors, such as increased contact between hosts Growth and spread within new host pop. ● Described by R0 Introduction – Novel Diseases ● R0: “basic reproductive number” – Average number of new infections per infected individual, in an otherwise totally susceptible population. – R0 < 1: disease dies out – R0 > 1: disease can spread. Introduction – Novel Diseases ● R0 – Average number of new infections per infected individual, in an otherwise totally susceptible population. – R0 < 1: disease dies out – R0 > 1: disease can spread. Introduction – Novel Diseases ● R0: “basic reproductive number” – Novel pathogens with R0 > 1 in humans are “an epidemic waiting to happen” – Those with R0 < 1 will die out unless R0 is increased by ecology or evolution. ● ● ● ● Host density or behavior, Genetic drift in pathogen, Adaptive evolution by pathogen, Host genetic changes (less likely). Scope of this paper ● From introduction into new host population, to possible emergence as epidemic. Scope of this paper Scope of this paper Scope of this paper ● Probability of emergence ● Depends on – Initial R0 (“un-evolved”, less than 1) – Epidemic R0 (“evolved”, greater than 1) – Number of mutational steps from initial to epidemic, n, – μ – the mutant transmission rate. Scope of this paper R0, introduced Scope of this paper R0, introduced R0, evolved Scope of this paper R0, introduced μ, mutant trans. rate R0, evolved Results Results Single step model Results Single step model Prob. that pathogen evolves to R0 > 1 depends on mutation rate and initial R0 Results Single step model Results Single step model Evolved R0 = 1000 1.5 1.2 Results Single step model Evolved R0 = 1000 1.5 1.2 Prob. that pathogen emerges depends on mutation rate, initial R0, and less on evolved R0 Results Multiple step model Results Multiple step model ● Multiple mutations needed to bring R0 > 1 Results Multiple step model ● Multiple mutations needed to bring R0 > 1 ● Jackpot model: R0 = 2 R0 = 0.5 R0 = 0.5 n = number of steps R0 = 0.5 R0 = 0.5 Results Multiple step model Results Multiple step model Highly sensitive to n, especially at low R0 Results Multiple step model ● Multiple mutations needed to bring R0 > 1 ● Additive model: R0 = 1 R0 = 0.75 R0 = 0.5 Results Multiple step model ● Multiple mutations needed to bring R0 > 1 ● Fitness Valley model: Results Multiple step model ● Multiple mutations needed to bring R0 > 1 ● Fitness Valley model: R0 = 1 R0 = 0.5 R0 = 0.2 Results Multiple step model Results Multiple step model Additive Jackpot Valley Results Multiple step model Additive Jackpot Valley Depends on - Initial R0, - mutation rate, - evolutionary model Conclusions Conclusions ● ● Disease where R0 < 1 may nevertheless emerge. Probability of emergence is sensitive to – Initial and evolved R0, – Evolutionary rate, – Type of evolution (jackpot, additive, etc) – “mutational distance” from R0<1 to R0>1 Conclusions ● Slight increases in R0, via ecology or behaviour, increase the length of transmission chains and thereby increase probability of emergence. Conclusions ● Slight increases in R0, via ecology or behaviour, increase the length of transmission chains and thereby increase probability of emergence.