Human Population Density Drives Pneumococcal Disease Risk Via Density-Dependent Serotype Transmission
Metcalf, B.; Wollein Waldetoft, K.; Beall, B.; Brown, S.
Show abstract
In human infectious diseases, the likelihood of infection in a susceptible individual is generally assumed to be dependent on the frequency of infected individuals in the population (higher infection prevalence means more risk of infection per contact) and not dependent on population density. In this investigation we use CDC Active Bacterial Core surveillance data on over 34 million US citizens to test for density-dependent transmission in the pneumococcus. We show that 1) Streptococcus pneumoniae (Spn) transmission is dependent on host population density and 2) serotypes with shorter carriage durations and higher invasiveness are more likely to transmit in more populated areas. These results have important implications for pneumococcal epidemiology, given substantial variation in human population density, and the connection of carriage duration with critical infection properties including antimicrobial resistance, recombination, invasiveness, and serotype prevalence.
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